Oscar Texas - 2026 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.
2026 Oscar Plan Information
- Select EPO Provider Finder
- Choice EPO (Houston) - Provider Finder
- Urgent Care Finder
- Oscar 2025 Texas Formulary
- Pharmacy Finder
Choosing your metal tier:
Bronze Plan
Lower premium, higher out-of-pocket expenses 60% of covered health costs paid by Oscar, 40% paid by you. Good choice if you don't expect to use your plan often, but still want coverage to protect you from very high costs
Silver Plan
Moderate premium, moderate out-of-pocket expenses 70% of covered health costs paid by Oscar, 30% paid by you. Cost share reductions available if you're eligible. Good choice if you're willing to pay a slightly higher monthly premium and get more care covered.
Gold Plan
Higher premium, lower out-of-pocket expenses 80% of covered health costs paid by Oscar, 20% paid by you. Good choice if you need care often.
Choosing your Plan Suite
Simple
Lowest monthly premium. More coinsurance based cost-shares. Mostly available in Bronze and Silver metal tiers.
Classic
Mid to high monthly premium. Out-of-pocket costs will be a mix of coinsurance & copays. For example, you may have a copay for labs and coinsurance for a hospital stay.
Elite
Highest monthly premium. More copay based cost-shares. $0 medical deductible
| Elite + PCP Saver Plus | Classic 4700 | Simple Chronic Care CKM | Simple Diabetes | Bronze Classic Standard | Simple Breathe Easy w/ Enhanced COPD Benefits | |
|---|---|---|---|---|---|---|
| The Basics | Plan Summary | Plan Summary | Plan Summary | Plan Summary | Plan Summary | Plan Summary |
| Deductible (Ind/Fam) | None | $4,700 / $9,400 | $5,500 / $11,000 | $5,500 / $11,000 | $7,500 / $15,000 | $9,000 / $18,000 |
| Out of Pocket Max | $10,150 / $20,300 | $9,800 / $19,600 | $10,150 / $20,300 | $10,150 / $20,300 | $10,000 / $20,000 | $10,600 / $21,200 |
| Primary Care Visit | $40 | $70 | $50 (first 5 visit(s) at $0) | $50 (first 5 visit(s) at $0) | $50 | 40% after ded |
| Specialist Office | $130 | $125 | $150 | $150 | $100 | 40% after ded |
| Urgent Care | $75 | $125 | $200 | $200 | $75 | 40% after ded |
| Emergency Room | $2,500 | 50% after ded | 50% after ded | 50% after ded | 50% after ded | 40% after ded |
| Mental Health Office Visits | $130 | $70 | $50 (first 5 visit(s) at $0) | $50 (first 5 visit(s) at $0) | $50 | 40% after ded |
| Labs | $65 | $70 | $75 | $75 | 50% after ded | 40% after ded |
| RX Generic: Preferred (Tier 1a) | $3 | $3 | $3 | $3 | $25 | $3 |
| RX | Generics: Non-preferred (Tier 1b) | $35 | $30 | $30 | $30 | $25 | $30 |
| RX | Brand: Preferred (Tier 2) | $125 after ded | 50% after ded | $75 after ded | $75 after ded | $50 after ded | $75 after ded |
| RX | Brand: Non-preferred (Tier 3 | 50% after ded | 50% after ded | 50% after ded | 50% after ded | $100 after ded | 50% after ded |
| RX | Brand: Specialty (Tier 4) | 50% after ded | 50% after ded | 50% after ded | 50% after ded | 50% after ded | 50% after ded |
| Classic | Classic Standard | Classic Standard Guided Care | |
|---|---|---|---|
| The Basics | Plan Summary | Plan Summary | Plan Summary |
| Deductible (Ind/Fam) | $5,500 / $11,000 | $6,000 / $12,000 | $6,000 / $12,000 |
| Out of Pocket Max | $8,900 / $17,800 | $8,900 / $17,800 | $8,900 / $17,800 |
| Primary Care Visit | $35 | $40 | $40 |
