Plan Overview

Health Insurance Exchange Plan Overview

CHRISTUS Health Plan offers individual and family health insurance exchange plans in an HMO style. That means you’ll have a Primary Care Provider (PCP) for your care, and your coverage includes doctor and hospital benefits, prescriptions and more. Find plan details below.

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Who the Plan is For

If you fit one of these bullet points, you might be eligible for coverage under an individual or family health insurance exchange plan. For more information, read about eligibility and coverage.

  • Uninsured people looking for health insurance plans in New Mexico and Texas
  • People without full health insurance coverage through an employer
  • People recently dropped from their parents’ health insurance plans
  • People retiring early

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
  • Vision (limited)
  • Preventive care, screenings and immunizations

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 healthcare 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.

MM161 & MM162
Last Updated: 2/23/17