Oscar Texas – Texas Health Plans
Plan Overviews
All of Oscar Texas health plans come with access to great care and the Oscar experience, with free 24/7 calls with doctors and a dedicated health concierge to help manage your care.
A new type of health insurance company, Oscar is focused on using technology to keep costs low. They appear to have the lowest rates available in their coverage area for 2018, and the extraordinary level of service offered makes them the best value in Texas.
Oscar has partnered with hospitals in Austin and San Antonio to provide the best possible care, but only offers EPOs. Out of network care will not be covered except in the case of an emergency. No referrals needed – ever. Make an appointment with any in-network doctor, including specialists, without a referral.
Their San Antonio service area includes Bexar and Comal Counties; their new Austin service area includes Travis, Williamson, and Hays Counties.
2022 Oscar Plan Information
| Classic Bronze | Classic Silver | Classic Gold | |
|---|---|---|---|
| The Basics | |||
| Free 24/7 calls with doctors | ✔️ | ✔️ | ✔️ |
| Up to $100/year in step tracking rewards | ✔️ | ✔️ | ✔️ |
| Free preventive care | ✔️ | ✔️ | ✔️ |
| Dedicated Concierge | ✔️ | ✔️ | ✔️ |
| Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim.* | $3,500 | $4,500 | $1,500 |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services* | $7,350 | $7,350 | $7,350 |
| HSA-Compatible? | No | No | No |
|
Prices before you meet your deductible
|
|||
| Primary Care / OBGYN visits | Full Price | $50 | $25 |
| Specialist visits | Full Price | $75 | $50 |
| Mental health office visits | Full Price | $75 | $50 |
| Physical, Occupational, and Speech Therapy | Full Price | $75 | $50 |
| Urgent Care | $100 | $100 | $100 |
| Labs | Full Price | Full Price | $25 |
| Generic Drugs | Full Price | $15 | $10 |
| Preferred Brand Drugs | Full Price | $100 | $50 |
| Non-Preferred Brand Drugs | Full Price | Full Price | Full Price |
|
Prices after you meet your deductible
|
|||
| Primary Care / OBGYN visits | 50% | $50 | $25 |
| Mental health office visits | 50% | $75 | $50 |
| Urgent Care | $100 | $100 | $100 |
| Xrays & Diagnostic Imaging | 50% | 50% | 20% |
| Emergency Room | 50% | 50% | 20% |
| Outpatient Facility | 50% | 50% | 20% |
| Generic Drugs | 50% | $15 | $10 |
| Non-Preferred Brand Drugs | 50% | 50% | 20% |
| Simple Secure | Simple Bronze | Simple Silver | |
|---|---|---|---|
| The Basics | |||
| Free 24/7 calls with doctors | ✔️ | ✔️ | ✔️ |
| Up to $100/year in step tracking rewards | ✔️ | ✔️ | ✔️ |
| Free preventive care | ✔️ | ✔️ | ✔️ |
| Dedicated Concierge | ✔️ | ✔️ | ✔️ |
| Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim.* | $7,350 | $7,350 | $7,000 |
| Individual Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services* | $7,350 | $7,350 | $7,000 |
| HSA-Compatible? | No | No | No |
|
Prices before you meet your deductible
|
|||
| Primary Care / OBGYN visits | 3 for $0 | Full Price | $25 |
| Specialist visits | Full Price | Full Price | $50 |
| Mental health office visits | 3 for $0 | Full Price | $50 |
| Physical, Occupational, and Speech Therapy | Full Price | Full Price | $50 |
| Urgent Care | Full Price | $100 | $100 |
| Labs | Full Price | Full Price | $50 |
| Generic Drugs | Full Price | Full Price | $20 |
| Preferred Brand Drugs | Full Price | Full Price | $100 |
| Non-Preferred Brand Drugs | Full Price | Full Price | Full Price |
|
Prices after you meet your deductible
|
|||
| Primary Care / OBGYN visits |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Mental health office visits |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Urgent Care |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Xrays & Diagnostic Imaging |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Emergency Room |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Outpatient Facility |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Generic Drugs |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Non-Preferred Brand Drugs |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
