Standard Gold + Vision + Adult Dental
Gold · EPO · Ambetter from Superior HealthPlan · Texas
At age 40 it costs between $596.03 and $879.67 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 | 29418TX0160052 |
|---|---|
| Insurer | Ambetter from Superior HealthPlan |
| Metal level | Gold |
| Plan type | EPO |
| Standardised design | Design 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 deductible | Included 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 room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| Adult dental included | Yes |
| Child dental included | No |
| Share of premium buying essential health benefits | 96.27% |
| 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 | $466.39 | $529.34 | $596.03 | $832.96 | $1,265.76 |
| Panola County | $466.39 | $529.34 | $596.03 | $832.96 | $1,265.76 |
| Rusk County | $466.39 | $529.34 | $596.03 | $832.96 | $1,265.76 |
| Andrews County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Ector County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Hardin County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Houston County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Jefferson County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Midland County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Nacogdoches County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Orange County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| San Jacinto County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Trinity County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Tyler County | $478.56 | $543.16 | $611.59 | $854.69 | $1,298.79 |
| Brooks County | $481.38 | $546.36 | $615.19 | $859.73 | $1,306.44 |
| Hidalgo County | $481.38 | $546.36 | $615.19 | $859.73 | $1,306.44 |
| Starr County | $481.38 | $546.36 | $615.19 | $859.73 | $1,306.44 |
| Webb County | $481.38 | $546.36 | $615.19 | $859.73 | $1,306.44 |
| Zapata County | $481.38 | $546.36 | $615.19 | $859.73 | $1,306.44 |
| Cherokee County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Henderson County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Rains County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Smith County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Van Zandt County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Wood County | $504.78 | $572.92 | $645.10 | $901.52 | $1,369.95 |
| Jack County | $513.19 | $582.46 | $655.84 | $916.54 | $1,392.77 |
| Montague County | $513.19 | $582.46 | $655.84 | $916.54 | $1,392.77 |
| Brazos County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Burleson County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Grimes County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Leon County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Madison County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Milam County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Robertson County | $520.71 | $591 | $665.46 | $929.97 | $1,413.19 |
| Austin County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Brazoria County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Colorado County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Fort Bend County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Matagorda County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Waller County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Wharton County | $528.18 | $599.47 | $675 | $943.31 | $1,433.46 |
| Bosque County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| Falls County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| Freestone County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| Hill County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| Limestone County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| McLennan County | $534.76 | $606.94 | $683.41 | $955.07 | $1,451.32 |
| Chambers County | $540.35 | $613.29 | $690.56 | $965.05 | $1,466.49 |
| Liberty County | $540.35 | $613.29 | $690.56 | $965.05 | $1,466.49 |
| Montgomery County | $540.35 | $613.29 | $690.56 | $965.05 | $1,466.49 |
| Walker County | $540.35 | $613.29 | $690.56 | $965.05 | $1,466.49 |
| Bell County | $542.23 | $615.42 | $692.96 | $968.41 | $1,471.59 |
| Hamilton County | $542.23 | $615.42 | $692.96 | $968.41 | $1,471.59 |
| Lampasas County | $542.23 | $615.42 | $692.96 | $968.41 | $1,471.59 |
| Mills County | $542.23 | $615.42 | $692.96 | $968.41 | $1,471.59 |
| San Saba County | $542.23 | $615.42 | $692.96 | $968.41 | $1,471.59 |
| Atascosa County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Bandera County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Bexar County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Comal County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Edwards County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Frio County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Gillespie County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Gonzales County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Guadalupe County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Kendall County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Kerr County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Kinney County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Maverick County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Medina County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Real County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Val Verde County | $544.11 | $617.56 | $695.36 | $971.77 | $1,476.69 |
| Aransas County | $547.87 | $621.82 | $700.17 | $978.48 | $1,486.90 |
| Nueces County | $547.87 | $621.82 | $700.17 | $978.48 | $1,486.90 |
| Refugio County | $547.87 | $621.82 | $700.17 | $978.48 | $1,486.90 |
| Armstrong County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Carson County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Castro County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Collingsworth County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Dallam County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Deaf Smith County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Donley County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Gray County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Hartley County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Oldham County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Parmer County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Potter County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Randall County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Sherman County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Wheeler County | $571.27 | $648.38 | $730.07 | $1,020.28 | $1,550.41 |
| Cameron County | $580.62 | $659 | $742.02 | $1,036.97 | $1,575.78 |
| Willacy County | $580.62 | $659 | $742.02 | $1,036.97 | $1,575.78 |
| Camp County | $581.56 | $660.06 | $743.22 | $1,038.65 | $1,578.33 |
| Delta County | $581.56 | $660.06 | $743.22 | $1,038.65 | $1,578.33 |
| Calhoun County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| De Witt County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| Goliad County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| Jackson County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| Lavaca County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| Victoria County | $583.44 | $662.20 | $745.63 | $1,042.01 | $1,583.44 |
| Galveston County | $586.26 | $665.40 | $749.23 | $1,047.05 | $1,591.09 |
| Harris County | $586.26 | $665.40 | $749.23 | $1,047.05 | $1,591.09 |
| Bastrop County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Blanco County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Burnet County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Caldwell County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Fayette County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Hays County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Lee County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Llano County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Travis County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Williamson County | $605.90 | $687.69 | $774.33 | $1,082.12 | $1,644.39 |
| Brewster County | $618.07 | $701.50 | $789.88 | $1,103.86 | $1,677.42 |
| El Paso County | $618.07 | $701.50 | $789.88 | $1,103.86 | $1,677.42 |
| Cooke County | $626.53 | $711.11 | $800.70 | $1,118.97 | $1,700.39 |
| Fannin County | $626.53 | $711.11 | $800.70 | $1,118.97 | $1,700.39 |
| Grayson County | $626.53 | $711.11 | $800.70 | $1,118.97 | $1,700.39 |
| Brown County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Coleman County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Comanche County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Fisher County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Mitchell County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Runnels County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Scurry County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Stonewall County | $663.04 | $752.54 | $847.36 | $1,184.18 | $1,799.48 |
| Denton County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Hood County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Johnson County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Palo Pinto County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Parker County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Somervell County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Tarrant County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Wise County | $674.27 | $765.29 | $861.71 | $1,204.24 | $1,829.95 |
| Coke County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Concho County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Irion County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Kimble County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Mason County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| McCulloch County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Menard County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Schleicher County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Sterling County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Sutton County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Tom Green County | $682.68 | $774.84 | $872.46 | $1,219.26 | $1,852.78 |
| Collin County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
| Dallas County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
| Ellis County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
| Hunt County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
| Navarro County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
| Rockwall County | $688.33 | $781.24 | $879.67 | $1,229.33 | $1,868.09 |
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.