Texas · Insurer
Ambetter Marketplace Plans in Texas
Ambetter from Superior HealthPlan covers about 433,000 Texans across Celtic EPO plans in 150 counties and Superior HMO VALUE plans in 10 metro counties. The enrollment-weighted filed 2027 average is about 7.6%.
- Headline uses Celtic EPO rating (3 stars). Superior HMO VALUE rated 2 stars in 2026..
- Proposed changes are as filed. Final 2027 rates are published when open enrollment starts.
Compare plans for my ZIP codeFree. See your price after tax credits.
What makes Ambetter different
Celtic EPO plans sell across most of Texas, including El Paso, the Rio Grande Valley and San Antonio. HMO VALUE plans are limited to Houston, Dallas–Fort Worth and Austin metros.
Enhanced Diabetes Care Silver lists $0 preferred insulin, diabetic supplies, A1c labs, and routine eye and foot exams.
Members can earn up to $500 a year toward premiums, copays or deductibles (not pharmacy copays).
EPO filed about 4.7% and HMO about 11.1%. The blended figure is among the lower large-carrier filings in Texas.
Is Ambetter a good fit?
A good fit if
- You live outside the big metros and need a wide-county EPO
- You manage diabetes and want $0 preferred insulin on the diabetes Silver
- You want adult dental and vision bundled on a "+" plan
Think twice if
- EPO and HMO VALUE use different networks and star ratings. Confirm which product you're buying.
- HMO VALUE scored 2 stars overall in 2026 (1 star in 2025).
- Virtual care may have cost sharing; it isn't automatically free.
Good starting points
From its 30 2026 plans statewide, lowest price in any Texas rating area.2027 plan-by-plan prices and copays appear here once HealthCare.gov publishes them on November 1.
See my price after tax creditsCompare every insurer in your county and check your doctors.
Ambetter plans and prices
All 2026 Ambetter plans in Texas
| Plan | Metal | Type | Premium (age 40) | Deductible | OOP max | Primary care | Specialist | Generic Rx | HSA | Counties |
|---|---|---|---|---|---|---|---|---|---|---|
| Standard Silver VALUE | MetalSilver | TypeHMO | Premium (age 40)$592 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties3 |
| Focused VALUE Silver | MetalSilver | TypeHMO | Premium (age 40)$595 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties3 |
| Standard Silver VALUE + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$614 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties3 |
| Focused VALUE Silver + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$618 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties3 |
| Standard Silver | MetalSilver | TypeEPO | Premium (age 40)$629 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties150 |
| Focused Silver | MetalSilver | TypeEPO | Premium (age 40)$632 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties150 |
| Enhanced Diabetes Care Silver with $0 Drug Options | MetalSilver | TypeEPO | Premium (age 40)$638 | Deductible$5,000 | OOP max$8,650 | Primary care$30 | Specialist$50 | Generic Rx$3 | HSANo | Counties150 |
| Standard Silver + Vision + Adult Dental | MetalSilver | TypeEPO | Premium (age 40)$652 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties150 |
| Focused Silver + Vision + Adult Dental | MetalSilver | TypeEPO | Premium (age 40)$656 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties150 |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | MetalSilver | TypeEPO | Premium (age 40)$662 | Deductible$5,000 | OOP max$8,650 | Primary care$30 | Specialist$50 | Generic Rx$3 | HSANo | Counties150 |
| Standard Silver VALUE | MetalSilver | TypeHMO | Premium (age 40)$667 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties5 |
| Focused VALUE Silver | MetalSilver | TypeHMO | Premium (age 40)$671 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties5 |
| Standard Silver VALUE + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$693 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties5 |
| Focused VALUE Silver + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$696 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties5 |
| Standard Silver VALUE | MetalSilver | TypeHMO | Premium (age 40)$706 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties2 |
| Focused VALUE Silver | MetalSilver | TypeHMO | Premium (age 40)$709 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties2 |
| Standard Silver VALUE + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$732 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties2 |
| Focused VALUE Silver + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$736 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties2 |
| Standard Gold VALUE | MetalGold | TypeHMO | Premium (age 40)$541 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties3 |
| Complete VALUE Gold | MetalGold | TypeHMO | Premium (age 40)$554 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties3 |
| Standard Gold | MetalGold | TypeEPO | Premium (age 40)$575 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties150 |
| Everyday Gold | MetalGold | TypeEPO | Premium (age 40)$577 | Deductible$800 | OOP max$7,250 | Primary care$35 | Specialist$55 | Generic Rx$3 | HSANo | Counties150 |
| Complete Gold | MetalGold | TypeEPO | Premium (age 40)$588 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties150 |
| Standard Gold + Vision + Adult Dental | MetalGold | TypeEPO | Premium (age 40)$596 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties150 |
| Everyday Gold + Vision + Adult Dental | MetalGold | TypeEPO | Premium (age 40)$599 | Deductible$800 | OOP max$7,250 | Primary care$35 | Specialist$55 | Generic Rx$3 | HSANo | Counties150 |
| Complete Gold + Vision + Adult Dental | MetalGold | TypeEPO | Premium (age 40)$610 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties150 |
| Standard Gold VALUE | MetalGold | TypeHMO | Premium (age 40)$610 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties5 |
| Complete VALUE Gold | MetalGold | TypeHMO | Premium (age 40)$624 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties5 |
| Standard Gold VALUE | MetalGold | TypeHMO | Premium (age 40)$645 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties2 |
| Complete VALUE Gold | MetalGold | TypeHMO | Premium (age 40)$660 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties2 |
Good to know
TDI fined Celtic $550,000 in 2025 over surprise-billing arbitration payments (Order 2025-9482) and $190,000 in 2024 after a quality-of-care exam (Order 2024-8761). Superior was fined $240,000 in 2024 (Order 2024-8760).
Other Texas Marketplace insurers
Sources
- Centene, Ambetter Texas 2026 release, November 3, 2025
- CMS rate review, Celtic and Superior 2027 filings, July 2026
- TDI Order 2025-9482 (Celtic), August 22, 2025
- CMS State-based Exchange Public Use Files, plan year 2026, checked October 4, 2026
← Texas Marketplace guide and all insurers
Reviewed by Jacob Guidi, licensed health insurance agent (NPN 19902041), Thrive Benefits Group.
Thrive Benefits Group is not HealthCare.gov or a government agency. Premiums shown are before tax credits, for one person age 40, and most people who qualify for tax credits pay less. Your price depends on your county, age, household and income. Plan details can change; the insurer's plan documents are final.