| Silver $10 Generic Rx | |
|---|---|
| The Basics | |
| Free 24/7 calls with doctors | ✔️ |
| Up to $100/year in step tracking rewards | ✔️ |
| Free preventive care | ✔️ |
| Dedicated Concierge | ✔️ |
| Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim.* | $4,500 |
| Individual Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services* | $7,350 |
| HSA-Compatible? | No |
| Prices before you meet your deductible | |
| Primary Care visits | $50 |
| Specialist visits | $75 |
| Mental Health visits | $75 |
| Physical, Occupational, and Speech Therapy | $75 |
| Urgent Care | $100 |
| Labs | Full Price |
| Generic Drugs | $10 |
| Preferred Brand Drugs | $100 |
| Prices after you meet your deductible | |
| Primary Care visits | $50 |
| Specialist visits | $75 |
| Mental Health visits | $75 |
| Physical, Occupational, and Speech Therapy | $75 |
| Urgent Care | $100 |
| Labs | 50% |
| Xrays & Diagnostic Imaging | 50% |
| MRIs & Advanced Imaging | 50% |
| Emergency Room | 50% |
| Inpatient Facility & Skilled Nursing Facility | 50% |
| Outpatient Facility | 50% |
| Outpatient Professional | 50% |
| Generic Drugs | $10 |
| Preferred Brand Drugs | $100 |
| Non-Preferred Brand Drugs | 50% |
| Specialty Drugs | 50% |
| Saver Bronze | Saver Silver | |
|---|---|---|
| The Basics | ||
| Free 24/7 calls with doctors | ✔️ | ✔️ |
| Up to $100/year in step tracking rewards | ✔️ | ✔️ |
| Free preventive care | ✔️ | ✔️ |
| Dedicated Concierge | ✔️ | ✔️ |
| Individual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim.* | $6,500 | $5,000 |
| Individual Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services* | $6,500 | $5,000 |
| HSA-Compatible? | Yes | Yes |
|
Prices before you meet your deductible
|
||
| Primary Care / OBGYN visits | Full Price | Full Price |
| Specialist visits | Full Price | Full Price |
| Mental health office visits | Full Price | Full Price |
| Physical, Occupational, and Speech Therapy | Full Price | Full Price |
| Urgent Care | Full Price | Full Price |
| Labs | Full Price | Full Price |
| Generic Drugs | Full Price | Full Price |
| Preferred Brand Drugs | Full Price | Full Price |
| Non-Preferred Brand Drugs | Full Price | Full Price |
|
Prices after you meet your deductible
|
|||
| Primary Care / OBGYN visits |
Why aren’t there copays or coinsurance amounts here? With our plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Mental health office visits |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Urgent Care |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Xrays & Diagnostic Imaging |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Emergency Room |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Outpatient Facility |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Generic Drugs |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
||
| Non-Preferred Brand Drugs |
Why aren’t there copays or coinsurance amounts here? With our Simple plans, you pay for covered services up to your deductible. After that, Oscar pays for all covered services. No more copays. No coinsurance.
|
Coverage Map
Austin
San Antonio
2021/2022 Participating Hospital List
Check the Provider Finder to see if it’s in-network!
Oscar Announces Partnerships with HCA Healthcare to offer seamlessly connected health insurance and care across El Paso, San Antonio, Austin, Houston, and Dallas-Fort Worth, Texas. HCA Healthcare’s facilities in those markets are referred to locally as:
- St. David’s HealthCare – Austin
- Medical City Healthcare – Dallas-Fort Worth
- Las Palmas Del Sol Healthcare – El Paso
- HCA Houston Healthcare – Houston
- Methodist Healthcare System – San Antonio
Other Hospitals below by county. Don’t see your preferred hospital? Check the Provider Finder to see if it’s in-network!
