ENGLISH

• Louisiana American Indian Zero Cost Sharing Plan Brochure (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Plan Brochure (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Plan Brochure (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Dental Vision Plan Brochure (PDF)
• Louisiana Bronze Essential Plan Brochure (PDF)
• Louisiana Bronze Essential Limited Plan Brochure (PDF)
• Louisiana Bronze Essential Plus Plan Brochure (PDF)
• Louisiana Bronze Essential Plus Limited Plan Brochure (PDF)
• Louisiana Gold Plan Brochure (PDF)
• Louisiana Gold Essential Plan Brochure (PDF)
• Louisiana Gold Essential Limited Plan Brochure (PDF)
• Louisiana Gold Essential Plus Plan Brochure (PDF)
• Louisiana Gold Essential Plus Limited Plan Brochure (PDF)
• Louisiana Gold Limited Plan Brochure (PDF)
• Louisiana Gold Plus Plan Brochure (PDF)
• Louisiana Gold Plus Limited Plan Brochure (PDF)
• Louisiana Silver Essential Plan Brochure (PDF)
• Louisiana Silver Essential 73 Plan Brochure (PDF)
• Louisiana Silver Essential 87 Plan Brochure (PDF)
• Louisiana Silver Essential 94 Plan Brochure (PDF)
• Louisiana Silver Essential Limited Plan Brochure (PDF)
• Louisiana Silver Essential Plus Plan Brochure (PDF)
• Louisiana Silver Essential Plus 73 Plan Brochure (PDF)
• Louisiana Silver Essential Plus 87 Plan Brochure (PDF)
• Louisiana Silver Essential Plus 94 Plan Brochure (PDF)
• Louisiana Silver Essential Plus Limited Plan Brochure (PDF)
• Louisiana Standard Expanded Bronze Plan Brochure (PDF)
• Louisiana Standard Expanded Bronze Limited Plan Brochure (PDF)
• Louisiana Standard Gold Plan Brochure (PDF)
• Louisiana Standard Gold Limited Plan Brochure (PDF)
• Louisiana Standard Silver Plan Brochure (PDF)
• Louisiana Standard Silver 73 Plan Brochure (PDF)
• Louisiana Standard Silver 87 Plan Brochure (PDF)
• Louisiana Standard Silver 94 Plan Brochure (PDF)
• Louisiana Standard Silver Limited Plan Brochure (PDF)
• Louisiana Value Bronze Plan Brochure (PDF)
• Louisiana Value Bronze Limited Plan Brochure (PDF)
• Louisiana Value Bronze Plus Plan Brochure (PDF)
• Louisiana Value Bronze Plus Limited Plan Brochure (PDF)
• Louisiana Value Silver Plan Brochure (PDF)
• Louisiana Value Silver 73 Plan Brochure (PDF)
• Louisiana Value Silver 87 Plan Brochure (PDF)
• Louisiana Value Silver 94 Plan Brochure (PDF)
• Louisiana Value Silver Limited Plan Brochure (PDF)
• Louisiana Value Silver Plus Plan Brochure (PDF)
• Louisiana Value Silver Plus 73 Plan Brochure (PDF)
• Louisiana Value Silver Plus 87 Plan Brochure (PDF)
• Louisiana Value Silver Plus 94 Plan Brochure (PDF)
• Louisiana Value Silver Plus Limited Plan Brochure (PDF)

English

• Louisiana Off-Exchange Evidence of Coverage (PDF)
• Louisiana On-Exchange Evidence of Coverage (PDF)

Spanish

• Louisiana Off-Exchange Evidence of Coverage en español (PDF)
• Louisiana On-Exchange Evidence of Coverage en español (PDF)

