Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.
Gold Elite Saver Plus Guided Care
Oscar Insurance Company · 2027 plan year
Gold
- Ind. medical deductible
- $0
- Rx deductible (separate)
- $2,750
- Family deductible
- $0
- Ind. OOP max
- $11,750
- Family OOP max
- $23,500
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Other cost-sharing reduction variants for this plan:
More Oscar Insurance Company plans in TX
Monthly premiums by age
Rating Area 25
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $409 | $409 |
| 21 | $535 | $535 |
| 30 | $607 | $637 |
| 40 | $684 | $745 |
| 50 | $955 | $1,041 |
| 60 | $1,452 | $1,633 |
| 64 and over | $1,605 | $1,805 |
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 | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 35.00% |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35.00% |
| Outpatient Surgery Physician/Surgical Services | 35.00% |
| Urgent Care Centers or Facilities | $25.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $4.00 |
| Non-Preferred Brand Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | 50.00% |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 35.00% |
| Mental/Behavioral Health Outpatient Services | $20.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 35.00% |
| Acupuncture | Not covered |
| Allergy Testing | $50.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | 35.00% |
| Chiropractic Care | $20.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 35.00% |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | No charge |
| Dialysis | 35.00% |
| Durable Medical Equipment | 35.00% |
| Emergency Transportation/Ambulance | 35.00% |
| Eye Glasses for Children | No charge |
| Habilitation Services | 35.00% |
| Hearing Aids | 35.00% |
| Home Health Care Services | 35.00% |
| Hospice Services | 35.00% |
| Imaging (CT/PET Scans, MRIs) | 35.00% |
| Infertility Treatment | Not covered |
| Infusion Therapy | 35.00% |
| Inpatient Physician and Surgical Services | 35.00% |
| Laboratory Outpatient and Professional Services | $25.00 |
| 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 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 35.00% |
| Outpatient Rehabilitation Services | 35.00% |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 35.00% |
| Radiation | 35.00% |
| Reconstructive Surgery | 35.00% |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 35.00% |
| Rehabilitative Speech Therapy | 35.00% |
| 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 | 35.00% |
| Substance Abuse Disorder Inpatient Services | 35.00% |
| Substance Abuse Disorder Outpatient Services | $20.00 |
| Transplant | 35.00% |
| Treatment for Temporomandibular Joint Disorders | 35.00% |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 35.00% |
Service area
This plan covers 2 geographic areas.
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