Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives)
Silver · HMO · WellPoint · Texas
At age 40 it costs between $693.62 and $851.10 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 | $3,500 | $9,950 | $25 | $10 |
| up to 150% of the federal poverty level | $50 | $1,050 | No Charge | $3 |
| 150% to 200% | $600 | $2,800 | No Charge | $3 |
| 200% to 250% | $2,800 | $7,250 | $25 | $10 |
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 | 47501TX0040010 |
|---|---|
| Insurer | WellPoint |
| Metal level | Silver |
| Plan type | HMO |
| Deductible (individual) | $3,500 |
| Deductible (family) | $7,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,950 |
| Family maximum | $19,900 |
| Primary care visit | $25 |
| Specialist visit | $80 |
| Emergency room | $500 Copay after deductible and 40% Coinsurance after deductible |
| Inpatient stay | $500 Copay per Stay after deductible and 40% Coinsurance after deductible |
| Generic drugs | $10 |
| Preferred brand drugs | $40 |
| Specialty drugs | 50% Coinsurance after deductible |
| Adult dental included | Yes |
| Child dental included | No |
| Share of premium buying essential health benefits | 98.99% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-833-476-1458 · TTY 1-711-000-0000 |
Where it is sold, and what it costs there
30 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 |
|---|---|---|---|---|---|
| Bexar County | $542.74 | $616.01 | $693.62 | $969.33 | $1,473 |
| Comal County | $542.74 | $616.01 | $693.62 | $969.33 | $1,473 |
| Guadalupe County | $542.74 | $616.01 | $693.62 | $969.33 | $1,473 |
| Medina County | $542.74 | $616.01 | $693.62 | $969.33 | $1,473 |
| Wilson County | $542.74 | $616.01 | $693.62 | $969.33 | $1,473 |
| Collin County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Dallas County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Ellis County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Hunt County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Kaufman County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Rockwall County | $562.36 | $638.28 | $718.70 | $1,004.37 | $1,526.25 |
| Jefferson County | $582.92 | $661.61 | $744.97 | $1,041.10 | $1,582.04 |
| Orange County | $582.92 | $661.61 | $744.97 | $1,041.10 | $1,582.04 |
| Montgomery County | $590.33 | $670.02 | $754.44 | $1,054.33 | $1,602.16 |
| Walker County | $590.33 | $670.02 | $754.44 | $1,054.33 | $1,602.16 |
| Caldwell County | $591.33 | $671.16 | $755.72 | $1,056.12 | $1,604.87 |
| El Paso County | $591.56 | $671.42 | $756.01 | $1,056.53 | $1,605.49 |
| Hidalgo County | $595.24 | $675.60 | $760.72 | $1,063.10 | $1,615.48 |
| Denton County | $597.28 | $677.91 | $763.32 | $1,066.74 | $1,621.02 |
| Johnson County | $597.28 | $677.91 | $763.32 | $1,066.74 | $1,621.02 |
| Tarrant County | $597.28 | $677.91 | $763.32 | $1,066.74 | $1,621.02 |
| Cameron County | $599.74 | $680.70 | $766.47 | $1,071.14 | $1,627.69 |
| Harris County | $613.69 | $696.54 | $784.30 | $1,096.05 | $1,665.55 |
| Brazoria County | $617.66 | $701.04 | $789.37 | $1,103.14 | $1,676.33 |
| Fort Bend County | $617.66 | $701.04 | $789.37 | $1,103.14 | $1,676.33 |
| Matagorda County | $617.66 | $701.04 | $789.37 | $1,103.14 | $1,676.33 |
| Crosby County | $665.96 | $755.86 | $851.10 | $1,189.40 | $1,807.42 |
| Lubbock County | $665.96 | $755.86 | $851.10 | $1,189.40 | $1,807.42 |
| Lynn County | $665.96 | $755.86 | $851.10 | $1,189.40 | $1,807.42 |
| Terry County | $665.96 | $755.86 | $851.10 | $1,189.40 | $1,807.42 |
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.