English

• Louisiana American Indian Zero Cost Sharing Summary of Benefits and Coverage (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Summary of Benefits and Coverage (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Summary of Benefits and Coverage (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Dental Vision Summary of Benefits and Coverage (PDF)
• Louisiana Bronze Essential Summary of Benefits and Coverage (PDF)
• Louisiana Bronze Essential Limited Summary of Benefits and Coverage (PDF)
• Louisiana Bronze Essential Plus Summary of Benefits and Coverage (PDF)
• Louisiana Bronze Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Louisiana Gold Summary of Benefits and Coverage (PDF)
• Louisiana Gold Essential Summary of Benefits and Coverage (PDF)
• Louisiana Gold Essential Limited Summary of Benefits and Coverage (PDF)
• Louisiana Gold Essential Plus Summary of Benefits and Coverage (PDF)
• Louisiana Gold Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Louisiana Gold Limited Summary of Benefits and Coverage (PDF)
• Louisiana Gold Plus Summary of Benefits and Coverage (PDF)
• Louisiana Gold Plus Limited Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential 73 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential 87 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential 94 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Limited Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Plus Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Plus 73 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Plus 87 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Plus 94 Summary of Benefits and Coverage (PDF)
• Louisiana Silver Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Louisiana Standard Expanded Bronze Summary of Benefits and Coverage (PDF)
• Louisiana Standard Expanded Bronze Limited Summary of Benefits and Coverage (PDF)
• Louisiana Standard Gold Summary of Benefits and Coverage (PDF)
• Louisiana Standard Gold Limited Summary of Benefits and Coverage (PDF)
• Louisiana Standard Silver Summary of Benefits and Coverage (PDF)
• Louisiana Standard Silver 73 Summary of Benefits and Coverage (PDF)
• Louisiana Standard Silver 87 Summary of Benefits and Coverage (PDF)
• Louisiana Standard Silver 94 Summary of Benefits and Coverage (PDF)
• Louisiana Standard Silver Limited Summary of Benefits and Coverage (PDF)
• Louisiana Value Bronze Summary of Benefits and Coverage (PDF)
• Louisiana Value Bronze Limited Summary of Benefits and Coverage (PDF)
• Louisiana Value Bronze Plus Summary of Benefits and Coverage (PDF)
• Louisiana Value Bronze Plus Limited Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver 73 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver 87 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver 94 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Limited Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Plus Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Plus 73 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Plus 87 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Plus 94 Summary of Benefits and Coverage (PDF)
• Louisiana Value Silver Plus Limited Summary of Benefits and Coverage (PDF)

Spanish

• Lousiana American Indian Zero Cost Sharing Summary of Benefits and Coverage en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Fitness Summary of Benefits and Coverage en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Fitness Dental Vision Summary of Benefits and Coverage en español (PDF)
• Lousiana Bronze Essential Summary of Benefits and Coverage en español (PDF)
• Lousiana Bronze Essential Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Bronze Essential Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Bronze Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Essential Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Essential Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Essential Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Gold Plus Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential 73 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential 87 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential 94 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Plus 73 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Plus 87 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Plus 94 Summary of Benefits and Coverage en español (PDF)
• Lousiana Silver Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Expanded Bronze Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Expanded Bronze Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Gold Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Gold Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Silver Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Silver 73 Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Silver 87 Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Silver 94 Summary of Benefits and Coverage en español (PDF)
• Lousiana Standard Silver Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Bronze Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Bronze Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Bronze Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Bronze Plus Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver 73 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver 87 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver 94 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Limited Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Plus Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Plus 73 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Plus 87 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Plus 94 Summary of Benefits and Coverage en español (PDF)
• Lousiana Value Silver Plus Limited Summary of Benefits and Coverage en español (PDF)

