Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Silver · EPO · Ambetter from Superior HealthPlan · Texas
At age 40 it costs between $661.66 and $976.52 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 | 29418TX0160053 |
|---|---|
| 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 | 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 | $517.74 | $587.62 | $661.66 | $924.67 | $1,405.12 |
| Panola County | $517.74 | $587.62 | $661.66 | $924.67 | $1,405.12 |
| Rusk County | $517.74 | $587.62 | $661.66 | $924.67 | $1,405.12 |
| Andrews County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Ector County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Hardin County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Houston County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Jefferson County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Midland County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Nacogdoches County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Orange County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| San Jacinto County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Trinity County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Tyler County | $531.25 | $602.96 | $678.92 | $948.79 | $1,441.78 |
| Brooks County | $534.38 | $606.51 | $682.93 | $954.39 | $1,450.28 |
| Hidalgo County | $534.38 | $606.51 | $682.93 | $954.39 | $1,450.28 |
| Starr County | $534.38 | $606.51 | $682.93 | $954.39 | $1,450.28 |
| Webb County | $534.38 | $606.51 | $682.93 | $954.39 | $1,450.28 |
| Zapata County | $534.38 | $606.51 | $682.93 | $954.39 | $1,450.28 |
| Cherokee County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Henderson County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Rains County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Smith County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Van Zandt County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Wood County | $560.36 | $635.99 | $716.12 | $1,000.78 | $1,520.78 |
| Jack County | $569.69 | $646.59 | $728.05 | $1,017.45 | $1,546.12 |
| Montague County | $569.69 | $646.59 | $728.05 | $1,017.45 | $1,546.12 |
| Brazos County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Burleson County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Grimes County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Leon County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Madison County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Milam County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Robertson County | $578.04 | $656.07 | $738.72 | $1,032.36 | $1,568.78 |
| Austin County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Brazoria County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Colorado County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Fort Bend County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Matagorda County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Waller County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Wharton County | $586.33 | $665.48 | $749.32 | $1,047.17 | $1,591.28 |
| Bosque County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| Falls County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| Freestone County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| Hill County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| Limestone County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| McLennan County | $593.64 | $673.77 | $758.66 | $1,060.22 | $1,611.11 |
| Chambers County | $599.84 | $680.81 | $766.59 | $1,071.30 | $1,627.95 |
| Liberty County | $599.84 | $680.81 | $766.59 | $1,071.30 | $1,627.95 |
| Montgomery County | $599.84 | $680.81 | $766.59 | $1,071.30 | $1,627.95 |
| Walker County | $599.84 | $680.81 | $766.59 | $1,071.30 | $1,627.95 |
| Bell County | $601.93 | $683.18 | $769.25 | $1,075.03 | $1,633.61 |
| Hamilton County | $601.93 | $683.18 | $769.25 | $1,075.03 | $1,633.61 |
| Lampasas County | $601.93 | $683.18 | $769.25 | $1,075.03 | $1,633.61 |
| Mills County | $601.93 | $683.18 | $769.25 | $1,075.03 | $1,633.61 |
| San Saba County | $601.93 | $683.18 | $769.25 | $1,075.03 | $1,633.61 |
| Atascosa County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Bandera County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Bexar County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Comal County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Edwards County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Frio County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Gillespie County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Gonzales County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Guadalupe County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Kendall County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Kerr County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Kinney County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Maverick County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Medina County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Real County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Val Verde County | $604.02 | $685.55 | $771.92 | $1,078.76 | $1,639.28 |
| Aransas County | $608.19 | $690.29 | $777.26 | $1,086.21 | $1,650.61 |
| Nueces County | $608.19 | $690.29 | $777.26 | $1,086.21 | $1,650.61 |
| Refugio County | $608.19 | $690.29 | $777.26 | $1,086.21 | $1,650.61 |
| Armstrong County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Carson County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Castro County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Collingsworth County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Dallam County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Deaf Smith County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Donley County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Gray County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Hartley County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Oldham County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Parmer County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Potter County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Randall County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Sherman County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Wheeler County | $634.17 | $719.77 | $810.46 | $1,132.61 | $1,721.11 |
| Cameron County | $644.55 | $731.55 | $823.72 | $1,151.15 | $1,749.28 |
| Willacy County | $644.55 | $731.55 | $823.72 | $1,151.15 | $1,749.28 |
| Camp County | $645.59 | $732.74 | $825.05 | $1,153.01 | $1,752.11 |
| Delta County | $645.59 | $732.74 | $825.05 | $1,153.01 | $1,752.11 |
| Calhoun County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| De Witt County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| Goliad County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| Jackson County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| Lavaca County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| Victoria County | $647.68 | $735.10 | $827.72 | $1,156.74 | $1,757.77 |
| Galveston County | $650.81 | $738.66 | $831.72 | $1,162.33 | $1,766.27 |
| Harris County | $650.81 | $738.66 | $831.72 | $1,162.33 | $1,766.27 |
| Bastrop County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Blanco County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Burnet County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Caldwell County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Fayette County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Hays County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Lee County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Llano County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Travis County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Williamson County | $672.61 | $763.40 | $859.59 | $1,201.27 | $1,825.44 |
| Brewster County | $686.12 | $778.74 | $876.85 | $1,225.40 | $1,862.11 |
| El Paso County | $686.12 | $778.74 | $876.85 | $1,225.40 | $1,862.11 |
| Cooke County | $695.52 | $789.40 | $888.86 | $1,242.17 | $1,887.60 |
| Fannin County | $695.52 | $789.40 | $888.86 | $1,242.17 | $1,887.60 |
| Grayson County | $695.52 | $789.40 | $888.86 | $1,242.17 | $1,887.60 |
| Brown County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Coleman County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Comanche County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Fisher County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Mitchell County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Runnels County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Scurry County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Stonewall County | $736.05 | $835.40 | $940.65 | $1,314.56 | $1,997.60 |
| Denton County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Hood County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Johnson County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Palo Pinto County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Parker County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Somervell County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Tarrant County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Wise County | $748.51 | $849.55 | $956.59 | $1,336.82 | $2,031.43 |
| Coke County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Concho County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Irion County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Kimble County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Mason County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| McCulloch County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Menard County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Schleicher County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Sterling County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Sutton County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Tom Green County | $757.85 | $860.14 | $968.52 | $1,353.50 | $2,056.77 |
| Collin County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
| Dallas County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
| Ellis County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
| Hunt County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
| Navarro County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
| Rockwall County | $764.11 | $867.25 | $976.52 | $1,364.68 | $2,073.76 |
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.