UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin)
UnitedHealthcare · 2027 plan year
Silver
- Ind. deductible
- $3,800
- Family deductible
- $7,600
- Ind. OOP max
- $10,000
- Family OOP max
- $20,000
Compare with other Silver plans in TX
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More UnitedHealthcare plans in TX
UHC Sanitas 18 Bronze Standard (HSA, $0 Insulin)UHC Sanitas 18 Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, $0 Insulin)UHC Sanitas 18 Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin)UHC Sanitas 18 Bronze Value ($0 Virtual Urgent Care, HSA, $0 Insulin)UHC Sanitas 26 Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, $0 Insulin)
Monthly premiums by age
Rating Area 6 — the lowest-priced of the 24 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $491 | $491 |
| 21 | $641 | $673 |
| 30 | $728 | $801 |
| 40 | $820 | $902 |
| 50 | $1,145 | $1,374 |
| 60 | $1,740 | $2,089 |
| 64 and over | $1,924 | $2,309 |
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 | $15.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $100.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $1000.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | $375.00 Copay after deductible |
| Urgent Care Centers or Facilities | $20.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $5.00 |
| Non-Preferred Brand Drugs | 40.00% Coinsurance after deductible |
| Preferred Brand Drugs | $85.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 30.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $15.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 30.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | 30.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | 30.00% Coinsurance after deductible |
| Chemotherapy | $750.00 Copay after deductible |
| Chiropractic Care | 30.00% Coinsurance after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 30.00% Coinsurance after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Education | 30.00% Coinsurance after deductible |
| Dialysis | $500.00 Copay after deductible |
| Durable Medical Equipment | 30.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | $1000.00 Copay after deductible |
| Eye Glasses for Children | 30.00% Coinsurance after deductible |
| Habilitation Services | $50.00 Copay after deductible |
| Hearing Aids | 30.00% Coinsurance after deductible |
| Home Health Care Services | 30.00% Coinsurance after deductible |
| Hospice Services | 30.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $300.00 Copay after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | $150.00 Copay after deductible |
| Inpatient Physician and Surgical Services | 30.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | $15.00 Copay after deductible |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | 30.00% Coinsurance after deductible |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 30.00% Coinsurance after deductible |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $550.00 Copay after deductible |
| Outpatient Rehabilitation Services | $50.00 Copay after deductible |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | 30.00% Coinsurance after deductible |
| Prosthetic Devices | 30.00% Coinsurance after deductible |
| Radiation | $200.00 Copay after deductible |
| Reconstructive Surgery | $550.00 Copay after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50.00 Copay after deductible |
| Rehabilitative Speech Therapy | $50.00 Copay after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $15.00 |
| Transplant | 30.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 30.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $35.00 Copay after deductible |
Plan rules
Service area
This plan covers 213 geographic areas.
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