GoldEPO

University Community Care Plan by Community First - Gold Plan

Community First

Starting at

$559

/month before subsidy

Key facts

University Community Care Plan by Community First - Gold Plan is a 2026 Gold EPO health insurance plan from Community First, sold on the ACA Marketplace in Texas under plan ID 63251TX0010001. The monthly premium starts at $559 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $0, and the individual out-of-pocket maximum is $7,250 ($14,500 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.

Plan ID
63251TX0010001
Plan year
2026
State
Texas
Metal level
Gold
Plan type
EPO
HSA-eligible
No

Individual Deductible

$0

Family: $0

Out-of-Pocket Max

$7,250

Family: $14,500

Coinsurance

30%

You pay after deductible

Network Type

EPO

TXN001

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$30.00
Specialist Visit$60.00
Urgent Care$30.00
Emergency Room$250.00

Prescription Drugs

Generic Drugs$10.00
Brand Name Drugs$50.00
Specialty Drugs30.00%
What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$1,900

your estimated cost

Deductible
$0
Copays
$1,900
Coinsurance
$0

Managing type 2 diabetes

A year of routine care

$1,500

your estimated cost

Deductible
$0
Copays
$1,500
Coinsurance
$0

A simple fracture

ER visit + follow-up

$1,600

your estimated cost

Deductible
$0
Copays
$1,600
Coinsurance
$0
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Who This Plan Is Best For

This Gold EPO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.

Consider this plan if you:

  • Have ongoing health conditions requiring regular care
  • Take multiple prescription medications
  • Prefer lower costs at the time of service
  • Want peace of mind with comprehensive coverage

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,163/month

Annual Premium

$6,708

OOP Maximum

$7,250

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $7,250 total. Then insurance covers everything else for the year.

More plans from Community First in Texas

View all Marketplace plans in Texas

Frequently asked questions about University Community Care Plan by Community First - Gold Plan

How much does University Community Care Plan by Community First - Gold Plan cost per month?

University Community Care Plan by Community First - Gold Plan from Community First starts at $559 per month before any subsidy in Texas. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for University Community Care Plan by Community First - Gold Plan?

The individual medical deductible is $0. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for University Community Care Plan by Community First - Gold Plan?

The most you would pay in a year for covered in-network care is $7,250 for an individual and $14,500 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is University Community Care Plan by Community First - Gold Plan HSA-eligible?

No. University Community Care Plan by Community First - Gold Plan is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does University Community Care Plan by Community First - Gold Plan use?

University Community Care Plan by Community First - Gold Plan is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.

Understand what you'd actually pay

Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.