Individual and Family Plans

Members under the Individual and Family health insurance plan enjoy the convenience of having pharmacy benefits, which include prescription drugs in our formularies.

 

A formulary is a list of generic and brand name drugs chosen by CHRISTUS Health Plan and a team of doctors as part of a quality treatment plan. These drugs are usually covered as long as it is medically necessary and the prescription is filled at a network pharmacy.

 

Check your formulary to see if a drug is covered. If you have questions, please contact us 5 days a week, 8 a.m. to 5 p.m. local time.

Summary of Benefits - English 

• Texas Bronze Summary of Benefits (PDF)
• Texas Bronze Summary of Benefits HSA (PDF)
• Texas Bronze Summary of Benefits HSA Limited Cost Sharing (PDF)
• Texas Bronze Summary of Benefits - Limited Cost Sharing (PDF)
• Texas Bronze - $0 PrefGen Summary of Benefits- (PDF)
• Texas Bronze - $0 PrefGen Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Bronze Plus Summary of Benefits (PDF)
• Texas Bronze Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Catastrophic Summary of Benefits (PDF)
• Texas Gold Summary of Benefits (PDF)
• Texas Gold Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Gold Plus Summary of Benefits - Limited Cost Sharing (PDF)
• Texas Gold Summary of Benefits- Plus (PDF) 
• Texas Platinum Summary of Benefits (PDF)
• Texas Silver Summary of Benefits- (PDF)
• Texas Silver Summary of Benefits - Limited (PDF)
• Texas Silver Summary of Benefits - 73% (PDF) 
• Texas Silver Summary of Benefits - 87% (PDF)
• Texas Silver Summary of Benefits - 94% (PDF)
• Texas Silver Summary of Benefits - High Deductible (PDF)
• Texas Silver Summary of Benefits - High Deductible Limited (PDF)
• Texas Silver Summary of Benefits - High Deductible 73% (PDF)
• Texas Silver Summary of Benefits - High Deductible 87%  (PDF)
• Texas Silver Summary of Benefits - High Deductible 94% (PDF)
• Texas Silver Summary of Benefits - Low Deductible (PDF)
• Texas Silver Summary of Benefits - Low Deductible Limited (PDF)
• Texas Silver Summary of Benefits - Low Deductible 73%(PDF)
• Texas Silver Summary of Benefits - Low Deductible 87% (PDF)
• Texas Silver Summary of Benefits - Low Deductible 94% (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 73% (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 87% (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 94% (PDF)
• Texas Silver Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Texas American Indian Zero Cost Sharing (PDF)
• Texas American Indian Zero Cost Plus Sharing (PDF)
• Texas Standard Bronze Summary of Benefits- (PDF) 
• Texas Standard Bronze Summary of Benefits- Limited Cost Sharing (PDF) 
• Texas Standard Silver Summary of Benefits- (PDF)
• Texas Standard Silver Summary of Benefits- Limited Cost Sharing (PDF) 
• Texas Standard Silver Summary of Benefits- 73% (PDF)
• Texas Standard Silver Summary of Benefits- 87% (PDF)
• Texas Standard Silver Summary of Benefits- 94% (PDF)
• Texas Standard Gold Summary of Benefits- (PDF)
• Texas Standard Gold Summary of Benefits- Limited Cost Sharing (PDF)

 

