Oscar Texas – 2025 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.
2025 Oscar Plan Information
- All Bronze Plans
- Silver Classic Plans
- Simple Care Plans
- Silver Simple PCP Saver Plans
- Silver Classic Standard Plans
- Silver Elite Saver Plus Plans
- All Gold Plans
| Classic Standard | Classic 4700 | Elite + PCP Saver Plus | |
|---|---|---|---|
| The Basics | Downloadable Plan Summary | Downloadable Plan Summary | Downloadable Plan Summary |
| Plan Type | EPO | EPO | EPO |
| Deductible (Individual / Family) | $7,500 / $15,000 | $4,700 / $9,400 | $0 / $0 |
| Out-of-Pocket Max (Individual / Family) | $9,200 / $18,400 | $9,200 / $18,400 | $9,200 / $18,400 |
| Prescription Drug Coverage Deductible | None | None | $6,500 Ind / $13,000 Fam |
| Referral Required for Specialist? | No | No | No |
| Primary Care Visit | $50 | $70 | $40 |
| Specialist Visit | $100 | $125 | $125 |
| Diagnostic Test | 50% | 50% | $150 |
| Imaging | 50% | 50% | $750 |
| Generic Drugs (Tier) | $25 copayment/ prescription not subject to deductible (retail) | $3 copayment/ prescription not subject to deductible (retail, Tier 1A), $30 copayment/ prescription not subject to deductible (retail, Tier 1B) | $3 copayment/ prescription not subject to deductible (retail, Tier 1A), $35 copayment/ prescription not subject to deductible (retail, Tier 1B) |
| Preferred Brand Drugs (Tier 2) | $50 copayment/ prescription subject to deductible (retail), $150 copayment/ prescription subject to deductible (mail order) |
50% coinsurance subject to deductible (retail/mail order) |
$100 copayment/ prescription prescription drug, subject to prescription deductible (retail), $300 copayment/ prescription prescription drug, subject to prescription deductible (mail order) |
| Non-Preferred Brand Drugs (Tier 3) | $100 copayment/ prescription subject to deductible (retail), $300 copayment/ prescription subject to deductible (mail order) |
50% coinsurance subject to deductible (retail/mail order) |
50% coinsurance prescription drug, subject to prescription deductible (retail/mail order) |
| Specialty Drugs (Tier 4) | $500 copayment/ prescription subject to deductible (retail/mail order) | 50% coinsurance subject to deductible (retail/mail order) |
50% coinsurance prescription drug, subject to prescription deductible (retail/mail order) |
| Outpatient Surgery Facility Fee / Physician & Surgeon Fee | 50% / 50% | 50% /50% | $1,200 / $350 |
| Emergency Room Care | 50% | 50% | $2,000 |
| Emergency Medical Transportation | 50% | 50% | $2,000 |
| Urgent Care | $75 | $125 | $75 |
| Hospital Stay Facility Fee / Physician & Surgeon Fee | 50% | 50% | $3,000 / $350 |
| Mental Health Outpatient Services | 50% | $70 | $125 |
| Mental Health Inpatient Services | 50% | 50% | $3,000 |
| Pregnancy Office Visit | No Charge | No Charge | No Charge |
| Childbirth/Delivery Professional Services | 50% | 50% | $350 |
| Childbirth/Delivery Facility Services | 50% | 50% | $3,000 |
| Classic | Classic Standard | Classic Standard Guided Care | |
|---|---|---|---|
| The Basics | Downloadable Plan Summary | Downloadable Plan Summary | Downloadable Plan Summary |
| Plan Type | EPO | EPO | HMO |
| Deductible (Individual / Family) | $5,400 / $10,800 | $5,000 / $10,000 | $5,000 / $10,000 |
| Out-of-Pocket Max (Individual / Family) | $8,500 / $17,000 | $8,000 / $16,000 | $8,000 / $16,000 |