Bexar County
- Baptist Medical Center
- Mission Trail Baptist Hospital
- North Central Baptist Hospital
- Northeast Baptist Hospital
- St. Luke’s Baptist Hospital Comal
- Resolute Health Hospital
Comal County
- Resolute Health Hospital
Travis
- St. David’s South Austin Medical Center
- Dell Seton Medical Center at The University of Texas
- St. David’s Medical Center
- Ascension Seton Medical Center Austin
- Ascension Seton Northwest
- St. David’s North Austin Medical Center
Williamson
- Cedar Park Regional Medical Center
- Seton Medical Center Williamson
- St. David’s Round Rock Medical Center
- Medical Center – Cedar Park
Hays
-
- Seton Medical Center Hays
Apply Online Now
Oscar Texas Perks
Dedicated Health Concierge Team
With Oscar, you get your own Concierge team – three care guides and a nurse. You talk to the same people every time you call or message. And you get personalized care from people who know you as more than just a member ID number.
Innovative Mobile App
“Simple, useful, and actually gives me money!” – App Store review
Simple. Smart. Snazzy. It’s a health insurance app that doesn’t look or act like one. The Oscar app makes it easy to manage your health, find great care, and see everything in one place. And it’s easy on the eyes. Here’s what members love most about it.
Reach your Concierge team in one tap.
Don’t go through an annoying automated phone system to get help. Ask your dedicated Concierge team about bills, benefits, prescriptions, and doctors right from the Oscar app. You’ll talk to one of the same four people every time you message or call.
Get a diagnosis and prescription in two taps.
The average Doctor on Call user saves $600-$900 by using the free service instead of visiting the ER or urgent care. Send a request 24/7, and a board-certified Doctor will call you within 15 minutes. No booking ahead, no waiting rooms, no off-hours.
See all of your stuff in one place.
You shouldn’t have to navigate a clunky website just to find your own health info. Your plan details, labs, prescriptions, health history, bills, and ID card are on the app.
Get Money For Walking.
Earn $1 toward an Amazon® Gift Card for every day that you hit your step goal. It’s hassle-free – the app automatically syncs your steps from Apple Health or Google Fit.
Dual Networks
In 2022, Oscar is proud to offer individuals and families even more options for new and renewing members by offering two comprehensive net works in select Texas markets.* Why dual net work options? Oscar offers two network options with high- quality health systems and providers so you can choose the network with the right doctors for you and your family.
If you live in Harris, Fort Bend, Montgomery, Galvest on or Brazoria counties, you can choose between two provider networks:
Oscar Choice Network
The Choice network is broad and offers an expansive network of quality doctors, specialists, clinical facilities and hospitals. This network is in partnership with Hermann, HCA Gulf Coast and St. Joseph?s.**
Oscar Select Network
The Select network provides a locally curated net work of doctors, specialists, hospitals and clinical facilities that offer cost-effective medical care without sacrificing the quality our members expect. This net work is in partnership with HCA and St. Joseph’s.**
*In Texas, the Choice network and the Select network are available in Harris, Fort Bend, Montgomery, Galvest on and Brazoria counties.
** Provider listings are not all-inclusive and are as of Sept ember 2021; subject to change. For a list ing of doctors and facilities that participate in the Select and Choice networks, contact your local broker or visit hioscar.com.
Coming Soon for Diabetic Members
Oscar plans to launch an innovative new plan to better serve diabetic members. The plan will be available to members on Individual and Family Plans. For members who enroll in the diabetes plan, they will enjoy cost-saving benefits, including:
- $0 diabetic eye and foot exams
- $0 labs to manage diabetes
- Out of pocket costs for insulin are capped at $100/month
- $0 PCP visits
Contact Us
Phone: (312) 726-6565
Email: [email protected]
Find What Plans Your Doctor Accepts
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