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Oscar Health Bronze Elite + PCP Saver Plus is a 2026 Texas individual and family health insurance plan with an Exclusive Provider Organization (EPO) network. It has a $0 general medical deductible for individuals and families, but prescription drugs have a separate deductible of $6,500 individual and $13,000 family. The out-of-pocket maximum is $10,150 individual and $20,300 family. In-network primary care visits cost $40, specialist visits cost $130, and urgent care visits cost $75. Eligible in-network preventive care and designated Oscar virtual primary and urgent care services are covered in full under the plan terms. Many hospital services have fixed copays, while some services have 50% coinsurance. Premium information is provided separately.
$0 medical deductible; $40 primary care; $130 specialist; separate prescription drug deductible
The plan’s $0 general medical deductible can make some in-network medical services easier to budget for, but it does not mean all treatment is free. Members remain responsible for applicable copays and coinsurance, and prescription drugs have a substantial separate deductible. Hospital facility services have a $3,000 per-day copay for up to two days per admission, while emergency-room facility care has a $2,500 copay. The EPO network generally excludes routine non-emergency out-of-network care. Applicants should review the full Summary of Benefits and Coverage, formulary and provider directory before enrolling.
Oscar Health
Key Insights
Founded
2012
Oscar Health was established 14 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
0% CSR, calculated as a 3-year average
Oscar Health settles 0% of all claims it receives.
Network Hospitals
60,000+ Providers
Oscar Health has a network of 60,000+ Providers hospitals, ensuring wide accessibility and convenience for policyholders.
The general medical deductible is $0 for individuals and families. The out-of-pocket maximum is $10,150 individual and $20,300 family.
Premiums, balance-billing charges and non-covered services are excluded from the out-of-pocket limit.
Prescription drug coverage has a separate deductible of $6,500 individual and $13,000 family.
Tier 1 generic prescriptions have stated copays before this deductible; other drug tiers may be subject to it.
In-network primary care visits to treat an illness or injury have a $40 copay per visit. Designated Oscar virtual primary care is covered in full.
Virtual pediatric primary care through Oscar Medical Group is not available under the plan summary.
In-network specialist visits have a $130 copay per visit and do not require a referral.
Routine out-of-network specialist care is not covered.
Eligible in-network preventive care is covered at no charge. The summary lists $65 for lab work, $150 for X-rays and $750 for covered imaging services.
These diagnostic copays are listed as not subject to the general medical deductible.
Oscar-related supplemental-plan information lists dental options, including options with vision coverage, and a dental, vision and hearing option for eligible members.
Separate supplemental coverage; confirm current Texas availability, eligibility, benefits, exclusions and price before purchase.
A separately offered accident plan may provide additional financial benefits for covered accidental injuries, subject to its own policy terms.
Conditions or treatments that the policy clearly says it will not cover.
Insurer
Oscar Health plans and claim process
It is a 2026 Texas individual and family health insurance plan with an EPO network. Confirm service-area and enrollment availability with Oscar Health.
The general medical deductible is $0 for individuals and families. Separate prescription drug cost-sharing rules still apply.
The separate prescription drug deductible is $6,500 for an individual and $13,000 for a family.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Ratings and figures are based on publicly available company disclosures and state insurance department filings. Finzony is not an insurance broker or agent. Verify all details on the official Oscar Health website before purchasing.
Contact Details
1-855-672-2788
Headquarters: 75 Varick Street, 5th Floor, New York, NY 10013, United States
Official Website
hioscar.com
Visit the official Oscar Health website for plan brochures, premium quotes and policy services.
The aforementioned ratios have been averaged over three years (FY24-FY26)
Not a benefit automatically included in this Oscar medical plan. Confirm availability and the exact benefit schedule.
A separately offered supplemental product is listed for additional financial support related to specified serious conditions.
Separate policy and eligibility requirements apply. Do not assume it pays every medical bill or covers every diagnosis.
Supplemental life insurance is listed among the optional products offered through Oscar-related supplemental-plan information.
Separate life insurance product; verify current availability, underwriting and policy terms.
The plan lists $10,150 for an individual and $20,300 for a family. Premiums and non-covered services are excluded.
An in-network primary care visit to treat an illness or injury has a $40 copay. Designated Oscar virtual primary care is covered in full under plan terms.
An in-network specialist visit has a $130 copay. The plan summary says a referral is not required.
Eligible in-network preventive care is covered at no charge. Non-preventive services may have separate cost-sharing amounts.
An in-network urgent care visit has a $75 copay. Designated Oscar virtual urgent care is covered in full under plan terms.
Tier 1A generic prescriptions have a $3 copay and Tier 1B generics have a $35 copay. Other drug tiers have different cost-sharing rules.
The plan lists a $2,500 copay for the emergency-room facility fee and no charge for the emergency-room physician fee. Emergency out-of-network care is covered when the services are for an emergency condition.
The plan lists a $3,000 per-day facility copay for up to two days per admission and a $350 copay for inpatient physician or surgeon services.
The plan document says premium information is provided separately. The actual premium depends on the applicant’s location, age, household details and applicable financial assistance.