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Marketplace Plan Information

Enroll Now Member Resources

Individual Health Plans For You and Your Family

Also known as Affordable Care Act (ACA) plans or health insurance exchange plans, Baylor Scott & White Health Plan offers you a range of Gold, Silver and Bronze Marketplace plans with different coverage levels, deductibles and benefits tailored to individuals and families.

All of our plans offer coverage for preventive care, telehealth, maternity and wellness programs. Pharmacy benefits are also included. And you'll have access to more than 40,000 in-network doctors and the renowned Baylor Scott & White Health system.

Where We Offer Marketplace Plans

coverage map
coverage map

*If you don't live in one of the counties shown on the map or if you'd prefer to see additional options, click here.

Enroll

We're happy to help you find a plan that fits your health needs as well as your budget. We can also check to see if you're eligible for assistance with the Advance Premium Tax Credit or Cost Share Reduction program.

Visit our Direct Enrollment Portal to enroll, get a quote or compare plans.

Standard of Excellence

Ranked in the top 5% of healthcare providers in delivering patient experience.

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Plan Details

Gold

Are you are looking for a health plan with no or low deductibles and/or copays? Then our Marketplace Gold Plans are for you.

For benefit comparisons, formulary information and plan documents, call us at 866.522.2515.

Silver

With our Marketplace Silver Plans, you will pay lower premiums than our Gold Plans. Your deductible may be as low as $0, with doctor visit or medication copayments as low as $5.

More information

The costs and benefit levels of our Marketplace Silver Plans all depend on your income and how that compares to the Federal Poverty Level (FPL). If you qualify for one of our lower cost-sharing Silver Plans, you will have lower copays, lower deductibles and further assistance through tax credits. To see if you qualify for a subsidy, try this subsidy calculator.

For benefit comparison, formulary information and plan documents, call us at 866.522.2515.

Bronze

These are our most affordable Marketplace plans. With a Bronze Plan, you will pay lower premiums with slightly higher out-of-pocket costs.

More information

Do you just want to be protected if the unexpected happens without paying large monthly premiums? Our Marketplace Bronze plans provide preventive care and limited options before you reach your deductible, but provide coverage when you need it. We also allow you to pair a Health Savings Account (HSA) with your Bronze Plan. See the HMO Bronze HSA Eligible Plan option for details.

For benefit comparisons, formulary information and plan documents, call us at 866.522.2515.

Additional Individual and Family Plan Options

Additional plan options are available in the following counties for 2024

HMO and EPO Plans: Austin, Bastrop*, Bell, Bexar*, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coke, Coleman, Collin, Comal*, Concho, Coryell, Crockett, Dallas, Denton, El Paso*, Ellis, Erath, Falls, Fayette, Freestone, Grimes, Hamilton, Hays*, Hill, Hood, Irion, Johnson, Kimble, Lampasas, Lee, Leon, Limestone, Llano, Mason, McCulloch, McLennan, Madison, Menard, Milam, Mills, Reagan, Robertson, Rockwall, Runnels, San Saba, Schleicher, Somervell, Sterling, Sutton, Tarrant, Tom Green, Travis, Walker*, Waller, Washington and Williamson.

*EPO Plans not available in these counties.

HMO Plan Information, Monthly Premiums and Application

Online HMO Enrollment & Rates

An HMO — Health Maintenance Organization — gives you a range of benefits for a prepaid monthly fee. The plan focuses on wellness, prevention and treatment within a network of providers. Out-of-network providers are usually not covered, unless in an emergency. Designated primary care physicians and referrals are not required for in-network care.

The HMO plan offers access to more than 14,000 in-network doctors and the renowned Baylor Scott & White Health system. Other physicians and providers are also available in our networks.

2024 Plan Details

EPO Plan Information, Monthly Premiums and Application

Online EPO Enrollment & Rates

The EPO — Exclusive Provider Organization — has a separate provider network. As a member of the EPO, you can use doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits, except emergency and urgent care. Designated primary care physicians and referrals are not required for in-network care.

The EPO plan offers access to more than 14,000 in-network doctors and the renowned Baylor Scott & White Health system. Other physicians and providers are also available in our networks.

2024 Plan Details
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