Oscar Texas

Our Rating:

★★★★★

Currently serving the areas around Austin and San Antonio, Oscar’s plans offer low premiums in exchange for technology based care 24/7.

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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

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 Oscar, 20% paid by you. Good choice if you need care often.

Choosing your Plan Suite

Simple

Lowest monthly premiu. 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 Downloadable Plan Summary Downloadable Plan Summary Downloadable Plan Summary Downloadable Plan Summary Downloadable Plan Summary Downloadable 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 Downloadable Plan Summary Downloadable Plan Summary Downloadable 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 Downloadable Plan Summary Downloadable Plan Summary Downloadable 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 Downloadable Plan Summary Downloadable Plan Summary Downloadable Plan Summary Downloadable 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 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.

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 1or 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 t hat 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 1or 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 t o $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 document s 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 assist ant . 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 t o 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 t he 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 prescript ion 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: (312) 726-6565 Email: [email protected]

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Oscar Texas

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(312) 726-6565 – Call or Text