Gold Elite
Gold · EPO · Oscar Insurance Company · Texas
At age 40 it costs between $586.42 and $774.97 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 20069TX0100056 |
|---|---|
| Insurer | Oscar Insurance Company |
| Metal level | Gold |
| Plan type | EPO |
| Deductible (individual) | $1,200 |
| Deductible (family) | $2,400 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $7,800 |
| Family maximum | $15,600 |
| Primary care visit | $25 |
| Specialist visit | $50 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $75 |
| 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 | $458.86 | $520.80 | $586.42 | $819.51 | $1,245.33 |
| Austin County | $500.31 | $567.84 | $639.39 | $893.54 | $1,357.82 |
| Brazoria County | $500.31 | $567.84 | $639.39 | $893.54 | $1,357.82 |
| Fort Bend County | $500.31 | $567.84 | $639.39 | $893.54 | $1,357.82 |
| Waller County | $500.31 | $567.84 | $639.39 | $893.54 | $1,357.82 |
| Hidalgo County | $503.58 | $571.55 | $643.56 | $899.37 | $1,366.68 |
| Atascosa County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Bandera County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Bexar County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Comal County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Gonzales County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Guadalupe County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Kendall County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| La Salle County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Medina County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| Wilson County | $506.58 | $574.96 | $647.40 | $904.74 | $1,374.84 |
| McMullen County | $507.49 | $575.99 | $648.56 | $906.36 | $1,377.29 |
| Cameron County | $509.22 | $577.96 | $650.78 | $909.46 | $1,382.01 |
| Kenedy County | $509.22 | $577.96 | $650.78 | $909.46 | $1,382.01 |
| Willacy County | $509.22 | $577.96 | $650.78 | $909.46 | $1,382.01 |
| El Paso County | $514.18 | $583.59 | $657.11 | $918.31 | $1,395.47 |
| Hudspeth County | $514.18 | $583.59 | $657.11 | $918.31 | $1,395.47 |
| Galveston County | $516.69 | $586.43 | $660.31 | $922.78 | $1,402.26 |
| Harris County | $516.69 | $586.43 | $660.31 | $922.78 | $1,402.26 |
| Cooke County | $526.81 | $597.92 | $673.25 | $940.87 | $1,429.74 |
| Collin County | $528.40 | $599.72 | $675.28 | $943.70 | $1,434.05 |
| Dallas County | $528.40 | $599.72 | $675.28 | $943.70 | $1,434.05 |
| Ellis County | $528.40 | $599.72 | $675.28 | $943.70 | $1,434.05 |
| Rockwall County | $528.40 | $599.72 | $675.28 | $943.70 | $1,434.05 |
| Jack County | $532.97 | $604.91 | $681.13 | $951.87 | $1,446.46 |
| Liberty County | $535 | $607.22 | $683.72 | $955.50 | $1,451.97 |
| Montgomery County | $535 | $607.22 | $683.72 | $955.50 | $1,451.97 |
| Walker County | $535 | $607.22 | $683.72 | $955.50 | $1,451.97 |
| Denton County | $573.29 | $650.67 | $732.65 | $1,023.87 | $1,555.87 |
| Parker County | $573.29 | $650.67 | $732.65 | $1,023.87 | $1,555.87 |
| Tarrant County | $573.29 | $650.67 | $732.65 | $1,023.87 | $1,555.87 |
| Wise County | $573.29 | $650.67 | $732.65 | $1,023.87 | $1,555.87 |
| Bastrop County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Blanco County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Burnet County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Caldwell County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Hays County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Lee County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Llano County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Travis County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| Williamson County | $590.99 | $670.76 | $755.27 | $1,055.49 | $1,603.92 |
| San Jacinto County | $606.40 | $688.25 | $774.97 | $1,083.01 | $1,645.74 |
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.