Summary of Benefits - Spanish

• Texas Bronze Summary of Benefits (PDF)  
• Texas Bronze Summary of Benefits HSA (PDF)
• Texas Bronze Summary of Benefits HSA Limited Cost Sharing (PDF)
• Texas Bronze Summary of Benefits - Limited Cost Sharing (PDF)   
• Texas Bronze - $0 PrefGen Summary of Benefits (PDF)
• Texas Bronze - $0 PrefGen Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Bronze Plus Summary of Benefits (PDF)
• Texas Bronze Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Catastrophic Summary of Benefits (PDF)
• Texas Gold Summary of Benefits (PDF)
• Texas Gold Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Gold Plus Summary of Benefits - Limited Cost Sharing (PDF)
• Texas Gold Summary of Benefits- Plus (PDF)
• Texas Platinum Summary of Benefits (PDF)
• Texas Silver Summary of Benefits (PDF)
• Texas Silver Summary of Benefits - Limited (PDF)
• Texas Silver Summary of Benefits - 73% (PDF)
• Texas Silver Summary of Benefits - 87% (PDF)  
• Texas Silver Summary of Benefits - 94% (PDF)
• Texas Silver Summary of Benefits - High Deductible (PDF)
• Texas Silver Summary of Benefits - High Deductible Limited (PDF)
• Texas Silver Summary of Benefits - High Deductible 73% (PDF)
• Texas Silver Summary of Benefits - High Deductible 87% (PDF)
• Texas Silver Summary of Benefits - High Deductible 94% (PDF)
• Texas Silver Summary of Benefits - Low Deductible 
• Texas Silver Summary of Benefits - Low Deductible Limited (PDF)
• Texas Silver Summary of Benefits - Low Deductible 73% (PDF)
• Texas Silver Summary of Benefits - Low Deductible 87% (PDF) 
• Texas Silver Summary of Benefits – Low Deductible 94%
• Texas Silver Plus Summary of Benefits- High Deductible (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 73% (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 87% (PDF)
• Texas Silver Plus Summary of Benefits- High Deductible 94% (PDF)
• Texas Silver Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Texas American Indian Zero Cost Sharing (PDF)
• Texas American Indian Zero Cost Plus Sharing (PDF)
• Texas Standard Bronze Summary of Benefits (PDF)
• Texas Standard Bronze Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Standard Silver Summary of Benefits (PDF)
• Texas Standard Silver Summary of Benefits- Limited Cost Sharing (PDF)
• Texas Standard Silver Summary of Benefits- 73% (PDF) 
• Texas Standard Silver Summary of Benefits- 87% (PDF)
• Texas Standard Silver Summary of Benefits- 94% (PDF)
• Texas Standard Gold Summary of Benefits (PDF)
• Texas Standard Gold Summary of Benefits- Limited Cost Sharing (PDF)

English

• Louisiana Bronze Summary of Benefits (PDF)
• Louisiana Bronze Summary of Benefits HSA (PDF)
• Louisiana Bronze Summary of Benefits HSA Limited Cost Sharing (PDF)
• Louisiana Bronze Summary of Benefits - Limited Cost Sharing (PDF)
• Louisiana Bronze - $0 PrefGen Summary of Benefits- (PDF)
• Louisiana Bronze - $0 PrefGen Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Bronze Plus Summary of Benefits (PDF)
• Louisiana Bronze Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Gold Summary of Benefits (PDF)
• Louisiana Gold Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Gold Plus Summary of Benefits - Limited Cost Sharing (PDF)
• Louisiana Gold Plus Summary of Benefits- Plus (PDF)
• Louisiana Silver Summary of Benefits- (PDF)
• Louisiana Silver Summary of Benefits - Limited (PDF)
• Louisiana Silver Summary of Benefits - 73% (PDF)
• Louisiana Silver Summary of Benefits - 87% (PDF)
• Louisiana Silver Summary of Benefits - 94% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible (PDF)
• Louisiana Silver Summary of Benefits - High Deductible Limited (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 73% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 87% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 94% (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible Limited (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 73%(PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 87% (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 94% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 73% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 87% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 94% (PDF)
• Louisiana Silver Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana American Indian Zero Cost Sharing (PDF)
• Louisiana American Indian Zero Cost Plus Sharing (PDF)
• Louisiana Standard Bronze Summary of Benefits- (PDF)
• Louisiana Standard Bronze Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Standard Silver Summary of Benefits- (PDF))
• Louisiana Standard Silver Summary of Benefits- 73% (PDF)
• Louisiana Standard Silver Summary of Benefits- 87% (PDF)
• Louisiana Standard Silver Summary of Benefits- 94% (PDF)
• Louisiana Standard Gold Summary of Benefits- (PDF)
• Louisiana Standard Gold Summary of Benefits- Limited Cost Sharing (PDF)

