Enhanced Diabetes Care Silver with $0 Drug Options
Silver · EPO · Ambetter from Superior HealthPlan · Texas
At age 40 it costs between $637.68 and $941.14 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 | $5,000 | $8,650 | $30 | $3 |
| up to 150% of the federal poverty level | $0 | $1,400 | $5 | $3 |
| 150% to 200% | $750 | $3,350 | $10 | $3 |
| 200% to 250% | $4,000 | $8,000 | $25 | $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 | 29418TX0140049 |
|---|---|
| Insurer | Ambetter from Superior HealthPlan |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $5,000 |
| Deductible (family) | $10,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,650 |
| Family maximum | $17,300 |
| Primary care visit | $30 |
| Specialist visit | $50 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $60 |
| 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 | 1-877-687-1196 · TTY 1-800-735-2989 |
Where it is sold, and what it costs there
150 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 |
|---|---|---|---|---|---|
| Gregg County | $498.98 | $566.33 | $637.68 | $891.16 | $1,354.21 |
| Panola County | $498.98 | $566.33 | $637.68 | $891.16 | $1,354.21 |
| Rusk County | $498.98 | $566.33 | $637.68 | $891.16 | $1,354.21 |
| Andrews County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Ector County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Hardin County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Houston County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Jefferson County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Midland County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Nacogdoches County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Orange County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| San Jacinto County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Trinity County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Tyler County | $512 | $581.11 | $654.33 | $914.42 | $1,389.54 |
| Brooks County | $515.02 | $584.54 | $658.18 | $919.81 | $1,397.73 |
| Hidalgo County | $515.02 | $584.54 | $658.18 | $919.81 | $1,397.73 |
| Starr County | $515.02 | $584.54 | $658.18 | $919.81 | $1,397.73 |
| Webb County | $515.02 | $584.54 | $658.18 | $919.81 | $1,397.73 |
| Zapata County | $515.02 | $584.54 | $658.18 | $919.81 | $1,397.73 |
| Cherokee County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Henderson County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Rains County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Smith County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Van Zandt County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Wood County | $540.05 | $612.95 | $690.18 | $964.52 | $1,465.68 |
| Jack County | $549.05 | $623.16 | $701.67 | $980.59 | $1,490.10 |
| Montague County | $549.05 | $623.16 | $701.67 | $980.59 | $1,490.10 |
| Brazos County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Burleson County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Grimes County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Leon County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Madison County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Milam County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Robertson County | $557.10 | $632.30 | $711.96 | $994.96 | $1,511.94 |
| Austin County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Brazoria County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Colorado County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Fort Bend County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Matagorda County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Waller County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Wharton County | $565.09 | $641.37 | $722.17 | $1,009.23 | $1,533.63 |
| Bosque County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| Falls County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| Freestone County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| Hill County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| Limestone County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| McLennan County | $572.13 | $649.36 | $731.17 | $1,021.81 | $1,552.73 |
| Chambers County | $578.11 | $656.14 | $738.81 | $1,032.49 | $1,568.96 |
| Liberty County | $578.11 | $656.14 | $738.81 | $1,032.49 | $1,568.96 |
| Montgomery County | $578.11 | $656.14 | $738.81 | $1,032.49 | $1,568.96 |
| Walker County | $578.11 | $656.14 | $738.81 | $1,032.49 | $1,568.96 |
| Bell County | $580.12 | $658.43 | $741.38 | $1,036.08 | $1,574.42 |
| Hamilton County | $580.12 | $658.43 | $741.38 | $1,036.08 | $1,574.42 |
| Lampasas County | $580.12 | $658.43 | $741.38 | $1,036.08 | $1,574.42 |
| Mills County | $580.12 | $658.43 | $741.38 | $1,036.08 | $1,574.42 |
| San Saba County | $580.12 | $658.43 | $741.38 | $1,036.08 | $1,574.42 |
| Atascosa County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Bandera County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Bexar County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Comal County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Edwards County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Frio County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Gillespie County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Gonzales County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Guadalupe County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Kendall County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Kerr County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Kinney County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Maverick County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Medina County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Real County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Val Verde County | $582.13 | $660.71 | $743.95 | $1,039.67 | $1,579.88 |
| Aransas County | $586.16 | $665.28 | $749.10 | $1,046.86 | $1,590.80 |
| Nueces County | $586.16 | $665.28 | $749.10 | $1,046.86 | $1,590.80 |
| Refugio County | $586.16 | $665.28 | $749.10 | $1,046.86 | $1,590.80 |
| Armstrong County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Carson County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Castro County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Collingsworth County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Dallam County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Deaf Smith County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Donley County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Gray County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Hartley County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Oldham County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Parmer County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Potter County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Randall County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Sherman County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Wheeler County | $611.19 | $693.69 | $781.09 | $1,091.57 | $1,658.75 |
| Cameron County | $621.19 | $705.04 | $793.87 | $1,109.44 | $1,685.90 |
| Willacy County | $621.19 | $705.04 | $793.87 | $1,109.44 | $1,685.90 |
| Camp County | $622.20 | $706.19 | $795.16 | $1,111.23 | $1,688.63 |
| Delta County | $622.20 | $706.19 | $795.16 | $1,111.23 | $1,688.63 |
| Calhoun County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| De Witt County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| Goliad County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| Jackson County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| Lavaca County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| Victoria County | $624.21 | $708.47 | $797.73 | $1,114.83 | $1,694.09 |
| Galveston County | $627.23 | $711.89 | $801.59 | $1,120.22 | $1,702.28 |
| Harris County | $627.23 | $711.89 | $801.59 | $1,120.22 | $1,702.28 |
| Bastrop County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Blanco County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Burnet County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Caldwell County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Fayette County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Hays County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Lee County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Llano County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Travis County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Williamson County | $648.24 | $735.74 | $828.44 | $1,157.74 | $1,759.30 |
| Brewster County | $661.26 | $750.52 | $845.08 | $1,181 | $1,794.64 |
| El Paso County | $661.26 | $750.52 | $845.08 | $1,181 | $1,794.64 |
| Cooke County | $670.32 | $760.80 | $856.65 | $1,197.17 | $1,819.21 |
| Fannin County | $670.32 | $760.80 | $856.65 | $1,197.17 | $1,819.21 |
| Grayson County | $670.32 | $760.80 | $856.65 | $1,197.17 | $1,819.21 |
| Brown County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Coleman County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Comanche County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Fisher County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Mitchell County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Runnels County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Scurry County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Stonewall County | $709.38 | $805.13 | $906.57 | $1,266.93 | $1,925.22 |
| Denton County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Hood County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Johnson County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Palo Pinto County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Parker County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Somervell County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Tarrant County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Wise County | $721.39 | $818.77 | $921.93 | $1,288.39 | $1,957.83 |
| Coke County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Concho County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Irion County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Kimble County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Mason County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| McCulloch County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Menard County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Schleicher County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Sterling County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Sutton County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Tom Green County | $730.39 | $828.98 | $933.42 | $1,304.46 | $1,982.25 |
| Collin County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
| Dallas County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
| Ellis County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
| Hunt County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
| Navarro County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
| Rockwall County | $736.42 | $835.83 | $941.14 | $1,315.23 | $1,998.63 |
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.