| Prescription Drug Coverage Deductible | No | No | No |
| Referral Required for Specialist? | No | No | Yes |
| Primary Care Visit | $35 | $40 | $40 |
| Specialist Visit | $60 | $80 | $80 |
| Diagnostic Test | $70 | 40% | 40% |
| Imaging | 50% | 40% | 40% |
| Generic Drugs (Tier) | $3 copayment/ prescription not subject to deductible (retail, Tier 1A), $25 copayment/ prescription not subject to deductible (retail, Tier 1B) |
$20 copayment/ prescription not subject to deductible (retail) |
$20 copayment/ prescription not subject to deductible (retail) |
| Preferred Brand Drugs (Tier 2) | $75 copayment/ prescription not subject to deductible (retail), $225 copayment/ prescription not subject to deductible (mail order) |
$40 copayment/ prescription not subject to deductible (retail), $120 copayment/ prescription not subject to deductible (mail order) |
$40 copayment/prescription not subject to deductible (retail), $120 copayment/ prescription not subject to deductible (mail order) |
| Non-Preferred Brand Drugs (Tier 3) | 50% coinsurance subject to deductible (retail/mail order) | $80 copayment/ prescription subject to deductible (retail), $240 copayment/ prescription subject to deductible (mail order) |
$80 copayment/ prescription subject to deductible (retail), $240 copayment/prescription subject to deductible (mail order) |
| Specialty Drugs (Tier 4) | 50% coinsurance subject to deductible (retail/mail order) | $350 copayment/ prescription subject to deductible (retail/mail order) | $350 copayment/ prescription subject to deductible (retail/mail order) |
| Outpatient Surgery Facility Fee / Physician & Surgeon Fee | 50% / 50% | 40% / 40% | 40% / 40% |
| Emergency Room Care | $750 | 40% | 40% |
| Emergency Medical Transportation | $750 | 40% | 40% |
| Urgent Care | $100 | $60 | $60 |
| Hospital Stay Facility Fee / Physician & Surgeon Fee | 50% / 50% | 40% / 40% | 40% / 40% |
| Mental Health Outpatient Services | $60 | $40 | $40 |
| Mental Health Inpatient Services | 50% | 40% | 40% |
| Pregnancy Office Visit | No Charge | No Charge | No Charge |
| Childbirth/Delivery Professional Services | 50% | 40% | 40% |
| Childbirth/Delivery Facility Services | 50% | 40% | 40% |
| Simple Guided Care | Simple Chronic Care CKM Guided Care | Simple Diabetes Guided Care | |
|---|---|---|---|
| The Basics | Downloadable Plan Summary | Downloadable Plan Summary | Downloadable Plan Summary |
| Plan Type | HMO | HMO | HMO |
| Deductible (Individual / Family) | $6,200 / $12,400 | $5,750 / $11,500 | $6,500 / $13,000 |
| Out-of-Pocket Max (Individual / Family) | $9,200 / $18,400 | $9,200 / $18,400 | $8,550 / $17,100 |
| Prescription Drug Coverage Deductible | No | No | No |
| Referral Required for Specialist? | Yes | Yes | Yes |
| Primary Care Visit | $10 | No Charge | No Charge |
| Specialist Visit | $70 | $35 | $40 |
| Diagnostic Test | $80 | 50% | 50% |
| Imaging | 50% | 50% | 50% |
| Generic Drugs (Tier) | $3 copayment/ prescription not subject to deductible (retail, Tier 1A), $25 copayment/ prescription not subject to deductible (retail, Tier 1B) | No charge (retail, Tier 1A), $25 copayment/ prescription not subject to deductible (retail, Tier 1B) | No charge (retail, Tier 1A), $25 copayment/ prescription not subject to deductible (retail, Tier 1B) |
