QHP Index

Gold Classic Standard Guided Care

Gold · HMO · Oscar Insurance Company · Texas

At age 40 it costs $582.45 a month before any subsidy.

What CMS publishes about it

Plan ID20069TX0510036
InsurerOscar Insurance Company
Metal levelGold
Plan typeHMO
Standardised designDesign 1 — a plan CMS defined the benefits of, so it can be compared like for like
Deductible (individual)$2,000
Deductible (family)$4,000
Drug deductibleIncluded in the medical deductible
Most you could pay in a year$8,200
Family maximum$16,400
Primary care visit$30
Specialist visit$60
Emergency room25% Coinsurance after deductible
Inpatient stay25% Coinsurance after deductible
Generic drugs$15
Preferred brand drugs$30
Specialty drugs$250
Adult dental includedNo
Child dental includedNo
Share of premium buying essential health benefits100.00%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-855-672-2755

Where it is sold, and what it costs there

1 county. The premium is the price before any tax credit; what you pay depends on your income.

CountyAt 21At 30At 40At 50At 60
El Paso County $455.76$517.27 $582.45$813.96 $1,236.90

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.