| Specialist Office | $60 | $80 | $80 |
| Urgent Care | $100 | $60 | $60 |
| Emergency Room | $750 after deductible | 40% after deductible | 40% after deductible |
| Mental Health Office Visits | $60 | $40 | $40 |
| Labs | $50 | 40% after deductible | 40% after deductible |
| RX Generic: Preferred (Tier 1a) | $3 | $20 | $20 |
| RX | Generics: Non-preferred (Tier 1b) | $25 | $20 | $20 |
| RX | Brand: Preferred (Tier 2) | $75 | $40 | $40 |
| RX | Brand: Non-preferred (Tier 3 | 50% after ded | $80 after deductible | $80 after deductible |
| RX | Brand: Specialty (Tier 4) | 50% after ded | $350 after deductible | $350 after deductible |
| Simple Chronic Care CKM Guided Care |
Simple Women's Health with Menopause Benefits Guided Care |
Simple Breathe Easy with Enhanced COPD Benefits Guided Care |
|
|---|---|---|---|
| The Basics | Plan Summary | Plan Summary | Plan Summary |
| Deductible (Ind/Fam) | $5,900 / $11,800 | $6,000 / $12,000 | $6,200 / $12,400 |
| Out of Pocket Max | $10,150 / $20,300 | $10,150 / $20,300 | $9,600 / $19,200 |
| Primary Care Visit | $0 | $0 | $0 |
| Specialist Office | $35 | $40 | $40 |
| Urgent Care | $75 | $75 | $75 |
| Emergency Room | 50% after deductible | 50% after deductible | 50% after deductible |
| Mental Health Office Visits | $0 | $0 | $0 |
| Labs | $65 | $40 | $65 |
| RX Generic: Preferred (Tier 1a) | $3 | $0 | $0 |
| RX | Generics: Non-preferred (Tier 1b) | $25 | $25 | $25 |
| RX | Brand: Preferred (Tier 2) | $75 after deductible | $75 after deductible | $75 after deductible |
| RX | Brand: Non-preferred (Tier 3 | 50% after deductible | 50% after deductible | 50% after deductible |
| RX | Brand: Specialty (Tier 4) | 50% after deductible | 50% after deductible | 50% after deductible |
| Simple PCP Saver | Simple PCP Saver Guided Care |
Simple Guided Care |
Simple Diabetes Guided Care |
|
|---|---|---|---|---|
| The Basics | Plan Summary | Plan Summary | Plan Summary | Plan Summary |
| Deductible (Ind/Fam) | $5,750 / $11,500 | $5,750 / $11,500 | $6,300 / $12,600 | $6,500 / $13,000 |
| Out of Pocket Max | $10,150 / $20,300 | $10,150 / $20,300 | $9,300 / $18,600 | $10,000 / $20,000 |
| Primary Care Visit | $10 | $10 | $10 | $0 |
| Specialist Office | $70 | $70 | $70 | $40 |
| Urgent Care | $75 | $75 | $100 | $75 |
| Emergency Room | 40% after deductible | 40% after deductible | 50% after deductible | 50% after deductible |
| Mental Health Office Visits | $10 | $10 | $10 | $0 |
| Labs | 40% after deductible | 40% after deductible | 50% after deductible | $65 |
| RX Generic: Preferred (Tier 1a) | $3 | $3 | $3 | $0 |
| RX | Generics: Non-preferred (Tier 1b) | $25 | $25 | $20 | $25 |
| RX | Brand: Preferred (Tier 2) | $100 | $100 | $125 after deductible | $75 after deductible |
| RX | Brand: Non-preferred (Tier 3 | 50% after deductible | 50% after deductible | 50% after deductible | 50% after deductible |
| RX | Brand: Specialty (Tier 4) | 50% after deductible | 50% after deductible | 50% after deductible | 50% after deductible |
| Elite | Classic Standard | Classic Standard Guided | Simple Diabetes Guided | Classic | Classic Guided | Simple Guided | |
|---|---|---|---|---|---|---|---|
| The Basics | Plan Summary | Plan Summary | Plan Summary | Plan Summary | Plan Summary | Plan Summary | Plan Summary |
| Deductible (Ind/Fam) | $1,200 / $2,400 | $2,000 / $4,000 | $2,000 / $4,000 | $2,000 / $4,000 | $2,500 / $4,000 | $2,500 / $5,000 | $3,300 / $6,600 |