English

• Louisiana American Indian Zero Cost Sharing Schedule of Benefits (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Schedule of Benefits (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Schedule of Benefits (PDF)
• Louisiana American Indian Zero Cost Sharing Plus Fitness Dental Vision Schedule of Benefits (PDF)
• Louisiana Bronze Essential Schedule of Benefits (PDF)
• Louisiana Bronze Essential Limited Schedule of Benefits (PDF)
• Louisiana Bronze Essential Plus Schedule of Benefits (PDF)
• Louisiana Bronze Essential Plus Limited Schedule of Benefits (PDF)
• Louisiana Gold Schedule of Benefits (PDF)
• Louisiana Gold Essential Schedule of Benefits (PDF)
• Louisiana Gold Essential Limited Schedule of Benefits (PDF)
• Louisiana Gold Essential Plus Schedule of Benefits (PDF)
• Louisiana Gold Essential Plus Limited Schedule of Benefits (PDF)
• Louisiana Gold Limited Schedule of Benefits (PDF)
• Louisiana Gold Plus Schedule of Benefits (PDF)
• Louisiana Gold Plus Limited Schedule of Benefits (PDF)
• Louisiana Silver Essential Schedule of Benefits (PDF)
• Louisiana Silver Essential 73 Schedule of Benefits (PDF)
• Louisiana Silver Essential 87 Schedule of Benefits (PDF)
• Louisiana Silver Essential 94 Schedule of Benefits (PDF)
• Louisiana Silver Essential Limited Schedule of Benefits (PDF)
• Louisiana Silver Essential Plus Schedule of Benefits (PDF)
• Louisiana Silver Essential Plus 73 Schedule of Benefits (PDF)
• Louisiana Silver Essential Plus 87 Schedule of Benefits (PDF)
• Louisiana Silver Essential Plus 94 Schedule of Benefits (PDF)
• Louisiana Silver Essential Plus Limited Schedule of Benefits (PDF)
• Louisiana Standard Expanded Bronze Schedule of Benefits (PDF)
• Louisiana Standard Expanded Bronze Limited Schedule of Benefits (PDF)
• Louisiana Standard Gold Schedule of Benefits (PDF)
• Louisiana Standard Gold Limited Schedule of Benefits (PDF)
• Louisiana Standard Silver Schedule of Benefits (PDF)
• Louisiana Standard Silver 73 Schedule of Benefits (PDF)
• Louisiana Standard Silver 87 Schedule of Benefits (PDF)
• Louisiana Standard Silver 94 Schedule of Benefits (PDF)
• Louisiana Standard Silver Limited Schedule of Benefits (PDF)
• Louisiana Value Bronze Schedule of Benefits (PDF)
• Louisiana Value Bronze Limited Schedule of Benefits (PDF)
• Louisiana Value Bronze Plus Schedule of Benefits (PDF)
• Louisiana Value Bronze Plus Limited Schedule of Benefits (PDF)
• Louisiana Value Silver Schedule of Benefits (PDF)
• Louisiana Value Silver 73 Schedule of Benefits (PDF)
• Louisiana Value Silver 87 Schedule of Benefits (PDF)
• Louisiana Value Silver 94 Schedule of Benefits (PDF)
• Louisiana Value Silver Limited Schedule of Benefits (PDF)
• Louisiana Value Silver Plus Schedule of Benefits (PDF)
• Louisiana Value Silver Plus 73 Schedule of Benefits (PDF)
• Louisiana Value Silver Plus 87 Schedule of Benefits (PDF)
• Louisiana Value Silver Plus 94 Schedule of Benefits (PDF)
• Louisiana Value Silver Plus Limited Schedule of Benefits (PDF)

Spanish

• Lousiana American Indian Zero Cost Sharing Schedule of Benefits en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Schedule of Benefits en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Fitness Schedule of Benefits en español (PDF)
• Lousiana American Indian Zero Cost Sharing Plus Fitness Dental Vision Schedule of Benefits en español (PDF)
• Lousiana Bronze Essential Schedule of Benefits en español (PDF)
• Lousiana Bronze Essential Limited Schedule of Benefits en español (PDF)
• Lousiana Bronze Essential Plus Schedule of Benefits en español (PDF)
• Lousiana Bronze Essential Plus Limited Schedule of Benefits en español (PDF)
• Lousiana Gold Schedule of Benefits en español (PDF)
• Lousiana Gold Essential Schedule of Benefits en español (PDF)
• Lousiana Gold Essential Limited Schedule of Benefits en español (PDF)
• Lousiana Gold Essential Plus Schedule of Benefits en español (PDF)
• Lousiana Gold Essential Plus Limited Schedule of Benefits en español (PDF)
• Lousiana Gold Limited Schedule of Benefits en español (PDF)
• Lousiana Gold Plus Schedule of Benefits en español (PDF)
• Lousiana Gold Plus Limited Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Schedule of Benefits en español (PDF)
• Lousiana Silver Essential 73 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential 87 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential 94 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Limited Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Plus Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Plus 73 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Plus 87 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Plus 94 Schedule of Benefits en español (PDF)
• Lousiana Silver Essential Plus Limited Schedule of Benefits en español (PDF)
• Lousiana Standard Expanded Bronze Schedule of Benefits en español (PDF)
• Lousiana Standard Expanded Bronze Limited Schedule of Benefits en español (PDF)
• Lousiana Standard Gold Schedule of Benefits en español (PDF)
• Lousiana Standard Gold Limited Schedule of Benefits en español (PDF)
• Lousiana Standard Silver Schedule of Benefits en español (PDF)
• Lousiana Standard Silver 73 Schedule of Benefits en español (PDF)
• Lousiana Standard Silver 87 Schedule of Benefits en español (PDF)
• Lousiana Standard Silver 94 Schedule of Benefits en español (PDF)
• Lousiana Standard Silver Limited Schedule of Benefits en español (PDF)
• Lousiana Value Bronze Schedule of Benefits en español (PDF)
• Lousiana Value Bronze Limited Schedule of Benefits en español (PDF)
• Lousiana Value Bronze Plus Schedule of Benefits en español (PDF)
• Lousiana Value Bronze Plus Limited Schedule of Benefits en español (PDF)
• Lousiana Value Silver Schedule of Benefits en español (PDF)
• Lousiana Value Silver 73 Schedule of Benefits en español (PDF)
• Lousiana Value Silver 87 Schedule of Benefits en español (PDF)
• Lousiana Value Silver 94 Schedule of Benefits en español (PDF)
• Lousiana Value Silver Limited Schedule of Benefits en español (PDF)
• Lousiana Value Silver Plus Schedule of Benefits en español (PDF)
• Lousiana Value Silver Plus 73 Schedule of Benefits en español (PDF)
• Lousiana Value Silver Plus 87 Schedule of Benefits en español (PDF)
• Lousiana Value Silver Plus 94 Schedule of Benefits en español (PDF)
• Lousiana Value Silver Plus Limited Schedule of Benefits en español (PDF)

