ACA individual plans: Texas

Standard individual plans

You can find important benefits details for our Bronze, Silver and Gold plans below.

Check out our brochure

Discover the value, care and access included with all ACA plans.

Benefits at a glance - English (PDF)

Benefits at a glance - Spanish (PDF)

Use our menu below to see different plan types.

Individual plans

Interested in plans for Native Americans and Alaska Natives (AI/AN)?
Check out our zero and limited cost-sharing plans to meet your health care needs.

AI/AN plan benefits

Aetna CVS Health™ Bronze

$0 walk-in clinic visits, pediatric dental*

Deductible

(Individual/Family)

$8,700/$17,400

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

0% after deductible

Coinsurance

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Bronze

Low-cost walk-in clinic visits, pediatric dental*

Deductible

(Individual/Family)

$5,500/$11,000

Out-of-pocket max

(Individual/Family)

$7,000/$14,000

PCP office visit

50% after deductible

Coinsurance

50%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Bronze

$0 walk-in clinic visits***

Deductible

(Individual/Family)

$8,700/$17,400

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

0% after deductible

Coinsurance

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Bronze

Low-cost walk-in clinic visits***

Deductible

(Individual/Family)

$5,500 / $11,000

Out-of-pocket max

(Individual/Family)

$7,000/$14,000

PCP office visit

50% after deductible

Coinsurance

50%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 1

$0 walk-in clinic visits, pediatric dental*

Deductible

(Individual/Family)

$4,000 / $8,000

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

$30 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 1

$0 walk-in clinic visits***

Deductible

(Individual/Family)

$4,000 / $8,000

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

$30 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 1

$0 walk-in clinic visits, 73% cost-sharing reduction**

Deductible

(Individual/Family)

$3,300 / $6,600

Out-of-pocket max

(Individual/Family)

$6,800/$13,600

PCP office visit

$20 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 1

$0 walk-in clinic visits, 87% cost-sharing reduction**

Deductible

(Individual/Family)

$750 / $1,500

Out-of-pocket max

(Individual/Family)

$2,700/$5,400

PCP office visit

$15 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 1

$0 walk-in clinic visits, 94% cost-sharing reduction**

Deductible

(Individual/Family)

$100 / $200

Out-of-pocket max

(Individual/Family)

$1,000/$2,000

PCP office visit

$0 after deductible

Coinsurance

25%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 2

$0 walk-in clinic visits, pediatric dental*

Deductible

(Individual/Family)

$6,000 / $12,000

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

$25 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 2

$0 walk-in clinic visits***

Deductible

(Individual/Family)

$6,000 / $12,000

Out-of-pocket max

(Individual/Family)

$8,700/$17,400

PCP office visit

$25 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 2

$0 walk-in clinic visits, 73% cost-sharing reduction**

Deductible

(Individual/Family)

$3,300 / $6,800

Out-of-pocket max

(Individual/Family)

$6,800/$13,600

PCP office visit

$25 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 2

$0 walk-in clinic visits, 87% cost-sharing reduction**

Deductible

(Individual/Family)

$500 / $1,000

Out-of-pocket max

(Individual/Family)

$2,700/$5,400

PCP office visit

$15 after deductible

Coinsurance

40%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Aetna CVS Health™ Silver 2

$0 walk-in clinic visits, 94% cost-sharing reduction**

Deductible

(Individual/Family)

$200 / $400

Out-of-pocket max

(Individual/Family)

$1,000/$2,000

PCP office visit

$5 after deductible

Coinsurance

25%

Summary of Benefits & Coverage

Evidence of Coverage

Find covered drugs

Interested in plans for Native Americans and Alaska Natives (A1/AN)?

Check out our zero and limited cost-sharing plans to meet your health care needs.

A1/AN plan benefits

*These plans are available only off-exchange (not eligible for subsidies) and include pediatric dental benefits.

**These plans are available only on-exchange (may qualify for subsidies).

***These plans are available both on-exchange (may qualify for subsidies) and off-exchange (not eligible for subsidies).

Shoppers: To find TX plan consumer cost estimate information on medical benefits for physician-administered drugs, see the plan’s Evidence of Coverage.

Members: Log in to your member website and review your Evidence of Coverage to find your current member cost estimate information for medical benefits for physician-administered drugs.

Note: MinuteClinic® includes select services. Not all MinuteClinic® services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic® services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states and on indemnity plans. For a complete list of participating walk-in clinic providers, log in to Aetna.com and use our provider search tool.

Note: Keep in mind that the cost shown on our find covered drugs tool may not accurately reflect what you will pay at the pharmacy. Your actual cost may vary depending on your benefit plan design, deductible status, pharmacy-specific pricing or prior authorizations.

Legal notices

Health plans are offered or underwritten or administered by Aetna Health Inc. (Texas) (Aetna). Aetna is part of the CVS Health family of companies.

MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) is part of the CVS Health family of companies.

Health benefits and health insurance plans contain exclusions and limitations.

See all legal notices