Spanish

• Louisiana Bronze Summary of Benefits (PDF)
• Louisiana Bronze Summary of Benefits HSA (PDF)
• Louisiana Bronze Summary of Benefits HSA Limited Cost Sharing (PDF)
• Louisiana Bronze Summary of Benefits - Limited Cost Sharing (PDF)
• Louisiana Bronze - $0 PrefGen Summary of Benefits- (PDF)
• Louisiana Bronze - $0 PrefGen Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Bronze Plus Summary of Benefits (PDF)
• Louisiana Bronze Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Gold Summary of Benefits (PDF)
• Louisiana Gold Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Gold Plus Summary of Benefits - Limited Cost Sharing (PDF)
• Louisiana Gold Plus Summary of Benefits- Plus (PDF)
• Louisiana Silver Summary of Benefits- (PDF)
• Louisiana Silver Summary of Benefits - Limited (PDF)
• Louisiana Silver Summary of Benefits - 73% (PDF)
• Louisiana Silver Summary of Benefits - 87% (PDF)
• Louisiana Silver Summary of Benefits - 94% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible (PDF)
• Louisiana Silver Summary of Benefits - High Deductible Limited (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 73% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 87% (PDF)
• Louisiana Silver Summary of Benefits - High Deductible 94% (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible Limited (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 73%(PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 87% (PDF)
• Louisiana Silver Summary of Benefits - Low Deductible 94% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 73% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 87% (PDF)
• Louisiana Silver Plus Summary of Benefits- High Deductible 94% (PDF)
• Louisiana Silver Plus Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana American Indian Zero Cost Sharing (PDF)
• Louisiana American Indian Zero Cost Plus Sharing (PDF)
• Louisiana Standard Bronze Summary of Benefits- (PDF)
• Louisiana Standard Bronze Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Standard Silver Summary of Benefits- (PDF)
• Louisiana Standard Silver Summary of Benefits- Limited Cost Sharing (PDF)
• Louisiana Standard Silver Summary of Benefits- 73% (PDF)
• Louisiana Standard Silver Summary of Benefits- 87% (PDF)
• Louisiana Standard Silver Summary of Benefits- 94% (PDF)
• Louisiana Standard Gold Summary of Benefits- (PDF)
• Louisiana Standard Gold Summary of Benefits- Limited Cost Sharing (PDF)

English

• Louisiana Schedule of Benefits Bronze Plus - (PDF)
• Louisiana Schedule of Benefits Bronze HSA- (PDF)
• Louisiana Schedule of Benefits Bronze - (PDF)
• Louisiana Schedule of Benefits Bronze $0 PrefGen - (PDF)
• Louisiana Schedule of Benefits Gold Plus - (PDF)
• Louisiana Schedule of Benefits Gold - (PDF)
• Louisiana Schedule of Benefits Gold Standard - (PDF)
• Louisiana Schedule of Benefits Silver 73% - (PDF)
• Louisiana Schedule of Benefits Silver 87% - (PDF)
• Louisiana Schedule of Benefits Silver 94% - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD 73% - (PDF
• Louisiana Schedule of Benefits Silver Plus HD 87% - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD 94% - (PDF)
• Louisiana Schedule of Benefits Silver - (PDF)
• Louisiana Schedule of Benefits Bronze Standard - (PDF)
• Louisiana Schedule of Benefits Silver Standard 73% - (PDF)
• Louisiana Schedule of Benefits Silver Standard 87% - (PDF)
• Louisiana Schedule of Benefits Silver Standard 94% - (PDF)
• Louisiana Schedule of Benefits Silver Standard - (PDF)
• Louisiana Schedule of Benefits Silver LD 73% - (PDF)
• Louisiana Schedule of Benefits Silver LD 94% - (PDF)
• Louisiana Schedule of Benefits Silver LD 87% - (PDF)
• Louisiana Schedule of Benefits Silver LD - (PDF)
• Louisiana Schedule of Benefits Silver HD - (PDF)
• Louisiana Schedule of Benefits Silver HD 73% - (PDF)
• Louisiana Schedule of Benefits Silver HD 87% - (PDF)
• Louisiana Schedule of Benefits Silver HD 94% - (PDF)

 

Spanish

• Louisiana Schedule of Benefits Bronze HSA- (PDF)
• Louisiana Schedule of Benefits Bronze - (PDF)
• Louisiana Schedule of Benefits Gold Plus - (PDF)
• Louisiana Schedule of Benefits Silver 73% - (PDF)
• Louisiana Schedule of Benefits Silver 87% - (PDF)
• Louisiana Schedule of Benefits Silver 94% - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD 87% - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD 94% - (PDF)
• Louisiana Schedule of Benefits Silver - (PDF)
• Louisiana Schedule of Benefits Bronze Standard - (PDF)
• Louisiana Schedule of Benefits Gold Standard - (PDF)
• Louisiana Schedule of Benefits Silver Standard 73% - (PDF)
• Louisiana Schedule of Benefits Silver Standard 87% - (PDF)
• Louisiana Schedule of Benefits Silver Standard 94% - (PDF)
• Louisiana Schedule of Benefits Silver Standard - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD - (PDF)
• Louisiana Schedule of Benefits Silver HD 73% - (PDF)
• Louisiana Schedule of Benefits Silver LD 94% - (PDF)
• Louisiana Schedule of Benefits Silver LD 87% - (PDF)
• Louisiana Schedule of Benefits Silver LD 73% - (PDF)
• Louisiana Schedule of Benefits Silver LD - (PDF)
• Louisiana Schedule of Benefits Gold - (PDF)
• Louisiana Schedule of Benefits Silver HD - (PDF)
• Louisiana Schedule of Benefits Silver HD 94% - (PDF)
• Louisiana Schedule of Benefits Silver HD 87% - (PDF)
• Louisiana Schedule of Benefits Silver Plus HD 73% - (PDF)
• Louisiana Schedule of Benefits Bronze Plus - (PDF)