ENGLISH

• Texas American Indian Zero Cost Sharing Plan Brochure (PDF)
• Texas American Indian Zero Cost Sharing Plus Plan Brochure (PDF)
• Texas American Indian Zero Cost Sharing Plus Dental Vision Fitness Plan Brochure (PDF)
• Texas American Indian Zero Cost Sharing Plus Fitness Plan Brochure (PDF)
• Texas Bronze Plan Brochure (PDF)
• Texas Bronze Essential Plan Brochure (PDF)
• Texas Bronze Essential Limited Plan Brochure (PDF)
• Texas Bronze Essential Plus Plan Brochure (PDF)
• Texas Bronze Essential Plus Limited Plan Brochure (PDF)
• Texas Bronze Limited Plan Brochure (PDF)
• Texas Bronze Plus Plan Brochure (PDF)
• Texas Bronze Plus Limited Plan Brochure (PDF)
• Texas Catastrophic Plan Brochure (PDF)
• Texas Gold Plan Brochure (PDF)
• Texas Gold Essential Plan Brochure (PDF)
• Texas Gold Essential Limited Plan Brochure (PDF)
• Texas Gold Essential Plus Plan Brochure (PDF)
• Texas Gold Essential Plus Limited Plan Brochure (PDF)
• Texas Gold Limited Plan Brochure (PDF)
• Texas Gold Plus Plan Brochure (PDF)
• Texas Gold Plus Limited Plan Brochure (PDF)
• Texas Off Exchange Silver Essential Plan Brochure (PDF)
• Texas Off Exchange Silver Essential Plus Plan Brochure (PDF)
• Texas Off Exchange Standard Silver Plan Brochure (PDF)
• Texas Off Exchange Value Silver Plan Brochure (PDF)
• Texas Off Exchange Value Silver Plus Plan Brochure (PDF)
• Texas Silver Essential Plan Brochure (PDF)
• Texas Silver Essential 73 Plan Brochure (PDF)
• Texas Silver Essential 87 Plan Brochure (PDF)
• Texas Silver Essential 94 Plan Brochure (PDF)
• Texas Silver Essential Limited Plan Brochure (PDF)
• Texas Silver Essential Plus Plan Brochure (PDF)
• Texas Silver Essential Plus 73 Plan Brochure (PDF)
• Texas Silver Essential Plus 87 Plan Brochure (PDF)
• Texas Silver Essential Plus 94 Plan Brochure (PDF)
• Texas Silver Essential Plus Limited Plan Brochure (PDF)
• Texas Standard Expanded Bronze Plan Brochure (PDF)
• Texas Standard Expanded Bronze Limited Plan Brochure (PDF)
• Texas Standard Gold Plan Brochure (PDF)
• Texas Standard Gold Limited Plan Brochure (PDF)
• Texas Standard Silver Plan Brochure (PDF)
• Texas Standard Silver 73 Plan Brochure (PDF)
• Texas Standard Silver 87 Plan Brochure (PDF)
• Texas Standard Silver 94 Plan Brochure (PDF)
• Texas Standard Silver Limited Plan Brochure (PDF)
• Texas Value Bronze Plan Brochure (PDF)
• Texas Value Bronze Limited Plan Brochure (PDF)
• Texas Value Bronze Plus Plan Brochure (PDF)
• Texas Value Bronze Plus Limited Plan Brochure (PDF)
• Texas Value Silver Plan Brochure (PDF)
• Texas Value Silver 73 Plan Brochure (PDF)
• Texas Value Silver 87 Plan Brochure (PDF)
• Texas Value Silver 94 Plan Brochure (PDF)
• Texas Value Silver Limited Plan Brochure (PDF)
• Texas Value Silver Plus Plan Brochure (PDF)
• Texas Value Silver Plus 73 Plan Brochure (PDF)
• Texas Value Silver Plus 87 Plan Brochure (PDF)
• Texas Value Silver Plus 94 Plan Brochure (PDF)
• Texas Value Silver Plus Limited Plan Brochure (PDF)

