BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay)
Silver · HMO · Baylor Scott and White Health Plan · Texas
At age 40 it costs between $563.29 and $1,043.59 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 | $6,000 | $8,900 | $40 | $20 |
| up to 150% of the federal poverty level | $0 | $2,200 | No Charge | No Charge |
| 150% to 200% | $700 | $3,300 | $20 | $10 |
| 200% to 250% | $3,000 | $7,400 | $40 | $20 |
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 | 40788TX0460003 |
|---|---|
| Insurer | Baylor Scott and White Health Plan |
| Metal level | Silver |
| Plan type | HMO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $6,000 |
| Deductible (family) | $12,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,900 |
| Family maximum | $17,800 |
| Primary care visit | $40 |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $20 |
| Preferred brand drugs | $40 |
| Specialty drugs | $350 Copay 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 | 1-844-633-5325 · TTY 1-800-735-2989 |
Where it is sold, and what it costs there
104 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 |
|---|---|---|---|---|---|
| Cottle County | $440.76 | $500.26 | $563.29 | $787.19 | $1,196.21 |
| Knox County | $440.76 | $500.26 | $563.29 | $787.19 | $1,196.21 |
| Bexar County | $537.36 | $609.90 | $686.75 | $959.72 | $1,458.39 |
| Burnet County | $547.22 | $621.09 | $699.34 | $977.33 | $1,485.15 |
| Llano County | $547.22 | $621.09 | $699.34 | $977.33 | $1,485.15 |
| Travis County | $547.22 | $621.09 | $699.34 | $977.33 | $1,485.15 |
| Williamson County | $547.22 | $621.09 | $699.34 | $977.33 | $1,485.15 |
| Collin County | $552.96 | $627.61 | $706.69 | $987.59 | $1,500.74 |
| Dallas County | $552.96 | $627.61 | $706.69 | $987.59 | $1,500.74 |
| Ellis County | $552.96 | $627.61 | $706.69 | $987.59 | $1,500.74 |
| Navarro County | $552.96 | $627.61 | $706.69 | $987.59 | $1,500.74 |
| Rockwall County | $552.96 | $627.61 | $706.69 | $987.59 | $1,500.74 |
| Somervell County | $583.09 | $661.81 | $745.19 | $1,041.40 | $1,582.50 |
| Bosque County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| Falls County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| Freestone County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| Hill County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| Limestone County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| McLennan County | $594.52 | $674.78 | $759.80 | $1,061.82 | $1,613.54 |
| Andrews County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Borden County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Crane County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Dawson County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Ector County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Gaines County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Glasscock County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Howard County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Loving County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Martin County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Midland County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Pecos County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Reeves County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Upton County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Ward County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Winkler County | $601.78 | $683.02 | $769.07 | $1,074.77 | $1,633.22 |
| Crosby County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Dickens County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Floyd County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Garza County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Hale County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Hockley County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| King County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Lamb County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Lubbock County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Lynn County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Motley County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Terry County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Yoakum County | $609.61 | $691.91 | $779.08 | $1,088.76 | $1,654.48 |
| Bell County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| Coryell County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| Hamilton County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| Lampasas County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| Mills County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| San Saba County | $609.96 | $692.30 | $779.53 | $1,089.39 | $1,655.43 |
| Brazos County | $619.76 | $703.43 | $792.05 | $1,106.89 | $1,682.03 |
| Milam County | $619.76 | $703.43 | $792.05 | $1,106.89 | $1,682.03 |
| Washington County | $619.76 | $703.43 | $792.05 | $1,106.89 | $1,682.03 |
| Brewster County | $621.69 | $705.61 | $794.52 | $1,110.33 | $1,687.26 |
| Coke County | $761.99 | $864.86 | $973.83 | $1,360.92 | $2,068.05 |
| McCulloch County | $761.99 | $864.86 | $973.83 | $1,360.92 | $2,068.05 |
| Reagan County | $761.99 | $864.86 | $973.83 | $1,360.92 | $2,068.05 |
| Callahan County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Coleman County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Comanche County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Eastland County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Fisher County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Haskell County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Jones County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Kent County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Mitchell County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Nolan County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Runnels County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Scurry County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Shackelford County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Stephens County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Stonewall County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Taylor County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Throckmorton County | $786.30 | $892.45 | $1,004.89 | $1,404.33 | $2,134.02 |
| Armstrong County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Briscoe County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Carson County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Castro County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Childress County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Collingsworth County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Dallam County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Deaf Smith County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Donley County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Gray County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Hall County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Hansford County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Hartley County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Hemphill County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Hutchinson County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Lipscomb County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Moore County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Ochiltree County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Oldham County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Parmer County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Potter County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Randall County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Roberts County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Sherman County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Swisher County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
| Wheeler County | $816.58 | $926.82 | $1,043.59 | $1,458.41 | $2,216.19 |
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.