Texas · Insurer
Oscar Marketplace Plans in Texas
Oscar sold Marketplace plans to about 528,000 Texans in 47 counties in 2026, with EPO plans statewide in that footprint and Guided Care HMO in 14 metro counties. Its filed 2027 increase is about 9.6%.
- Member experience not rated by CMS; EPO rating shown.
- 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.
47 of 254Texas counties (2026)
EPO / HMOPlan type
2 of 5CMS quality rating (2026)
+9.6%Proposed 2027 change
What makes Oscar different
Texas lineup includes Simple Diabetes, Breathe Easy COPD, Chronic Care CKM and Women's Health with Menopause Benefits alongside standard metals.
EPO plans in 47 counties generally skip referrals. Guided Care HMO in 14 metros needs a PCP referral for most specialists.
Oscar has partnered with HCA systems in Austin, Dallas–Fort Worth, Houston and El Paso since the 2022 plan year.
The 9.6% proposed average sits under the roughly 13%–14% statewide tracker averages for Texas.
Is Oscar a good fit?
A good fit if
- You want a plan built around diabetes, COPD or another listed condition
- Your doctors are in an HCA system Oscar covers
- You prefer an EPO without specialist referrals
Think twice if
- Guided Care HMO needs referrals for most specialists (OB/GYN and mental health are exceptions).
- CMS rates Oscar's Texas EPO 2 of 5 overall; Guided Care HMO has no separate rating.
- TDI's 2025 order found late denials and missing peer-to-peer reviews on sampled cases.
Good starting points
From its 100 2026 plans statewide, lowest price in any Texas rating area.Bronze Simple Breathe Easy with Enhanced COPD Benefits$414/monthLowest monthly premium
Bronze Elite + PCP Saver Plus$452/monthLowest deductible, $0
Gold Simple Diabetes Guided Care$574/month$0 primary care visits before the deductible
Bronze Simple Diabetes$434/monthDesigned for a specific health need
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.
Oscar plans and prices
All 2026 Oscar plans in Texas
| Plan | Metal | Type | Premium (age 40) | Deductible | OOP max | Primary care | Specialist | Generic Rx | HSA | Counties |
|---|---|---|---|---|---|---|---|---|---|---|
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | MetalBronze | TypeEPO | Premium (age 40)$414 | Deductible$9,000 | OOP max$10,600 | Primary care40% after deductible | Specialist40% after deductible | Generic Rx$3 | HSANo | Counties47 |
| Bronze Classic Standard | MetalBronze | TypeEPO | Premium (age 40)$428 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties47 |
| Bronze Classic 4700 | MetalBronze | TypeEPO | Premium (age 40)$433 | Deductible$4,700 | OOP max$9,800 | Primary care$70 | Specialist$125 | Generic Rx$3 | HSANo | Counties47 |
| Bronze Simple Diabetes | MetalBronze | TypeEPO | Premium (age 40)$434 | Deductible$5,500 | OOP max$10,150 | Primary care$50 | Specialist$150 | Generic Rx$3 | HSANo | Counties47 |
| Bronze Simple Chronic Care CKM | MetalBronze | TypeEPO | Premium (age 40)$442 | Deductible$5,500 | OOP max$10,150 | Primary care$50 | Specialist$150 | Generic Rx$3 | HSANo | Counties47 |
| Bronze Elite + PCP Saver Plus | MetalBronze | TypeEPO | Premium (age 40)$452 | Deductible$0 | OOP max$10,150 | Primary care$40 | Specialist$130 | Generic Rx$3 | HSANo | Counties47 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$647 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$651 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$652 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties3 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$655 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$659 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$659 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$660 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple PCP Saver | MetalSilver | TypeEPO | Premium (age 40)$660 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties47 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$662 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$664 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$665 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties3 |
| Silver Classic Standard | MetalSilver | TypeEPO | Premium (age 40)$665 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties47 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$666 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$668 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$670 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$672 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$673 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties1 |
| Silver Classic | MetalSilver | TypeEPO | Premium (age 40)$674 | Deductible$5,500 | OOP max$8,900 | Primary care$35 | Specialist$60 | Generic Rx$3 | HSANo | Counties47 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$675 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$675 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties3 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$675 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$680 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties3 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$684 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties1 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$689 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$693 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties2 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$694 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$700 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$701 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$702 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$706 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$706 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties2 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$707 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$707 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$708 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$708 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$709 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties2 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$709 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$713 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$713 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$715 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties1 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$718 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties2 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$719 