English

• Texas Gold Complete Evidence of Coverage (PDF)
• Texas Off-Exchange Evidence of Coverage (PDF)
• Texas On-Exchange Evidence of Coverage (PDF)

Spanish

• Texas Gold Complete Off-Exchange Evidence of Coverage en español (PDF)
• Texas Off-Exchange Evidence of Coverage en español (PDF)
• Texas On-Exchange Evidence of Coverage en español (PDF)

English

• Texas American Indian Zero Cost Sharing Summary of Benefits and Coverage (PDF)
• Texas American Indian Zero Cost Sharing Plus Summary of Benefits and Coverage (PDF)
• Texas American Indian Zero Cost Sharing Plus Dental Vision Fitness Summary of Benefits and Coverage (PDF)
• Texas American Indian Zero Cost Sharing Plus Fitness Summary of Benefits and Coverage (PDF)
• Texas Bronze Summary of Benefits and Coverage (PDF)
• Texas Bronze Essential Summary of Benefits and Coverage (PDF)
• Texas Bronze Essential Limited Summary of Benefits and Coverage (PDF)
• Texas Bronze Essential Plus Summary of Benefits and Coverage (PDF)
• Texas Bronze Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Bronze Limited Summary of Benefits and Coverage (PDF)
• Texas Bronze Plus Summary of Benefits and Coverage (PDF)
• Texas Bronze Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Catastrophic Summary of Benefits and Coverage (PDF)
• Texas Gold Summary of Benefits and Coverage (PDF)
• Texas Gold Essential Summary of Benefits and Coverage (PDF)
• Texas Gold Essential Limited Summary of Benefits and Coverage (PDF)
• Texas Gold Essential Plus Summary of Benefits and Coverage (PDF)
• Texas Gold Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Gold Limited Summary of Benefits and Coverage (PDF)
• Texas Gold Plus Summary of Benefits and Coverage (PDF)
• Texas Gold Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Off Exchange Silver Essential Summary of Benefits and Coverage (PDF)
• Texas Off Exchange Silver Essential Plus Summary of Benefits and Coverage (PDF)
• Texas Off Exchange Standard Silver Summary of Benefits and Coverage (PDF)
• Texas Off Exchange Value Silver Summary of Benefits and Coverage (PDF)
• Texas Off Exchange Value Silver Plus Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Summary of Benefits and Coverage (PDF)
• Texas Silver Essential 73 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential 87 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential 94 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Limited Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Plus Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Plus 73 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Plus 87 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Plus 94 Summary of Benefits and Coverage (PDF)
• Texas Silver Essential Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Standard Expanded Bronze Summary of Benefits and Coverage (PDF)
• Texas Standard Expanded Bronze Limited Summary of Benefits and Coverage (PDF)
• Texas Standard Gold Summary of Benefits and Coverage (PDF)
• Texas Standard Gold Limited Summary of Benefits and Coverage (PDF)
• Texas Standard Silver Summary of Benefits and Coverage (PDF)
• Texas Standard Silver 73 Summary of Benefits and Coverage (PDF)
• Texas Standard Silver 87 Summary of Benefits and Coverage (PDF)
• Texas Standard Silver 94 Summary of Benefits and Coverage (PDF)
• Texas Standard Silver Limited Summary of Benefits and Coverage (PDF)
• Texas Value Bronze Summary of Benefits and Coverage (PDF)
• Texas Value Bronze Limited Summary of Benefits and Coverage (PDF)
• Texas Value Bronze Plus Summary of Benefits and Coverage (PDF)
• Texas Value Bronze Plus Limited Summary of Benefits and Coverage (PDF)
• Texas Value Silver Summary of Benefits and Coverage (PDF)
• Texas Value Silver 73 Summary of Benefits and Coverage (PDF)
• Texas Value Silver 87 Summary of Benefits and Coverage (PDF)
• Texas Value Silver 94 Summary of Benefits and Coverage (PDF)
• Texas Value Silver Limited Summary of Benefits and Coverage (PDF)
• Texas Value Silver Plus Summary of Benefits and Coverage (PDF)
• Texas Value Silver Plus 73 Summary of Benefits and Coverage (PDF)
• Texas Value Silver Plus 87 Summary of Benefits and Coverage (PDF)
• Texas Value Silver Plus 94 Summary of Benefits and Coverage (PDF)
• Texas Value Silver Plus Limited Summary of Benefits and Coverage (PDF)

