Texas HSA Plans
There are 3 HSA eligible plans in Texas in 2021, available state-wide through Blue Cross Blue Shield of Texas and in the Austin & San Antonio area by Oscar Health Plans. Health Savings Accounts can reduce your out of pocket costs as well as your tax burden. Learn more at our HSA Guide.
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Blue Advantage Bronze HMO 201 & Oscar Saver Plans
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| Blue Cross And Blue Shield Of Texas · Blue Advantage Plus Bronze℠ 201 | Oscar · Saver Bronze | Oscar · Saver Silver |
|---|---|---|
| Blue Cross And Blue Shield Of Texas · Blue Advantage Plus Bronze℠ 201 | Oscar · Saver Bronze | Oscar · Saver Silver |
| Bronze HMO| Plan ID: 33602TX0770108 | Bronze EPO| Plan ID: 20069TX0340001 | Silver EPO| Plan ID: 20069TX0350001 |
| Deductible | Deductible | Deductible |
| $2,850 Individual | $6,500 Individual | $5,000 Individual |
| $6,550 Out-of-pocket maximum | $6,500 Out-of-pocket maximum | $5,000 Out-of-pocket maximum ( |
| 60% coinsurance after ded. | 100% coinsurance after ded. | 100% coinsurance after ded. |
| Copayments / Coinsurance | Copayments / Coinsurance | Copayments / Coinsurance |
| Emergency room care: $950 Copay with deductible/40% Coinsurance after deductible | Emergency room care: No Charge After Deductible | Emergency room care: No Charge After Deductible |
| Generic drugs: 20% Coinsurance after deductible | Generic drugs: No Charge After Deductible | Generic drugs: No Charge After Deductible |
| Primary doctor: 40% Coinsurance after deductible | Primary doctor: No Charge After Deductible | Primary doctor: No Charge After Deductible |
| Specialist doctor: 40% Coinsurance after deductible | Specialist doctor: No Charge After Deductible | Specialist doctor: No Charge After Deductible |
| DOCUMENTS | DOCUMENTS | DOCUMENTS |
| Summary of Benefits | Summary of Benefits | Summary of Benefits |
| Plan brochure | Plan Brochure |
Plan Brochure |
| Costs for medical care | Costs for medical care | Costs for medical care |
| Deductible | Deductible | Deductible |
| $2,850 Individual Total | $6,500 Individual Total | $5,000 Individual Total |
| Out-of-pocket maximum | Out-of-pocket maximum | Out-of-pocket maximum |
| $6,550 Individual Total | $6,500 Individual Total | $5,000 Individual Total |
| Primary care doctor visit | Primary care doctor visit | Primary care doctor visit |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out-of-Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Specialist visit | Specialist visit | Specialist visit |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out-of-Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| X-rays and diagnostic imaging | X-rays and diagnostic imaging | X-rays and diagnostic imaging |
| Limits and exclusions apply: X-rays and diagnostic imaging | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Laboratory outpatient and professional services | Laboratory outpatient and professional services | Laboratory outpatient and professional services |
| Limits and exclusions apply: Laboratory outpatient and professional services | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Outpatient facility | Outpatient facility | Outpatient facility |
| Limits and exclusions apply: Outpatient facility | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: $600 Copay with deductible/30% Coinsurance after deductible | Out-of-Network: Benefit Not Covered | Out-of-Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: $1500 Copay with deductible/50% Coinsurance after deductible | ||
| Outpatient professional services | Outpatient professional services | Outpatient professional services |
| In Network Tier 1: $200 Copay with deductible/40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Hearing aids | Hearing aids | Hearing aids |
| Limits and exclusions apply: Hearing aids | Limits and exclusions apply: Hearing aids | Limits and exclusions apply: Hearing aids |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Routine eye exam for adults | Routine eye exam for adults | Routine eye exam for adults |
| In Network: Benefit Not Covered | In Network: Benefit Not Covered | In Network: Benefit Not Covered |
| Routine eye exam for children | Routine eye exam for children | Routine eye exam for children |
| Limits and exclusions apply: Routine eye exam for children | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: No Charge | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: Benefit Not Covered | ||
| Eyeglasses for children | Eyeglasses for children | Eyeglasses for children |
| Limits and exclusions apply: Eyeglasses for children | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: No Charge After Deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | Eligible for Health Savings Account (HSA)YesPrescription drug coverage | Eligible for Health Savings Account (HSA)YesPrescription drug coverage |
| Out of Network: Benefit Not Covered | ||
| Eligible for Health Savings Account (HSA)Yes Prescription drug coverage | ||
| Generic drugs | Generic drugs | Generic drugs |
| Limits and exclusions apply: Generic drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 20% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 25% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Preferred brand drugs | Preferred brand drugs | Preferred brand drugs |
| Limits and exclusions apply: Preferred brand drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 35% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Non-preferred brand drugs | Non-preferred brand drugs | Non-preferred brand drugs |
| Limits and exclusions apply: Non-preferred brand drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 35% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 40% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Specialty drugs | Specialty drugs | Specialty drugs |
| Limits and exclusions apply: Specialty drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 45% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 45% Coinsurance after deductible | ||
| Out of Network: 45% Coinsurance after deductible | ||
| Emergency room care | Emergency room care | Emergency room care |
| Limits and exclusions apply: Emergency room care | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: $950 Copay with deductible/40% Coinsurance after deductible | Out of Network: No Charge After Deductible | Out of Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | ||
| Out-of-Network: $950 Copay with deductible/40% Coinsurance after deductible | ||
| Inpatient doctor and surgical services | Inpatient doctor and surgical services | Inpatient doctor and surgical services |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Inpatient hospital services (like a hospital stay) | Inpatient hospital services (like a hospital stay) | Inpatient hospital services (like a hospital stay) |
| Limits and exclusions apply: Inpatient hospital services (like a hospital stay) | Limits and exclusions apply: Inpatient hospital services (like a hospital stay) | Limits and exclusions apply: Inpatient hospital services (like a hospital stay) |
| In-network Tier 1: $850 Copay per Stay with deductible/40% Coinsurance after deductible | ||
| In Network Tier 2: Not Applicable | ||
| Out-of-Network: $1500 Copay per Stay with deductible/50% Coinsurance after deductible |
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