| Preferred Brand Drugs (Tier 2) | $125 copayment/ prescription not subject to deductible (retail), $375 copayment/ prescription not subject to deductible (mail order) | $75 copayment/ prescription subject to deductible (retail), $225 copayment/ prescription subject to deductible (mail order) |
$75 copayment/ prescription subject to deductible (retail), $225 copayment/ prescription subject to deductible (mail order) |
| Non-Preferred Brand Drugs (Tier 3) | 50% coinsurance subject to deductible (retail/mail order) | 50% coinsurance subject to deductible (retail/mail order) | 50% coinsurance subject to deductible (retail/mail order) |
| Specialty Drugs (Tier 4) | 50% coinsurance subject to deductible (retail/mail order) | 50% coinsurance subject to deductible (retail/mail order) | 50% coinsurance subject to deductible (retail/mail order) |
| Outpatient Surgery Facility Fee / Physician & Surgeon Fee | 50% / 50% | 50% / 50% | 50% / 50% |
| Emergency Room Care | 50% | 50% | 50% |
| Emergency Medical Transportation | 50% | 50% | 50% |
| Urgent Care | $100 | $75 | $75 |
| Hospital Stay Facility Fee / Physician & Surgeon Fee | 50% / 50% | 50% / 50% | 50% / 50% |
| Mental Health Outpatient Services | $10 | No Charge | No Charge |
| Mental Health Inpatient Services | 50% | 50% | 50% |
| Pregnancy Office Visit | No Charge | No charge | No charge |
| Childbirth/Delivery Professional Services | 50% | 50% | 50% |
| Childbirth/Delivery Facility Services | 50% | 50% | 50% |
| Simple PCP Saver | Simple PCP Saver Off Exchange | Simple PCP Saver CSR 150 | Simple PCP Saver CSR 200 | Simple PCP Saver CSR 250 | |
|---|---|---|---|---|---|
| The Basics | |||||
| Deductible (Individual / Family) | $5,750 / $11,500 | $5,750 / $11,500 | $0 / $0 | $600 / $1,200 | $4,750 / $9,500 |
| Pharmacy Deductible (Individual / Family) | N/A | N/A | N/A | N/A | N/A |
| Out-of-Pocket Max (Individual / Family) | $8,900 / $17,800 | $8,900 / $17,800 | $1,550 / $3,100 | $3,000 / $6,000 | $7,200 / $14,400 |
| $0 Preventive care | ✔️ | ✔️ | ✔️ | ✔️ | ✔️ |
| Dedicated Care Team | ✔️ | ✔️ | ✔️ | ✔️ | ✔️ |
| HSA-Compatible? | No | No | No | No | No |
|
Prices for Benefits
|
|||||
| Virtual Primary Care (3) | $0 | $0 | $0 | $0 | $0 |
| Virtual Urgent Care (4) | $0 | $0 | $0 | $0 | $0 |
| Primary Care Office Visits | $20 | $20 | $5 | $10 | $20 |
| Specialist Office Visits | $80 | $80 | $10 | $40 | $80 |
| Urgent Care | $75 | $75 | $30 | $50 | $75 |
| Emergency Room | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| Mental Health Office Visits | $20 | $20 | $5 | $10 | $20 |
| Labs (Preferred) | $10 | $10 | $0 | $10 | $10 |
| Labs (Non-preferred) | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| X-rays & Diagnostic Imaging | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| MRIs & Advanced Imaging | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| Inpatient Facility Fee | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| Outpatient Facility Fee | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| RX | Generics: Preferred (Tier 1a) | $3 | $3 | $0 | $3 | $3 |
| RX | Generics: Non-preferred (Tier 1b) | $25 | $25 | $5 | $10 | $20 |
| RX | Brand: Preferred (Tier 2) | $100 | $100 | $30 | $40 | $80 |
| RX | Brand: Non-preferred (Tier 3) | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| RX | Brand: Specialty (Tier 4) | 40% after deductible | 40% after deductible | 20% | 40% after deductible | 40% after deductible |