Spanish

• Texas American Indian Zero Cost Sharing Summary of Benefits and Coverage en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Summary of Benefits and Coverage en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Dental Vision Fitness Summary of Benefits and Coverage en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Fitness Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Essential Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Essential Limited Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Essential Plus Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Limited Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Plus Summary of Benefits and Coverage en español (PDF)
• Texas Bronze Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Catastrophic Summary of Benefits and Coverage en español (PDF)
• Texas Gold Summary of Benefits and Coverage en español (PDF)
• Texas Gold Essential Summary of Benefits and Coverage en español (PDF)
• Texas Gold Essential Limited Summary of Benefits and Coverage en español (PDF)
• Texas Gold Essential Plus Summary of Benefits and Coverage en español (PDF)
• Texas Gold Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Gold Limited Summary of Benefits and Coverage en español (PDF)
• Texas Gold Plus Summary of Benefits and Coverage en español (PDF)
• Texas Gold Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Off Exchange Silver Essential Summary of Benefits and Coverage en español (PDF)
• Texas Off Exchange Silver Essential Plus Summary of Benefits and Coverage en español (PDF)
• Texas Off Exchange Standard Silver Summary of Benefits and Coverage en español (PDF)
• Texas Off Exchange Value Silver Summary of Benefits and Coverage en español (PDF)
• Texas Off Exchange Value Silver Plus Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential 73 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential 87 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential 94 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Limited Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Plus Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Plus 73 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Plus 87 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Plus 94 Summary of Benefits and Coverage en español (PDF)
• Texas Silver Essential Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Standard Expanded Bronze Summary of Benefits and Coverage en español (PDF)
• Texas Standard Expanded Bronze Limited Summary of Benefits and Coverage en español (PDF)
• Texas Standard Gold Summary of Benefits and Coverage en español (PDF)
• Texas Standard Gold Limited Summary of Benefits and Coverage en español (PDF)
• Texas Standard Silver Summary of Benefits and Coverage en español (PDF)
• Texas Standard Silver 73 Summary of Benefits and Coverage en español (PDF)
• Texas Standard Silver 87 Summary of Benefits and Coverage en español (PDF)
• Texas Standard Silver 94 Summary of Benefits and Coverage en español (PDF)
• Texas Standard Silver Limited Summary of Benefits and Coverage en español (PDF)
• Texas Value Bronze Summary of Benefits and Coverage en español (PDF)
• Texas Value Bronze Limited Summary of Benefits and Coverage en español (PDF)
• Texas Value Bronze Plus Summary of Benefits and Coverage en español (PDF)
• Texas Value Bronze Plus Limited Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver 73 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver 87 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver 94 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Limited Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Plus Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Plus 73 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Plus 87 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Plus 94 Summary of Benefits and Coverage en español (PDF)
• Texas Value Silver Plus Limited Summary of Benefits and Coverage en español (PDF)

