Loading...
Loading...
Oscar Health Silver Classic Standard is a 2026 Texas individual and family health insurance plan with an Exclusive Provider Organization (EPO) network. The plan has a $6,000 individual deductible and a $12,000 family deductible. The out-of-pocket maximum is $8,900 for an individual and $17,800 for a family. In-network primary care visits cost $40, specialist visits cost $80, and urgent care visits cost $60. Eligible in-network preventive care is covered at no charge. Generic Tier 1 prescriptions have a $20 copay, preferred brand prescriptions have a $40 copay, and many diagnostic, hospital and emergency services have 40% coinsurance after the deductible. Premium information is provided separately by the insurer.
$6,000 individual deductible; $40 primary care; $80 specialist; $8,900 individual out-of-pocket maximum
Silver Classic Standard provides fixed copays for several routine services, including primary care, specialist visits and generic medicines. However, the $6,000 individual deductible remains substantial, and many hospital, imaging and emergency services require 40% coinsurance after the deductible. The EPO network generally excludes routine non-emergency out-of-network care, so members should check doctors, hospitals and laboratories before receiving services. The plan also includes service limits for some rehabilitation and home health benefits. Review the full Summary of Benefits and Coverage and the 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 individual deductible is $6,000 and the family deductible is $12,000. The out-of-pocket maximum is $8,900 individual and $17,800 family.
Premiums, balance-billing charges and non-covered services do not count toward the out-of-pocket maximum.
Eligible in-network preventive care, screening and immunization services are covered at no charge under plan terms.
Services that are not classified as preventive may have separate cost sharing.
In-network primary care visits to treat an injury or illness have a $40 copay per visit, not subject to the deductible.
The same cost share applies to in-person and telemedicine services. Designated Oscar virtual primary care is covered in full.
In-network specialist visits have an $80 copay per visit, not subject to the deductible. A referral is not required.
Routine out-of-network specialist care is not covered.
Tier 1 generic prescriptions have a $20 copay and preferred brand prescriptions have a $40 copay, neither subject to the deductible. Non-preferred brand medicines have an $80 copay after the deductible; specialty medicines have a $350 copay after the deductible.
Retail prescriptions are generally limited to a 30-day supply. Prior authorization or step therapy may apply.
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 the service area and enrollment availability with Oscar Health.
The plan lists a $6,000 individual deductible. Many diagnostic and hospital services require the deductible to be met before coinsurance applies.
The plan lists a $12,000 family deductible. The official plan document explains how individual and family deductible amounts apply to covered members.
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 listed maximum is $8,900 for an individual and $17,800 for a family. Premiums and non-covered services are excluded.
An in-network primary care visit to treat an injury or illness has a $40 copay, not subject to the deductible.
An in-network specialist visit has an $80 copay, not subject to the deductible. A referral is not required.
Eligible in-network preventive care, screening and immunization services are covered at no charge. Non-preventive services may have cost sharing.
An in-network urgent care visit has a $60 copay. Designated Oscar virtual urgent care is covered in full under plan terms.
Tier 1 generic prescriptions have a $20 copay without the deductible applying first. Check the formulary and pharmacy network for coverage details.
Many inpatient, outpatient facility and diagnostic services have 40% coinsurance after the deductible. Review the official SBC for the exact service.
Routine out-of-network care is generally not covered under this EPO plan. Emergency services follow applicable plan and legal requirements.
The official plan summary provides premium information separately. The actual premium depends on location, age, household details and applicable financial assistance.