| Classic Standard | Classic Standard CSR 150 | Classic Standard CSR 200 | Classic Standard CSR 250 | |
|---|---|---|---|---|
| The Basics | ||||
| Deductible (Individual / Family) | $5,900 / $11,800 | $0 / $0 | $700 / $1,400 | $5,700 / $11,400 |
| Pharmacy Deductible (Individual / Family) | N/A | N/A | N/A | N/A |
| Out-of-Pocket Max (Individual / Family) | $9,100 / $18,200 | $1,800 / $3,600 | $3,000 / $6,000 | $7,200 / $14,400 |
| $0 Preventive care | ✔️ | ✔️ | ✔️ | ✔️ |
| Dedicated Care Team | ✔️ | ✔️ | ✔️ | ✔️ |
| HSA-Compatible? | No | No | No | No |
|
Prices for Benefits
|
||||
| Virtual Primary Care (3) | $0 | $0 | $0 | $0 |
| Virtual Urgent Care (4) | $0 | $0 | $0 | $0 |
| Primary Care Office Visits | $40 | $0 | $20 | $40 |
| Specialist Office Visits | $80 | $10 | $40 | $80 |
| Urgent Care | $60 | $5 | $30 | $60 |
| Emergency Room | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| Mental Health Office Visits | $40 | $0 | $20 | $40 |
| Labs (Preferred) | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| Labs (Non-preferred) | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| X-rays & Diagnostic Imaging | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| MRIs & Advanced Imaging | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| Inpatient Facility Fee | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| Outpatient Facility Fee | 40% after deductible | 25% | 30% after deductible | 40% after deductible |
| RX | Generics: Preferred (Tier 1a) | $20 | $0 | $10 | $20 |
| RX | Generics: Non-preferred (Tier 1b) | $20 | $0 | $10 | $20 |
| RX | Brand: Preferred (Tier 2) | $40 | $15 | $20 | $40 |
| RX | Brand: Non-preferred (Tier 3) | $80 after deductible | $50 | $60 after deductible | $80 after deductible |
| RX | Brand: Specialty (Tier 4) | $350 after deductible | $150 | $250 after deductible | $350 after deductible |
| Elite Saver Plus | Elite Saver Plus CSR 150 | Elite Saver Plus CSR 200 | Elite Saver Plus CSR 250 | |
|---|---|---|---|---|
| The Basics | ||||
| Deductible (Individual / Family) | $0 / $0 | $0 / $0 | $0 / $0 | $0 / $0 |
| Pharmacy Deductible (Individual / Family) | $200 / $400 | $50 / $100 | $100 / $200 | $200 / $400 |
| Out-of-Pocket Max (Individual / Family) | $9,100 / $18,200 | $1,500 / $3,000 | $2,500 / $5,000 | $7,250 / $14,500 |
| $0 Preventive care | ✔️ | ✔️ | ✔️ | ✔️ |
| Dedicated Care Team | ✔️ | ✔️ | ✔️ | ✔️ |
| HSA-Compatible? | No | No | No | No |
|
Prices for Benefits
|
||||
| Virtual Primary Care (3) | $0 | $0 | $0 | $0 |
| Virtual Urgent Care (4) | $0 | $0 | $0 | $0 |
| Primary Care Office Visits | $60 | $0 | $15 | $60 |
| Specialist Office Visits | $100 | $10 | $30 | $100 |
| Urgent Care | $50 | $15 | $15 | $50 |
| Emergency Room | 50% | 20% | 30% | 50% |
| Mental Health Office Visits | $60 | $0 | $15 | $60 |
| Labs (Preferred) | $10 | $0 | $10 | $10 |
| Labs (Non-preferred) | $50 | $10 | $20 | $50 |
| X-rays & Diagnostic Imaging | $100 | $10 | $50 | $100 |
| MRIs & Advanced Imaging | 50% | 20% | 30% | 50% |
| Inpatient Facility Fee | 5-% | 20% | 30% | 50% |
| Outpatient Facility Fee | 50% | 20% | 30% | 50% |
| RX | Generics: Preferred (Tier 1a) | $3 | $0 | $3 | $3 |
| RX | Generics: Non-preferred (Tier 1b) | $30 | $5 | $25 | $30 |
| RX | Brand: Preferred (Tier 2) | $125 | $30 | $75 | $125 |
