BSW Elite Gold HMO 012
Starting at
$491
/month before subsidy
BSW Elite Gold HMO 012 is a 2026 Gold HMO health insurance plan from Baylor Scott and White Health Plan, sold on the ACA Marketplace in Texas under plan ID 40788TX0460012. The monthly premium starts at $491 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $500 ($1,000 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 40788TX0460012
- Plan year
- 2026
- State
- Texas
- Metal level
- Gold
- Plan type
- HMO
- HSA-eligible
- No
Individual Deductible
$500
Family: $1,000
Out-of-Pocket Max
$10,600
Family: $21,200
Coinsurance
25%
You pay after deductible
Network Type
HMO
TXN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Not rated
- 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
$3,960
your estimated cost
- Deductible
- $500
- Copays
- $2,700
- Coinsurance
- $700
Managing type 2 diabetes
A year of routine care
$920
your estimated cost
- Deductible
- $100
- Copays
- $600
- Coinsurance
- $200
A simple fracture
ER visit + follow-up
$700
your estimated cost
- Deductible
- $0
- Copays
- $200
- Coinsurance
- $500
Enter your ZIP code first to search nearby doctors.
This Gold HMO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.
Consider this plan if you:
- Have ongoing health conditions requiring regular care
- Take multiple prescription medications
- Prefer lower costs at the time of service
- Want peace of mind with comprehensive coverage
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,374/month
Annual Premium
$5,892
OOP Maximum
$10,600
💡 What this means:
With a $500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 25% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.
More plans from Baylor Scott and White Health Plan in Texas
- BSW Savers Bronze HMO H S A 006from $352/mo
- BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay)from $358/mo
- BSW Savers Bronze HMO H S A 009from $362/mo
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay)from $563/mo
- BSW Prime Silver HMO 008from $564/mo
- BSW Prime Silver HMO 005from $564/mo
- BSW Diabetes Care Gold HMO 014from $613/mo
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay)from $470/mo
Frequently asked questions about BSW Elite Gold HMO 012
How much does BSW Elite Gold HMO 012 cost per month?
BSW Elite Gold HMO 012 from Baylor Scott and White Health Plan starts at $491 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 BSW Elite Gold HMO 012?
The individual medical deductible is $500, and the family deductible is $1,000. 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 BSW Elite Gold HMO 012?
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 BSW Elite Gold HMO 012 HSA-eligible?
No. BSW Elite Gold HMO 012 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 BSW Elite Gold HMO 012 use?
BSW Elite Gold HMO 012 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
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.