Eligibility and Benefits

CHRISTUS Health Plan offers individual and family health insurance plans within the Texas and New Mexico marketplaces.

You’re Eligible If:

  • You’re a resident in the service areas of New Mexico or Texas

AND

  • You don’t have full health insurance coverage because you:
    • Are retiring early
    • Don’t have full coverage through an employer
    • Were recently dropped from your parents’ insurance plan
    • Just don’t have health insurance

If you’re still unsure what plan is right for you or if you’re eligible contact us.

Plan Benefits

CHRISTUS Health Plan offers an HMO-style plan, meaning you have a Primary Care Provider (PCP) for all of your care. Individual and family health exchange plans include coverage for doctor and hospital benefits, prescriptions and more:

  • Inpatient care
  • Primary care visits
  • Specialist visits
  • Prenatal and postnatal care
  • Urgent and emergency care
  • Outpatient Services
  • Preventive care, screenings and immunizations
  • Prescriptions (See if your medication is covered here)

Learn more about our CHRISTUS Health Plan benefits.

Plan Requirements

To be eligible for the plan, you must meet these requirements:

  • Must physically live in the service areas within Texas and New Mexico (unless you are a dependent) and meet all terms and conditions for coverage in this policy. See more about eligibility and coverage.
  • Must receive health care services within our network of participating doctors and hospitals. If you use providers outside of this network, you may have to pay for the services you receive, unless you’re receiving urgent or emergency care.
  • Must pay your deductible, copay or coinsurance at the time you receive covered services. CHRISTUS Health Plan will reimburse the provider balance due for covered services. Your summary of benefits can be found in the forms and documents section with more information on cost sharing.
  • Know that some covered services, like hospitalizations and some outpatient care, will require Prior Authorization.