Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist
Sendero Health Plans, Local Nonprofit · 2026 plan year
Expanded BronzeHSA eligible
- Ind. deductible
- $7,500
- Family deductible
- $15,000
- Ind. OOP max
- $10,000
- Family OOP max
- $20,000
Compare with other Expanded Bronze plans in TX
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Sendero Health Plans, Local Nonprofit plans in TX
Monthly premiums by age
Rating Area 3
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $259 | $259 |
| 21 | $339 | $355 |
| 30 | $384 | $440 |
| 40 | $433 | $543 |
| 50 | $605 | $823 |
| 60 | $919 | $1,349 |
| 64 and over | $1,016 | $1,523 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $100.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 50.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 50.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 50.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $75.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $25.00 |
| Non-Preferred Brand Drugs | $100.00 Copay after deductible |
| Off Label Prescription Drugs | No Charge after deductible |
| Preferred Brand Drugs | $50.00 Copay after deductible |
| Prescription Drugs Other | No Charge after deductible |
| Specialty Drugs | $500.00 Copay after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental Health Other | No Charge after deductible |
| Mental/Behavioral Health Inpatient Services | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $50.00 |
Other
| Benefit | In-network |
|---|---|
| Allergy Testing | No Charge after deductible |
| Autism Spectrum Disorders | No Charge after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | No Charge after deductible |
| Accidental Dental | No Charge after deductible |
| Acupuncture | Not covered |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Brain Injury | No Charge after deductible |
| Cardiovascular Disease | No Charge after deductible |
| Chemotherapy | No Charge after deductible |
| Chiropractic Care | No Charge after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | No Charge after deductible |
| Dental Check-Up for Children | No Charge after deductible |
| Diabetes Care Management | No Charge after deductible |
| Diabetes Education | No Charge after deductible |
| Dialysis | No Charge after deductible |
| Durable Medical Equipment | No Charge after deductible |
| Emergency Transportation/Ambulance | 50.00% Coinsurance after deductible |
| Eye Glasses for Children | No Charge after deductible |
| Habilitation Services | $50.00 |
| Hearing Aids | No Charge after deductible |
| Home Health Care Services | No charge |
| Hospice Services | No Charge after deductible |
| Imaging (CT/PET Scans, MRIs) | 50.00% Coinsurance after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | No Charge after deductible |
| Inherited Metabolic Disorder - PKU | No Charge after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | 50.00% Coinsurance after deductible |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | No Charge after deductible |
| Mammography | $250.00 Copay after deductible |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | No Charge after deductible |
| Osteoporosis | No Charge after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 50.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | No Charge after deductible |
| Pediatric Services Other | No Charge after deductible |
| Post-Mastectomy Care | No Charge after deductible |
| Prenatal and Postnatal Care | No Charge after deductible |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | No Charge after deductible |
| Radiation | No Charge after deductible |
| Reconstructive Surgery | 20.00% |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50.00 |
| Rehabilitative Speech Therapy | $50.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No Charge after deductible |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 50.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 50.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $50.00 |
| Transplant | 20.00% |
| Transplant Donor Coverage | No Charge after deductible |
| Treatment for Temporomandibular Joint Disorders | No Charge after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 50.00% Coinsurance after deductible |
Plan rules
Service area
This plan covers 8 geographic areas.
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