Enhanced Diabetes Care Silver with $0 Drug Options
Starting at
$638
/month before subsidy
Enhanced Diabetes Care Silver with $0 Drug Options is a 2026 Silver EPO health insurance plan from Ambetter from Superior HealthPlan, sold on the ACA Marketplace in Texas under plan ID 29418TX0140049. The monthly premium starts at $638 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $5,000 ($10,000 for a family), and the individual out-of-pocket maximum is $8,650 ($17,300 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 29418TX0140049
- Plan year
- 2026
- State
- Texas
- Metal level
- Silver
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$5,000
Family: $10,000
Out-of-Pocket Max
$8,650
Family: $17,300
Coinsurance
50%
You pay after deductible
Network Type
EPO
TXN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$7,360
your estimated cost
- Deductible
- $5,000
- Copays
- $400
- Coinsurance
- $1,900
Managing type 2 diabetes
A year of routine care
$1,420
your estimated cost
- Deductible
- $800
- Copays
- $600
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,700
your estimated cost
- Deductible
- $2,500
- Copays
- $200
- Coinsurance
- $0
Enter your ZIP code first to search nearby doctors.
This Silver EPO 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
$1,359/month
Annual Premium
$7,656
OOP Maximum
$8,650
💡 What this means:
With a $5,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $8,650 total. Then insurance covers everything else for the year.
More plans from Ambetter from Superior HealthPlan in Texas
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dentalfrom $662/mo
- Focused Silverfrom $632/mo
- Focused Silver + Vision + Adult Dentalfrom $655/mo
- Focused VALUE Silverfrom $671/mo
- Focused VALUE Silverfrom $709/mo
- Focused VALUE Silverfrom $595/mo
- Focused VALUE Silver + Vision + Adult Dentalfrom $736/mo
- Focused VALUE Silver + Vision + Adult Dentalfrom $696/mo
Frequently asked questions about Enhanced Diabetes Care Silver with $0 Drug Options
How much does Enhanced Diabetes Care Silver with $0 Drug Options cost per month?
Enhanced Diabetes Care Silver with $0 Drug Options from Ambetter from Superior HealthPlan starts at $638 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 Enhanced Diabetes Care Silver with $0 Drug Options?
The individual medical deductible is $5,000, and the family deductible is $10,000. 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 Enhanced Diabetes Care Silver with $0 Drug Options?
The most you would pay in a year for covered in-network care is $8,650 for an individual and $17,300 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Enhanced Diabetes Care Silver with $0 Drug Options HSA-eligible?
No. Enhanced Diabetes Care Silver with $0 Drug Options 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 Enhanced Diabetes Care Silver with $0 Drug Options use?
Enhanced Diabetes Care Silver with $0 Drug Options is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.
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
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.