| Out of Pocket Max | $7,800 / $15,600 | $8,200 / $16,400 | $8,200 / $16,400 | $9,800 / $19,600 | $8,000 / $16,000 | $8,000 / $16,000 | $9,950 / $19,900 |
| Primary Care Visit | $25 | $30 | $30 | $0 | $25 | $25 | $5 |
| Specialist Office | $50 | $60 | $60 | $40 | $40 | $40 | $10 |
| Urgent Care | $50 | $45 | $45 | $100 | $75 | $75 | $50 |
| Emergency Room | 30% after deductible | 25% after deductible | 25% after deductible | 20% after deductible | $650 | $650 | 20% after deductible |
| Mental Health Office Visits | $50 | $30 | $30 | $0 | $25 | $25 | $5 |
| Labs | $25 | 25% after deductible | 25% after deductible | $40 | $60 | $60 | $30 |
| RX Generic: Preferred (Tier 1a) | $3 | $15 | $15 | $3 | $3 | $3 | $3 |
| RX | Generics: Non-preferred (Tier 1b) | $30 | $15 | $15 | $20 | $20 | $20 | $10 |
| RX | Brand: Preferred (Tier 2) | $75 | $30 | $30 | $75 | $50 | $50 | $65 after deductible |
| RX | Brand: Non-preferred (Tier 3 | 50% after deductible | $60 | $60 | 50% after deductible | 50% after deductible | 50% after deductible | 50% after deductible |
| RX | Brand: Specialty (Tier 4) | 50% after deductible | $250 | $250 | 50% after deductible | 50% after deductible | 50% after deductible | 50% after deductible |
2026 Participating Hospital List
Check the Provider Finder to see if it's in-network!
Oscar 2026 Participating Hospital List
Oscar’s Texas service area includes Atascosa, Bandera, Bastrop, Bexar, Bexar, Blanco, Burnet, Caldwell, Cameron, Collin, Comal, Cooke, Dallas, Denton, El Paso, Ellis, Fort Bend, Galveston, Gonzales, Guadalupe, Harris, Hays, Hidalgo, Hudspeth, Jack, Kendall, Kenedy, La Salle, Lee, Llano, McMullen, Medina, Milam, Montgomery, Nacogdoches, Parker, Rockwall, Shelby, Tarrant, Travis, Willacy, Williamson, Wilson, and Wise counties.
| Atascosa | Methodist Hospital Atascosa | ✔ | |
| Bell | Ascension Seton Hospital Harker Heights | ✔ | |
| Bexar | Baptist Medical Center | ✔ | ✔ |
| Bexar | Baptist Neighborhood Hospital - Hausman | ✔ | ✔ |
| Bexar | Baptist Neighborhood Hospital - Overlook | ✔ | ✔ |
| Bexar | Baptist Neighborhood Hospital - Thousand Oaks | ✔ | ✔ |
| Bexar | Baptist Neighborhood Hospital - Westover | ✔ | ✔ |
| Bexar | Medical City Plano | ✔ | ✔ |
| Bexar | Methodist Hospital of Sacramento | ✔ | |
| Bexar | Methodist Hospital Stone Oak | ✔ | |
| Bexar | Methodist Hospital Metropolitan | ✔ | |
| Bexar | Methodist Hospital Northeast | ✔ | |
| Bexar | Mission Trail Baptist Hospital | ✔ | ✔ |
| Bexar | North Central Baptist Hospital | ✔ | ✔ |
| Bexar | Northeast Baptist Hospital | ✔ | ✔ |
| Bexar | St Luke's Baptist Hospital | ✔ | ✔ |
| Brazoria | HCA Houston Healthcare Pearland | ✔ | |
| Brazoria | Memorial Hermann Pearland Hospital | ✔ | |
| Brazoria | Sweeny Community Hospital | ✔ | |
| Brazoria | UTMB Angleton Danbury Hospital Campus | ✔ | |
| Cameron | VBMC-Harlingen | ✔ | |
| Cameron | Valley Regional Medical Center | ✔ | |
| Cameron | VBMC - Brownsville | ✔ | |
| Cameron | Valley Baptist Emergency Center-Brownsville | ✔ | |
| Collin | Medical City Frisco Hospital | ✔ | |
| Collin | Medical City McKinney Hospital | ✔ | |
| Collin | Methodist Mckinney Hospital | ✔ | |
| Collin | Methodist Richardson Medical Center | ✔ | |
| Comal | Resolute Baptist Hospital | ✔ | ✔ |