English

• Texas American Indian Zero Cost Sharing Schedule of Benefits (PDF)
• Texas American Indian Zero Cost Sharing Plus Schedule of Benefits (PDF)
• Texas American Indian Zero Cost Sharing Plus Dental Vision Fitness Schedule of Benefits (PDF)
• Texas American Indian Zero Cost Sharing Plus Fitness Schedule of Benefits (PDF)
• Texas Bronze Schedule of Benefits (PDF)
• Texas Bronze Essential Schedule of Benefits (PDF)
• Texas Bronze Essential Limited Schedule of Benefits (PDF)
• Texas Bronze Essential Plus Schedule of Benefits (PDF)
• Texas Bronze Essential Plus Limited Schedule of Benefits (PDF)
• Texas Bronze Limited Schedule of Benefits (PDF)
• Texas Bronze Plus Schedule of Benefits (PDF)
• Texas Bronze Plus Limited Schedule of Benefits (PDF)
• Texas Catastrophic Schedule of Benefits (PDF)
• Texas Gold Schedule of Benefits (PDF)
• Texas Gold Essential Schedule of Benefits (PDF)
• Texas Gold Essential Limited Schedule of Benefits (PDF)
• Texas Gold Essential Plus Schedule of Benefits (PDF)
• Texas Gold Essential Plus Limited Schedule of Benefits (PDF)
• Texas Gold Limited Schedule of Benefits (PDF)
• Texas Gold Plus Schedule of Benefits (PDF)
• Texas Gold Plus Limited Schedule of Benefits (PDF)
• Texas Off Exchange Silver Essential Schedule of Benefits (PDF)
• Texas Off Exchange Silver Essential Plus Schedule of Benefits (PDF)
• Texas Off Exchange Standard Silver Schedule of Benefits (PDF)
• Texas Off Exchange Value Silver Schedule of Benefits (PDF)
• Texas Off Exchange Value Silver Plus Schedule of Benefits (PDF)
• Texas Silver Essential Schedule of Benefits (PDF)
• Texas Silver Essential 73 Schedule of Benefits (PDF)
• Texas Silver Essential 87 Schedule of Benefits (PDF)
• Texas Silver Essential 94 Schedule of Benefits (PDF)
• Texas Silver Essential Limited Schedule of Benefits (PDF)
• Texas Silver Essential Plus Schedule of Benefits (PDF)
• Texas Silver Essential Plus 73 Schedule of Benefits (PDF)
• Texas Silver Essential Plus 87 Schedule of Benefits (PDF)
• Texas Silver Essential Plus 94 Schedule of Benefits (PDF)
• Texas Silver Essential Plus Limited Schedule of Benefits (PDF)
• Texas Standard Expanded Bronze Schedule of Benefits (PDF)
• Texas Standard Expanded Bronze Limited Schedule of Benefits (PDF)
• Texas Standard Gold Schedule of Benefits (PDF)
• Texas Standard Gold Limited Schedule of Benefits (PDF)
• Texas Standard Silver Schedule of Benefits (PDF)
• Texas Standard Silver 73 Schedule of Benefits (PDF)
• Texas Standard Silver 87 Schedule of Benefits (PDF)
• Texas Standard Silver 94 Schedule of Benefits (PDF)
• Texas Standard Silver Limited Schedule of Benefits (PDF)
• Texas Value Bronze Schedule of Benefits (PDF)
• Texas Value Bronze Limited Schedule of Benefits (PDF)
• Texas Value Bronze Plus Schedule of Benefits (PDF)
• Texas Value Bronze Plus Limited Schedule of Benefits (PDF)
• Texas Value Silver Schedule of Benefits (PDF)
• Texas Value Silver 73 Schedule of Benefits (PDF)
• Texas Value Silver 87 Schedule of Benefits (PDF)
• Texas Value Silver 94 Schedule of Benefits (PDF)
• Texas Value Silver Limited Schedule of Benefits (PDF)
• Texas Value Silver Plus Schedule of Benefits (PDF)
• Texas Value Silver Plus 73 Schedule of Benefits (PDF)
• Texas Value Silver Plus 87 Schedule of Benefits (PDF)
• Texas Value Silver Plus 94 Schedule of Benefits (PDF)
• Texas Value Silver Plus Limited Schedule of Benefits (PDF)

