Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
Silver · HMO · WellPoint · Texas
At age 40 it costs between $686.61 and $842.50 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 | 47501TX0040012 |
|---|---|
| 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 | 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 | 1-833-476-1458 · 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 | $537.25 | $609.78 | $686.61 | $959.53 | $1,458.10 |
| Comal County | $537.25 | $609.78 | $686.61 | $959.53 | $1,458.10 |
| Guadalupe County | $537.25 | $609.78 | $686.61 | $959.53 | $1,458.10 |
| Medina County | $537.25 | $609.78 | $686.61 | $959.53 | $1,458.10 |
| Wilson County | $537.25 | $609.78 | $686.61 | $959.53 | $1,458.10 |
| Collin County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Dallas County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Ellis County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Hunt County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Kaufman County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Rockwall County | $556.68 | $631.83 | $711.44 | $994.23 | $1,510.83 |
| Jefferson County | $577.02 | $654.92 | $737.43 | $1,030.56 | $1,566.03 |
| Orange County | $577.02 | $654.92 | $737.43 | $1,030.56 | $1,566.03 |
| Montgomery County | $584.37 | $663.26 | $746.82 | $1,043.68 | $1,585.98 |
| Walker County | $584.37 | $663.26 | $746.82 | $1,043.68 | $1,585.98 |
| Caldwell County | $585.35 | $664.37 | $748.08 | $1,045.44 | $1,588.64 |
| El Paso County | $585.58 | $664.63 | $748.37 | $1,045.85 | $1,589.26 |
| Hidalgo County | $589.22 | $668.76 | $753.02 | $1,052.35 | $1,599.14 |
| Denton County | $591.25 | $671.07 | $755.62 | $1,055.97 | $1,604.65 |
| Johnson County | $591.25 | $671.07 | $755.62 | $1,055.97 | $1,604.65 |
| Tarrant County | $591.25 | $671.07 | $755.62 | $1,055.97 | $1,604.65 |
| Cameron County | $593.67 | $673.82 | $758.71 | $1,060.29 | $1,611.22 |
| Harris County | $607.49 | $689.50 | $776.37 | $1,084.98 | $1,648.73 |
| Brazoria County | $611.42 | $693.96 | $781.39 | $1,092 | $1,659.39 |
| Fort Bend County | $611.42 | $693.96 | $781.39 | $1,092 | $1,659.39 |
| Matagorda County | $611.42 | $693.96 | $781.39 | $1,092 | $1,659.39 |
| Crosby County | $659.23 | $748.23 | $842.50 | $1,177.38 | $1,789.15 |
| Lubbock County | $659.23 | $748.23 | $842.50 | $1,177.38 | $1,789.15 |
| Lynn County | $659.23 | $748.23 | $842.50 | $1,177.38 | $1,789.15 |
| Terry County | $659.23 | $748.23 | $842.50 | $1,177.38 | $1,789.15 |
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.