Silver Simple Diabetes Guided Care with Adult Dental & Vision
Starting at
$793
/month before subsidy
Silver Simple Diabetes Guided Care with Adult Dental & Vision is a 2027 Silver HMO health insurance plan from Oscar Insurance Company, sold on the ACA Marketplace in Texas under plan ID 20069TX0510177. The monthly premium starts at $793 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $6,500 ($13,000 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 45% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 20069TX0510177
- Plan year
- 2027
- State
- Texas
- Metal level
- Silver
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$6,500
Family: $13,000
Out-of-Pocket Max
$10,600
Family: $21,200
Coinsurance
45%
You pay after deductible
Network Type
HMO
TXN002
Medical Services
Prescription Drugs
Having a baby
Normal delivery
$8,400
your estimated cost
- Deductible
- $6,500
- Copays
- $200
- Coinsurance
- $1,700
Managing type 2 diabetes
A year of routine care
$4,400
your estimated cost
- Deductible
- $4,200
- Copays
- $200
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,680
your estimated cost
- Deductible
- $2,600
- Copays
- $80
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver HMO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.
Consider this plan if you:
- Visit the doctor a few times per year
- Take regular prescription medications
- Want moderate protection against high medical bills
- May qualify for Cost-Sharing Reductions (CSR) to lower deductibles
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,676/month
Annual Premium
$9,516
OOP Maximum
$10,600
💡 What this means:
With a $6,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 45% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.
More plans from Oscar Insurance Company in Texas
- Bronze Classic 4700from $474/mo
- Bronze Classic Standardfrom $475/mo
- Bronze Elite + PCP Saver Plusfrom $488/mo
- Bronze Simple Breathe Easy with Enhanced COPD Benefitsfrom $468/mo
- Bronze Simple Chronic Care CKMfrom $485/mo
- Bronze Simple Diabetesfrom $483/mo
- Bronze Simple Diabetes with Adult Dental & Visionfrom $502/mo
- Silver Classic Standardfrom $734/mo
Frequently asked questions about Silver Simple Diabetes Guided Care with Adult Dental & Vision
How much does Silver Simple Diabetes Guided Care with Adult Dental & Vision cost per month?
Silver Simple Diabetes Guided Care with Adult Dental & Vision from Oscar Insurance Company starts at $793 per month before any subsidy in Texas. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Silver Simple Diabetes Guided Care with Adult Dental & Vision?
The individual medical deductible is $6,500, and the family deductible is $13,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Silver Simple Diabetes Guided Care with Adult Dental & Vision?
The most you would pay in a year for covered in-network care is $10,600 for an individual and $21,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Silver Simple Diabetes Guided Care with Adult Dental & Vision HSA-eligible?
No. Silver Simple Diabetes Guided Care with Adult Dental & Vision is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Silver Simple Diabetes Guided Care with Adult Dental & Vision use?
Silver Simple Diabetes Guided Care with Adult Dental & Vision is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
- The SLCSP benchmark
The Silver plan that sets your subsidy and Form 1095-A
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.