| 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 |
| Classic | Classic Standard | Elite | |
|---|---|---|---|
| The Basics | |||
| Deductible (Individual / Family) | $3,500 / $7,000 | $1,500 / $3,000 | $750 / $1,500 |
| Pharmacy Deductible (Individual / Family) | N/A | N/A | N/A |
| Out-of-Pocket Max (Individual / Family) | $7,000 / $14,000 | $8,700 / $17,400 | $5,500 / $11,000 |
| $0 Preventive care | ✔️ | ✔️ | ✔️ |
| Dedicated Care Team | ✔️ | ✔️ | ✔️ |
| HSA-Compatible? | No | No | No |
|
Prices for Benefits
|
|||
| Virtual Primary Care (3) | $0 | $0 | $0 |
| Virtual Urgent Care (4) | $0 | $0 | $0 |
| Primary Care Office Visits | $40 | $30 | $25 |
| Specialist Office Visits | $40 | $60 | $50 |
| Urgent Care | $75 | $45 | $50 |
| Emergency Room | $650 | 25% after deductible | 30% after deductible |
| Mental Health Office Visits | $40 | $30 | $50 |
| Labs (Preferred) | $10 | 25% after deductible | $10 |
| Labs (Non-preferred) | $50 | 25% after deductible | $25 |
| X-rays & Diagnostic Imaging | $40 | 25% after deductible | $50 |
| X-rays & Diagnostic Imaging | $375 | 25% after deductible | 30% after deductible |
| MRIs & Advanced Imaging | 30% after deductible | 25% after deductible | 30% after deductible |
| Inpatient / Outpatient Facility Fee | 30% after deductible | 25% after deductible | 30% after deductible |
| RX | Generics: Preferred (Tier 1a) | $3 | $15 | $3 |
| RX | Generics: Non-preferred (Tier 1b) | $15 | $15 | $25 |
| RX | Brand: Preferred (Tier 2) | $59 | $30 | $75 |
| RX | Brand: Non-preferred (Tier 3) | 30% after deductible | $60 | 30% after deductible |
| RX | Brand: Specialty (Tier 4) | 30% after deductible | $250 | 30% after deductible |
Coverage Map
Austin
San Antonio
2025 Participating Hospital List
Check the Provider Finder to see if it’s in-network!
Oscar 2025 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.
| County | Hospital | EPO | HMO Guided Care |
| Atascosa | Methodist Hospital Atascosa | ✔ | |
| Bastrop | Ascension Seton Health Center-Bastrop | ✔ | |
| Bastrop | Ascension Seton Smithville Hospital | ✔ | |
| Bell | Ascension Seton Hospital Harker Heights | ✔ | |
| Bexar | Baptist Medical Center | ✔ | ✔ |
| Bexar | Kindred Hospital San Antonio | ✔ | ✔ |
| Bexar | Methodist Westover Hills Hospital | ✔ | |
| Bexar | Methodist Children’s Hospital | ✔ | |
| Bexar | Methodist Hospital Landmark | ✔ | |
| Bexar | Methodist Specialty and Transplant Hospital | ✔ | |
| Bexar | Methodist Hospital Stone Oak | ✔ | |
| Bexar | Methodist Hospital Texsan | ✔ | |
| 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 | Medical City Plano Hospital | ✔ | |
| Collin | Methodist Mckinney Hospital | ✔ | |
| Collin | Methodist Richardson Medical Center | ✔ | |
| Comal | Resolute Baptist Hospital | ✔ | ✔ |
| Cooke | North Texas Medical Center | ✔ | |
| Dallas | Medical City Children’s Hospital | ✔ | ✔ |
| Dallas | Medical City Dallas Hospital | ✔ | ✔ |
| Dallas | Medical City Spine Hospital | ✔ | ✔ |
| Dallas | Methodist Charlton Medical Center | ✔ | ✔ |
| Dallas | Methodist Dallas Medical Center | ✔ | ✔ |
| Dallas | Methodist Hospital for Surgery | ✔ | ✔ |
| Dallas | Medical City Sachse Hospital | ✔ | ✔ |
| Dallas | Medical City Heart Hospital | ✔ | ✔ |
| Dallas | Methodist Rehabilitation Hospital | ✔ | ✔ |
| Dallas | Kindred Hospital Dallas Central | ✔ | ✔ |
