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 – 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

Shaped more like traditional health plans, Classic plans offer higher levels of coverage and more copays than Simple plans.

	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.

This silver tier plan is only available off-exchange • It has lower premiums than other silver tier plans • Only difference vs. Classic Silver plan is copay on generic drugs lowered to $10 • Plan created in response to uncertainty around the federal government’s funding of cost share reduction (CSR) subsidies. This uncertainty has driven up premiums on silver tier plans available on the government exchange

	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

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Online Application

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: