Silver Simple PCP Saver
Silver · EPO · Oscar Insurance Company · Texas
At age 40 it costs between $660.34 and $872.66 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $5,750 | $10,150 | $10 | $3 |
| up to 150% of the federal poverty level | $0 | $1,850 | $5 | No Charge |
| 150% to 200% | $600 | $3,350 | $10 | $3 |
| 200% to 250% | $4,950 | $7,950 | $10 | $3 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 20069TX0100025 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $5,750 |
| Deductible (family) | $11,500 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,150 |
| Family maximum | $20,300 |
| Primary care visit | $10 |
| Specialist visit | $70 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $100 |
| Specialty drugs | 50% Coinsurance after deductible |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-855-672-2755 |
Where it is sold, and what it costs there
47 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Milam County | $516.71 | $586.45 | $660.34 | $922.82 | $1,402.32 |
| Austin County | $563.38 | $639.43 | $719.99 | $1,006.18 | $1,528.99 |
| Brazoria County | $563.38 | $639.43 | $719.99 | $1,006.18 | $1,528.99 |
| Fort Bend County | $563.38 | $639.43 | $719.99 | $1,006.18 | $1,528.99 |
| Waller County | $563.38 | $639.43 | $719.99 | $1,006.18 | $1,528.99 |
| Hidalgo County | $567.06 | $643.60 | $724.69 | $1,012.74 | $1,538.96 |
| Atascosa County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Bandera County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Bexar County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Comal County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Gonzales County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Guadalupe County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Kendall County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| La Salle County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Medina County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| Wilson County | $570.44 | $647.44 | $729.01 | $1,018.79 | $1,548.15 |
| McMullen County | $571.46 | $648.60 | $730.31 | $1,020.61 | $1,550.91 |
| Cameron County | $573.42 | $650.82 | $732.81 | $1,024.10 | $1,556.22 |
| Kenedy County | $573.42 | $650.82 | $732.81 | $1,024.10 | $1,556.22 |
| Willacy County | $573.42 | $650.82 | $732.81 | $1,024.10 | $1,556.22 |
| El Paso County | $579 | $657.15 | $739.95 | $1,034.08 | $1,571.38 |
| Hudspeth County | $579 | $657.15 | $739.95 | $1,034.08 | $1,571.38 |
| Galveston County | $581.82 | $660.35 | $743.55 | $1,039.11 | $1,579.03 |
| Harris County | $581.82 | $660.35 | $743.55 | $1,039.11 | $1,579.03 |
| Cooke County | $593.22 | $673.29 | $758.12 | $1,059.47 | $1,609.97 |
| Collin County | $595.01 | $675.32 | $760.40 | $1,062.66 | $1,614.82 |
| Dallas County | $595.01 | $675.32 | $760.40 | $1,062.66 | $1,614.82 |
| Ellis County | $595.01 | $675.32 | $760.40 | $1,062.66 | $1,614.82 |
| Rockwall County | $595.01 | $675.32 | $760.40 | $1,062.66 | $1,614.82 |
| Jack County | $600.16 | $681.17 | $766.99 | $1,071.86 | $1,628.80 |
| Liberty County | $602.45 | $683.76 | $769.91 | $1,075.95 | $1,635.01 |
| Montgomery County | $602.45 | $683.76 | $769.91 | $1,075.95 | $1,635.01 |
| Walker County | $602.45 | $683.76 | $769.91 | $1,075.95 | $1,635.01 |
| Denton County | $645.55 | $732.69 | $825 | $1,152.94 | $1,752 |
| Parker County | $645.55 | $732.69 | $825 | $1,152.94 | $1,752 |
| Tarrant County | $645.55 | $732.69 | $825 | $1,152.94 | $1,752 |
| Wise County | $645.55 | $732.69 | $825 | $1,152.94 | $1,752 |
| Bastrop County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Blanco County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Burnet County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Caldwell County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Hays County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Lee County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Llano County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Travis County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| Williamson County | $665.49 | $755.32 | $850.48 | $1,188.54 | $1,806.11 |
| San Jacinto County | $682.84 | $775.01 | $872.66 | $1,219.53 | $1,853.20 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.