| Dallas | Medical City Las Colinas Hospital | ✔ | ✔ |
| Denton | Medical City Denton Hospital | ✔ | |
| Denton | Medical City Lewisville Hospital | ✔ | |
| El Paso | Del Sol Medical Center | ✔ | |
| El Paso | Las Palmas Medical Center | ✔ | |
| El Paso | Las Palmas Healthcare Northeast | ✔ | |
| El Paso | Las Palmas Del Sol Healthcare Horizon | ✔ | |
| El Paso | Providence Children’s Hospital | ✔ | ✔ |
| 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 | Memorial Hermann Surgical Hospital First Colony | ✔ | ✔ |
| Fort Bend | Memorial Hermann Katy Hospital | ✔ | ✔ |
| Fort Bend | OakBend Medical Center Williams Way Hospital Campus | ✔ | ✔ |
| Fort Bend | OakBend Medical Center Jackson Street Hospital Campus | ✔ | ✔ |
| Galveston | HCA Houston Healthcare Mainland | ✔ | |
| Galveston | UTMB Health | ✔ | |
| Galveston | UTMB League City Campus Hospital | ✔ | |
| Guadalupe | Guadalupe Regional Medical Center | ✔ | |
| Harris | Cornerstone Specialty Hospitals Houston Medical Center | ✔ | ✔ |
| 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 Rehabilitation Hospital Southeast | ✔ | ✔ |
| Harris | Memorial Hermann Cypress Hospital | ✔ | ✔ |
| 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 Southwest Hospital | ✔ | ✔ |
| Harris | Memorial Hermann/Rockets Orthopedic Center | ✔ | ✔ |
| Harris | Memorial Hermann Children’s Hospital | ✔ | ✔ |
| Harris | TIRR Memorial Hermann | ✔ | ✔ |
| Harris | HCA Houston Healthcare North Cypress | ✔ | ✔ |
| Harris | Texas Orthopedic Hospital | ✔ | ✔ |
| Harris | UTMB Clear Lake Campus Hospital | ✔ | |
| Harris | The Woman’s Hospital of Texas | ✔ | ✔ |
| Hays | Ascension Seton Hays | ✔ | |
| Hidalgo | Rio Grande Regional Hospital | ✔ | |
| Hidalgo | VBMH-Weslaco | ✔ | |
| Liberty | Liberty Dayton Regional Medical Center | ✔ | |
| Montgomery | HCA Houston Healthcare Conroe | ✔ | ✔ |
| Montgomery | HCA Houston Healthcare Kingwood | ✔ | ✔ |
| Montgomery | Memorial Hermann The Woodlands Medical Center | ✔ | ✔ |
| Nacogdoches | Nacogdoches Medical Center | ✔ | |
| Parker | Medical City Weatherford | ✔ | |
| Tarrant | Medical City North Hills | ✔ | |
| Tarrant | Medical City Alliance Hospital | ✔ | |
| Tarrant | Medical City Arlington Hospital | ✔ | |
| Tarrant | Medical City Argyle Hospital | ✔ | |
| Tarrant | Medical City Fort Worth Hospital | ✔ | |
| Tarrant | Methodist Mansfield Medical Center | ✔ | |
| Tarrant | Methodist Southlake Medical Center | ✔ | |
| Tarrant | Texas Rehabilitation Hospital of Arlington | ✔ | |
| Travis | Ascension Seton Medical Center Austin | ✔ | |
| Travis | Dell Seton Medical Center At the University of Texas | ✔ | |
| Travis | Heart Hospital of Austin | ✔ | ✔ |
| Travis | Ascension Seton Northwest Hospital | ✔ | |
| Travis | Ascension Seton Southwest Hospital | ✔ | |
| Travis | St. David’s Medical Center | ✔ | ✔ |
| Travis | St. David’s Rehabilitation Hospital | ✔ | ✔ |
| Travis | St. David’s North Austin Medical Center | ✔ | ✔ |
| Travis | St. David’s South Austin Medical Center | ✔ | ✔ |
| Travis | St. David’s Surgical Hospital | ✔ | ✔ |
| Travis | St. David’s Children’s Hospital | ✔ | ✔ |
| Williamson | Cedar Park Regional Medical Center | ✔ | |
| Williamson | St. David’s Georgetown | ✔ | ✔ |
| 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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