Harbor Health Plans - TEXAS
About Harbor Health – Care and coverage combined
Harbor Health began in Austin, delivering healthcare for folks in the community. Then they decided to make their own health plan through Harbor Health Insurance Company, designed by Harbor Health doctors to keep you on the smartest path to health.
Harbor Health Top Plans
Gold G1 – Lowest monthly premium and slightly higher maximum out-of-pocket
Silver S5 and S6 – Slightly higher premium and lower maximum out-of-pocket
Harbor Health is in-network with Austin’s top docs
Harbor Health plans give you access to a trusted network of top clinicians across Austin. Whether you’re looking for everyday care or a specialist, Harbor Health makes it simple to explore your options and connect with providers who fit your needs.
Don’t see these plans when you’re shopping online? Individual eligibility and pricing for plans may vary. Email us at [email protected] so we can find the best plan for you.
| Benefit | Silver S1 | Silver S1S | Gold G1 | Gold G1S |
|---|---|---|---|---|
| Plan Summary of Benefits | Download PDF Here | Download PDF Here | Download PDF Here | Download PDF Here |
| Deductible (Individual / Family) | $5,500 / $11,000 | $6,300 / $12,600 | $0 | $2,000 / $4,000 |
| Out-of-Pocket Max (Individual / Family) | $8,850 / $17,700 | $8,500 / $17,000 | $10,150 / $20,300 | $8,200 / $16,400 |
| Primary Care Provider Visit | $30 copay | $0 copay | $0 copay | $0 copay |
| Specialist Office Visit | $60 copay | $0 copay | 50% coinsurance | 40% coinsurance |
| Urgent Care Visit | $75 copay | $40 copay | $50 copay | $50 copay |
| Virtual Care Visit | Same as office visit | Same as office visit | Same as office visit | Same as office visit |
| Emergency Room Visit | 50% coinsurance | 50% coinsurance | 50% coinsurance | 40% coinsurance |
| Prescription Medications | ||||
| Value Tier | $10 copay | $10 copay | $10 copay | $10 copay |
| Select (Generic) | 50% coinsurance | 50% coinsurance | 50% coinsurance | 40% coinsurance |
| Preferred Brand | 50% coinsurance | 50% coinsurance | 50% coinsurance | 40% coinsurance |
| Non-Preferred Brand | 50% coinsurance | 50% coinsurance | 50% coinsurance | 40% coinsurance |
| Preferred Specialty | 50% coinsurance | 50% coinsurance | 50% coinsurance | 40% coinsurance |
| Non-Preferred Specialty | Not covered | Not covered | Not covered | Not covered |
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