Silver Simple PCP Saver

Oscar Insurance Company · 2026 plan year

Silver

Ind. deductible: $5,750
Family deductible: $11,500
Ind. OOP max: $10,150
Family OOP max: $20,300

Compare with other Silver plans in TX

Side by side: deductibles, out-of-pocket limits and copays.

CHRISTUS Value Silver 70 ($0 Virtual Urgent Care)CHRISTUS Health Plan · Deductible $5,990 · Out-of-pocket max $5,990
CHRISTUS Value Silver 70 + Dental & Vision ($0 Virtual Urgent Care)CHRISTUS Health Plan · Deductible $5,990 · Out-of-pocket max $5,990
Blue Advantage Plus Silver℠ StandardBlue Cross and Blue Shield of Texas · Deductible $6,000 · Out-of-pocket max $8,900

Compare 4 plans Browse all Silver plans in TX

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan 94% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Zero Cost Sharing Plan Variation

More Oscar Insurance Company plans in TX

Bronze Elite + PCP Saver Plus Silver Classic Bronze Classic 4700

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 15 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$395	$395
21	$517	$517
30	$586	$616
40	$660	$720
50	$923	$1,006
60	$1,402	$1,578
64 and over	$1,550	$1,744

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	$10.00

Specialist

Benefit	In-network
Specialist Visit	$70.00

Hospital

Benefit	In-network
Emergency Room Services	40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	40.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$75.00

Pharmacy

Benefit	In-network
Generic Drugs	$3.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	$100.00
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$10.00

Other

Benefit	In-network
Other Practitioner Office Visit (Nurse, Physician Assistant)	$10.00
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	40.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	$70.00
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Chemotherapy	40.00% Coinsurance after deductible
Chiropractic Care	$70.00
Cosmetic Surgery	Not covered
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	40.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	40.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	No charge
Dialysis	40.00% Coinsurance after deductible
Durable Medical Equipment	40.00% Coinsurance after deductible
Emergency Transportation/Ambulance	40.00% Coinsurance after deductible
Eye Glasses for Children	50.00%
Habilitation Services	40.00% Coinsurance after deductible
Hearing Aids	40.00% Coinsurance after deductible
Home Health Care Services	40.00% Coinsurance after deductible
Hospice Services	40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	40.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	Not covered
Nutritional Counseling	Not covered
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Outpatient Rehabilitation Services	40.00% Coinsurance after deductible
Prenatal and Postnatal Care	No charge
Private-Duty Nursing	Not covered
Prosthetic Devices	40.00% Coinsurance after deductible
Radiation	40.00% Coinsurance after deductible
Reconstructive Surgery	40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	40.00% Coinsurance after deductible
Rehabilitative Speech Therapy	40.00% Coinsurance 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	40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$10.00
Transplant	40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	40.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	40.00% Coinsurance after deductible