English

• Texas Schedule of Benefits Bronze $0 PrefGen (PDF)
• Texas Schedule of Benefits Bronze HSA (PDF)
• Texas Schedule of Benefits Bronze (PDF)
• Texas Schedule of Benefits Gold Plus (PDF)
• Texas Schedule of Benefits Silver 73% (PDF)
• Texas Schedule of Benefits Silver 87% (PDF)
• Texas Schedule of Benefits Silver 94% (PDF)
• Texas Schedule of Benefits Silver Plus HD 87% (PDF)
• Texas Schedule of Benefits Silver Plus HD 94% (PDF)
• Texas Schedule of Benefits Silver (PDF)
• Texas Schedule of Benefits Bronze Standard (PDF)
• Texas Schedule of Benefits Gold Standard (PDF)
• Texas Schedule of Benefits Silver Standard 73% (PDF)
• Texas Schedule of Benefits Silver Standard 87% (PDF)
• Texas Schedule of Benefits Silver Standard 94% (PDF)
• Texas Schedule of Benefits Silver Standard (PDF)
• Texas Schedule of Benefits Silver Plus HD (PDF)
• Texas Schedule of Benefits Silver HD 73% (PDF)
• Texas Schedule of Benefits Silver LD 94% (PDF)
• Texas Schedule of Benefits Silver LD 87% (PDF)
• Texas Schedule of Benefits Silver LD 73% (PDF)
• Texas Schedule of Benefits Silver LD (PDF)
• Texas Schedule of Benefits Gold (PDF)
• Texas Schedule of Benefits Silver HD (PDF)
• Texas Schedule of Benefits Silver HD 94% (PDF)
• Texas Schedule of Benefits Silver HD 87% (PDF)
• Texas Schedule of Benefits Silver Plus HD 73% (PDF)
• Texas Schedule of Benefits Bronze Plus (PDF)
• Texas Schedule of Benefits Platinum (PDF)
• Texas Schedule of Benefits Catastrophic (PDF)

 

Spanish

• Texas Schedule of Benefits Bronze $0 PrefGen  (PDF)
• Texas Schedule of Benefits Bronze HSA  (PDF)
• Texas Schedule of Benefits Bronze (PDF)
• Texas Schedule of Benefits Gold Plus  (PDF)
• Texas Schedule of Benefits Silver 73%  (PDF)
• Texas Schedule of Benefits Silver 87%  (PDF)
• Texas Schedule of Benefits Silver 94%  (PDF)
• Texas Schedule of Benefits Silver Plus HD 87%  (PDF)
• Texas Schedule of Benefits Silver Plus HD 94%  (PDF)
• Texas Schedule of Benefits Silver  (PDF)
• Texas Schedule of Benefits Bronze Standard  (PDF)
• Texas Schedule of Benefits Gold Standard  (PDF)
• Texas Schedule of Benefits Silver Standard 73%  (PDF)
• Texas Schedule of Benefits Silver Standard 87%  (PDF)
• Texas Schedule of Benefits Silver Standard 94%  (PDF)
• Texas Schedule of Benefits Silver Standard  (PDF)
• Texas Schedule of Benefits Silver Plus HD (PDF)
• Texas Schedule of Benefits Silver HD 73% (PDF)
• Texas Schedule of Benefits Silver LD 94% (PDF)
• Texas Schedule of Benefits Silver LD 87% (PDF)
• Texas Schedule of Benefits Silver LD 73% (PDF)
• Texas Schedule of Benefits Silver LD (PDF)
• Texas Schedule of Benefits Gold (PDF)
• Texas Schedule of Benefits Silver HD (PDF)
• Texas Schedule of Benefits Silver HD 94% (PDF)
• Texas Schedule of Benefits Silver HD 87% (PDF)
• Texas Schedule of Benefits Bronze Plus (PDF)
• Texas Schedule of Benefits Platinum (PDF)
• Texas Schedule of Benefits Catastrophic (PDF)