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties1 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$723 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties2 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$724 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$725 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties1 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$727 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$730 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties1 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$732 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple Guided Care | MetalSilver | TypeHMO | Premium (age 40)$732 | Deductible$6,300 | OOP max$9,300 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties3 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$732 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties2 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$734 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties2 |
| Silver Simple Diabetes Guided Care | MetalSilver | TypeHMO | Premium (age 40)$740 | Deductible$6,500 | OOP max$10,000 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$744 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties2 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$746 | Deductible$6,200 | OOP max$9,600 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Simple Chronic Care CKM Guided Care | MetalSilver | TypeHMO | Premium (age 40)$746 | Deductible$5,900 | OOP max$10,150 | Primary care$0 | Specialist$35 | Generic Rx$3 | HSANo | Counties3 |
| Silver Simple Women's Health with Menopause Benefits Guided Care | MetalSilver | TypeHMO | Premium (age 40)$748 | Deductible$6,000 | OOP max$10,150 | Primary care$0 | Specialist$40 | Generic Rx$0 | HSANo | Counties3 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$749 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties2 |
| Silver Classic Standard Guided Care | MetalSilver | TypeHMO | Premium (age 40)$758 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties3 |
| Silver Simple PCP Saver Guided Care | MetalSilver | TypeHMO | Premium (age 40)$764 | Deductible$5,750 | OOP max$10,150 | Primary care$10 | Specialist$70 | Generic Rx$3 | HSANo | Counties3 |
| Gold Classic Standard | MetalGold | TypeEPO | Premium (age 40)$566 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties47 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$568 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$571 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties1 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$573 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties3 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$574 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic | MetalGold | TypeEPO | Premium (age 40)$575 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties47 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$576 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties3 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$578 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties3 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$579 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$580 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$582 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties1 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$585 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties3 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$585 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Elite | MetalGold | TypeEPO | Premium (age 40)$586 | Deductible$1,200 | OOP max$7,800 | Primary care$25 | Specialist$50 | Generic Rx$3 | HSANo | Counties47 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$591 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$608 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties2 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$609 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$611 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties2 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$612 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties1 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$614 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties2 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$614 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties1 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$615 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$617 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties1 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$620 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$620 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties2 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$621 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$627 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties1 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$631 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties2 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$634 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties2 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$637 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties2 |
| Gold Simple Guided Care | MetalGold | TypeHMO | Premium (age 40)$643 | Deductible$3,300 | OOP max$9,950 | Primary care$5 | Specialist$10 | Generic Rx$3 | HSANo | Counties3 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$644 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties2 |
| Gold Classic Standard Guided Care | MetalGold | TypeHMO | Premium (age 40)$647 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties3 |
| Gold Simple Diabetes Guided Care | MetalGold | TypeHMO | Premium (age 40)$649 | Deductible$2,000 | OOP max$9,800 | Primary care$0 | Specialist$40 | Generic Rx$3 | HSANo | Counties3 |
| Gold Classic Guided Care | MetalGold | TypeHMO | Premium (age 40)$656 | Deductible$2,500 | OOP max$8,000 | Primary care$25 | Specialist$40 | Generic Rx$3 | HSANo | Counties3 |
Good to know
TDI Order 2025-9465 (Aug 11, 2025): Oscar agreed to a $225,000 penalty after a quality-of-care exam of its EPO line, including late adverse determinations and missing peer-to-peer offers on sampled denials.
Other Texas Marketplace insurers
Sources
- Oscar 2027 Texas rate justification, July 21, 2026
- TDI Order 2025-9465, August 11, 2025
- CMS Marketplace Quality Rating System, PY2026, October 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.