| Cooke | North Texas Medical Center | ✔ | |
| Dallas | Crescent Regional Hospital | ✔ | ✔ |
| Dallas | Medical City Dallas Hospital | ✔ | ✔ |
| Dallas | Medical City Las Colinas Hospital | ✔ | ✔ |
| Dallas | Methodist Charlton Medical Center | ✔ | ✔ |
| Dallas | Methodist Dallas Medical Center | ✔ | ✔ |
| Denton | Medical City Denton Hospital | ✔ | ✔ |
| Denton | Medical City Lewisville Hospital | ✔ | ✔ |
| Denton | Methodist Southlake Medical Center | ✔ | ✔ |
| El Paso | Del Sol Medical Center | ✔ | |
| El Paso | Las Palmas Medical Center | ✔ | |
| El Paso | The Hospitals of Providence-Memorial Campus | ✔ | ✔ |
| El Paso | The Hospitals of Providence-East Campus | ✔ | ✔ |
| El Paso | The Hospitals of Providence-Horizon City Campus | ✔ | ✔ |
| El Paso | The Hospitals of Providence-Northeast Campus | ✔ | ✔ |
| El Paso | The Hospitals of Providence-Sierra Campus | ✔ | ✔ |
| El Paso | The Hospitals of Providence-Transmountain Campus | ✔ | ✔ |
| Ellis | Methodist Midlothian Medical Center | ✔ | ✔ |
| Fort Bend | Memorial Hermann Sugar Land Hospital | ✔ | ✔ |
| Fort Bend | OakBend Medical Center Jackson Street Hospital Campus | ✔ | ✔ |
| Galveston | HCA Houston Healthcare Mainland | ✔ | ✔ |
| Guadalupe | Guadalupe Regional Medical Center | ✔ | |
| Harris | HCA Houston Healthcare Conroe | ✔ | ✔ |
| Harris | HCA Houston Healthcare Clear Lake | ✔ | ✔ |
| Harris | HCA Houston Healthcare Medical Center | ✔ | ✔ |
| Harris | HCA Houston Healthcare Northwest | ✔ | ✔ |
| Harris | HCA Houston Healthcare Southeast | ✔ | ✔ |
| Harris | HCA Houston Healthcare Tomball | ✔ | ✔ |
| Harris | HCA Houston Healthcare West | ✔ | ✔ |
| Harris | Memorial Hermann Greater Heights Hospital | ✔ | ✔ |
| Harris | Memorial Hermann-Texas Medical Center | ✔ | ✔ |
| Harris | Memorial Hermann Memorial City Medical Center | ✔ | ✔ |
| Harris | Memorial Hermann Northeast Hospital | ✔ | ✔ |
| Harris | Memorial Hermann Southeast Hospital | ✔ | ✔ |
| Harris | Memorial Hermann Katy Hospital | ✔ | ✔ |
| Harris | HCA Houston Healthcare North Cypress | ✔ | ✔ |
| Hays | Ascension Seton Hays | ✔ | |
| Hays | Ascension Seton Southwest Hospital | ✔ | |
| Hays | St. David’s Medical Center | ✔ | ✔ |
| Hidalgo | Rio Grande Regional Hospital | ✔ | ✔ |
| Montgomery | HCA Houston Healthcare Kingwood | ✔ | ✔ |
| Montgomery | Memorial Hermann The Woodlands Medical Center | ✔ | ✔ |
| Parker | Medical City Weatherford | ✔ | ✔ |
| Tarrant | Medical City North Hills | ✔ | ✔ |
| Tarrant | Medical City Alliance Hospital | ✔ | ✔ |
| Tarrant | Medical City Arlington Hospital | ✔ | ✔ |
| Tarrant | Medical City Fort Worth Hospital | ✔ | ✔ |
| Tarrant | Methodist Mansfield Medical Center | ✔ | ✔ |
| Travis | Ascension Seton Medical Center Austin | ✔ | |
| Travis | Dell Seton Medical Center At the University of Texas | ✔ | |
| Travis | Ascension Seton Northwest Hospital | ✔ | |
| Travis | St. David's Georgetown Hospital | ✔ | ✔ |
| Travis | St. David's North Austin Medical Center | ✔ | ✔ |
| Travis | St. David's South Austin Medical Center | ✔ | ✔ |
| Williamson | Cedar Park Regional Medical Center | ✔ | |
| Williamson | St. David's Round Rock Medical Center | ✔ | ✔ |
| Williamson | Ascension Seton Williamson Hospital | ✔ | |
| Wise | Medical City Decatur Hospital | ✔ |
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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.
