Complete VALUE Gold
Gold · HMO · Ambetter from Superior HealthPlan · Texas
At age 40 it costs between $553.54 and $635.57 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 | 87226TX0100013 |
|---|---|
| Insurer | Ambetter from Superior HealthPlan |
| Metal level | Gold |
| Plan type | HMO |
| Deductible (individual) | $1,450 |
| Deductible (family) | $2,900 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $7,500 |
| Family maximum | $15,000 |
| Primary care visit | $15 |
| Specialist visit | $35 |
| Emergency room | 20% Coinsurance after deductible |
| Inpatient stay | 20% Coinsurance after deductible |
| Generic drugs | $3 |
| Preferred brand drugs | $30 |
| Specialty drugs | 30% 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 | 1-877-687-1196 · TTY 1-800-735-2989 |
Where it is sold, and what it costs there
3 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 |
|---|---|---|---|---|---|
| Harris County | $433.14 | $491.60 | $553.54 | $773.56 | $1,175.51 |
| Fort Bend County | $487.41 | $553.20 | $622.90 | $870.50 | $1,322.81 |
| Montgomery County | $497.33 | $564.46 | $635.57 | $888.21 | $1,349.73 |
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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When this plan’s price or benefits change.
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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.