Spanish

• Texas American Indian Zero Cost Sharing Schedule of Benefits en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Schedule of Benefits en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Dental Vision Fitness Schedule of Benefits en español (PDF)
• Texas American Indian Zero Cost Sharing Plus Fitness Schedule of Benefits en español (PDF)
• Texas Bronze Schedule of Benefits en español (PDF)
• Texas Bronze Essential Schedule of Benefits en español (PDF)
• Texas Bronze Essential Limited Schedule of Benefits en español (PDF)
• Texas Bronze Essential Plus Schedule of Benefits en español (PDF)
• Texas Bronze Essential Plus Limited Schedule of Benefits en español (PDF)
• Texas Bronze Limited Schedule of Benefits en español (PDF)
• Texas Bronze Plus Schedule of Benefits en español (PDF)
• Texas Bronze Plus Limited Schedule of Benefits en español (PDF)
• Texas Catastrophic Schedule of Benefits en español (PDF)
• Texas Gold Schedule of Benefits en español (PDF)
• Texas Gold Essential Schedule of Benefits en español (PDF)
• Texas Gold Essential Limited Schedule of Benefits en español (PDF)
• Texas Gold Essential Plus Schedule of Benefits en español (PDF)
• Texas Gold Essential Plus Limited Schedule of Benefits en español (PDF)
• Texas Gold Limited Schedule of Benefits en español (PDF)
• Texas Gold Plus Schedule of Benefits en español (PDF)
• Texas Gold Plus Limited Schedule of Benefits en español (PDF)
• Texas Off Exchange Silver Essential Schedule of Benefits en español (PDF)
• Texas Off Exchange Silver Essential Plus Schedule of Benefits en español (PDF)
• Texas Off Exchange Standard Silver Schedule of Benefits en español (PDF)
• Texas Off Exchange Value Silver Schedule of Benefits en español (PDF)
• Texas Off Exchange Value Silver Plus Schedule of Benefits en español (PDF)
• Texas Silver Essential Schedule of Benefits en español (PDF)
• Texas Silver Essential 73 Schedule of Benefits en español (PDF)
• Texas Silver Essential 87 Schedule of Benefits en español (PDF)
• Texas Silver Essential 94 Schedule of Benefits en español (PDF)
• Texas Silver Essential Limited Schedule of Benefits en español (PDF)
• Texas Silver Essential Plus Schedule of Benefits en español (PDF)
• Texas Silver Essential Plus 73 Schedule of Benefits en español (PDF)
• Texas Silver Essential Plus 87 Schedule of Benefits en español (PDF)
• Texas Silver Essential Plus 94 Schedule of Benefits en español (PDF)
• Texas Silver Essential Plus Limited Schedule of Benefits en español (PDF)
• Texas Standard Expanded Bronze Schedule of Benefits en español (PDF)
• Texas Standard Expanded Bronze Limited Schedule of Benefits en español (PDF)
• Texas Standard Gold Schedule of Benefits en español (PDF)
• Texas Standard Gold Limited Schedule of Benefits en español (PDF)
• Texas Standard Silver Schedule of Benefits en español (PDF)
• Texas Standard Silver 73 Schedule of Benefits en español (PDF)
• Texas Standard Silver 87 Schedule of Benefits en español (PDF)
• Texas Standard Silver 94 Schedule of Benefits en español (PDF)
• Texas Standard Silver Limited Schedule of Benefits en español (PDF)
• Texas Value Bronze Schedule of Benefits en español (PDF)
• Texas Value Bronze Limited Schedule of Benefits en español (PDF)
• Texas Value Bronze Plus Schedule of Benefits en español (PDF)
• Texas Value Bronze Plus Limited Schedule of Benefits en español (PDF)
• Texas Value Silver Schedule of Benefits en español (PDF)
• Texas Value Silver 73 Schedule of Benefits en español (PDF)
• Texas Value Silver 87 Schedule of Benefits en español (PDF)
• Texas Value Silver 94 Schedule of Benefits en español (PDF)
• Texas Value Silver Limited Schedule of Benefits en español (PDF)
• Texas Value Silver Plus Schedule of Benefits en español (PDF)
• Texas Value Silver Plus 73 Schedule of Benefits en español (PDF)
• Texas Value Silver Plus 87 Schedule of Benefits en español (PDF)
• Texas Value Silver Plus 94 Schedule of Benefits en español (PDF)
• Texas Value Silver Plus Limited Schedule of Benefits en español (PDF)

ENGLISH

• 2026 Louisiana Provider & Pharmacy Directory (PDF)
• 2026 Texas Provider & Pharmacy Directory (PDF)

SPANISH

• 2026 Louisiana Provider & Pharmacy Directory en español (PDF)
• 2026 Texas Provider & Pharmacy Directory en español (PDF)

CHRISTUS Health, Texas & Louisiana Individual and Family Plan members have access to a toll-free 24-hour nurse line. Call the number 844-581-3175 to speak with a registered nurse at any time, day or night. If you are experiencing a medical emergency, please dial 911.

Consent Form (PDF)

 

If you choose to go out-of-network for your dental care, you may be reimbursed for your treatment. Complete the patient and subscriber information on the Delta Dental Claims Form.

Mail the completed form and a copy of the dentist’s Statement of Treatment (or detailed receipt) to:
Delta Dental Insurance Company
PO Box 1809
Alpharetta, GA 30023

The Statement of Treatment or detailed receipt must include:

• Name, address, and complete phone number of dentist
• Date each service was performed
• Description, procedure code, and fee of each service performed
• List of affected teeth
• Total cost of services performed
• Dentist’s National Provider Identifier (NPI)
• Dentist’s Tax Identification Number (TIN)
• State license number
• Specialty code

Important note: If the Statement of Treatment or similar document you receive from your dentist is missing any of the information listed above, please enter it on the claim form. A dental office staff member can provide you with the dentist and treatment information.

Be sure to make a copy of the completed claim form and the dentist’s Statement of Treatment or detailed receipt for your records.

 

• Glossary of Terms (PDF)
  
  
• Online Glossary of Terms

• Payment Authorization Form (PDF)

• Medical Reimbursement Form

• CVS RX Claim Form (PDF)
• Louisiana Prescription Drug Prior Authorization Form (PDF)
• Texas Standard Prior Authorization Request Form (PDF)

• Transplant Travel Claim Form