Dual Networks
In 2026, Oscar is proud to offer individuals and families even more options for new and renewing members by offering two comprehensive networks in select Texas markets.* Why dual network 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, Galveston 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 network of doctors, specialists, hospitals and clinical facilities that offer cost-effective medical care without sacrificing the quality our members expect. This network 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, Galveston and Brazoria counties. ** Provider listings are not all-inclusive and are as of September 2026; subject to change. For a listing of doctors and facilities that participate in the Select and Choice networks, contact your local broker or visit hioscar.com.
For Diabetic Members
People often pay too much for plans that aren't right for them. That's why Oscar has plans custom designed for the kind of care you really need. If you have Type 1 or Type 2 diabetes, Oscar has plans that can save you money and help you manage your condition. Once your plan is active, it includes: Plan Benefits:*
- $0 HbA1c, urinalysis, metabolic, lipid panel
- $0 Tier 1a drugs
- $0 PCP visits
- $0 behavioral health visits
- $0 diabetic foot care and diabetic retinal exams
- $100 per month maximum on insulin****
Rewards and Incentives:
- Earn cash rewards for healthy groceries - up to $100 a year**
- Get access to a national network of gyms and fitness classes through ASH Fitness***
Reach out to one of our licensed experts to see which plan is best for you!
* Plans are available to all eligible persons, regardless of disease status. If you don't have type 1 or type 2 diabetes, or you have pre-diabetes or gestational diabetes, these plans may offer you certain reduced costs, but you are not eligible for all Rewards and Incentives program offerings that offer even more savings. Coverage for benefits is limited per clinical guidelines. These plans are not available in MI, TN, VA, CA, NY & NJ. ** To be eligible for healthy groceries rewards, members must have a type 1 or type 2 diabetes diagnosis, be active in Oscar's diabetic management program within 3 months of plan activation date, and complete either their annual physical or a wellness visit. Cash rewards are distributed through healthy groceries debit cards - up to $100 per year. *** Fitness class access is available after a member completes 2 recommended services (labs, eye exam)**** Maximum out-of-pocket insulin cost depends on applicable state rules. Review your plan documents to confirm costs. Oscar will apply the lower of the maximum state-mandated out-of-pocket insulin cost, or $100.
Primary and Urgent Care
Oscar Primary Care helps you put your health first with virtual visits right from home!
Staying on top of your routine care with regularly primary care provider visits helps you stay well. Oscar makes it easy for you to get it on your terms. With Oscar Primary Care, you'll have a virtual care team dedicated to you and your health for the long haul. AND virtual visits for $0* - Just log into the Oscar app and our virtual doctor's office will come to you through video, phone, or secure messaging. It's up to you.
A whole team is by your side Your Oscar Primary Care team includes a licensed provider, a nurse, and a medical assistant. When something comes up, simply message your medical team right through the app and they'll be in touch.
Ongoing support for chronic conditions Your team can also help you develop a tailored care plan and coordinate your care so you never miss anything. From ongoing diabetes management and resources to mental health support, and more.
Get in-person care whenever you need it Sometimes to get a full picture of your health you'll need in-person care. When that time comes, Oscar will direct you to the right specialist, lab, or imaging facility in their network. Some screenings and tests may be available to be done in the comfort of your home too.
Get care 24/7 without copays, appointments, or hassles
When a minor health issue comes up, stay put and get the help you need right from home with Virtual Urgent Care.
Here's how it works Log into the Oscar app or site and look for Virtual Urgent Care to book a visit. Tell us a few details and we'll reach out in as little as 15 minutes over the phone. Then, a provider will help you determine next steps and even provide a prescription or refill, if needed. It's really simple.
Think of it as your first step for things like:
- Sinus infections
- Sore throat, cough
- Allergies
- Skin conditions
- Nausea or vomiting
| Virtual Urgent Care | Urgent Care Center | Emergency Room | |
| Cost | $0 | $$ | $$$ |
| Wait Time | In as little as 15 minutes to get care | An hour or more | Over an hour |
| When to use it | Minor health issues that need immediate care and prescriptions | Urgent but not life-threatening issues that may require stitches or x-rays | Life threatening situations like broken bones, severe chest pain, heavy bleeding, etc |
Contact Us
Phone: (972) 666-0578
Email: help@ihealthagents.com
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