Texas health plan · 2026

Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs · 71837TX0010008

Sendero Health Plans, Inc. offers this marketplace health insurance plan (Plan ID 71837TX0010008) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Expanded Bronze Plan type: HMO CSR: Zero Cost Sharing Plan Variation Issuer: Sendero Health Plans, Inc.
Telehealth Data pending HSA eligible Yes Dental Child Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 100.00% (0.00% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$275 – $1078

Before subsidies

Estimate after subsidies

Deductible

$0

$0 per group

See deductible details

Max out-of-pocket

$0

$0 per group

Review MOOP rules

Office visits

Primary care $0.00, 0.00%
Specialist $0.00, 0.00%
HSA Eligible

Drug tiers

Generic $0.00, 0.00%
Preferred brand $0.00, 0.00%

View formulary tiers

$377 / mo before subsidies

≈ $4519 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1193 / mo before subsidies

≈ $14320 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1445 / mo before subsidies

≈ $17343 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$918 / mo before subsidies

≈ $11022 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

$0.00, 0.00%

Emergency Room Services

$0.00

Durable Medical Equipment

$0.00, 0.00%

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Texas). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Zero Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

$0.00, 0.00%

Emergency Room Services

$0.00

Durable Medical Equipment

$0.00, 0.00%

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 71837TX0010008
Coverage year 2026
State Texas
Issuer Sendero Health Plans, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 71837TX0010008-02
Available variants

Standard Off Exchange Plan · 71837TX0010008-00

Standard On Exchange Plan · 71837TX0010008-01

Open to Indians below 300% FPL · 71837TX0010008-02

Open to Indians above 300% FPL · 71837TX0010008-03
Last plan update Tue, 28 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Texas 12608
PCPs in Texas 1439
Telehealth support Data pending
Nationwide providers 14145
12,608 doctors statewide 1,439 PCPs 58 OB/GYN

Provider network(s)

Providers Texas All US states
All 12608 14145
PCP 1439 1683
Allergy 5 6
OB/GYN 58 71
Dentists 6 6

Drug coverage overview

5,952 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-GENERIC 2,552
NON-PREFERRED-BRAND 2,015
SPECIALTY-DRUGS 889
MEDICAL-SERVICE-DRUGS 496
Prior authorization Drugs
Required 1,066
Not Required 4,886
Step therapy Drugs
Required 103
Not Required 5,849
Quantity limits Drugs
Has Limit 1,269
No Limit 4,683

Customer highlights

What stands out for members

  • Issuer: Sendero Health Plans, Inc. · Plan ID 71837TX0010008 · 2026 filing.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 71837TX0010008-02 (Open to Indians below 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Year

Limited to combined 35 visits per year, including Chiropractic.

Diabetes Care Management

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Diabetes Education

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Home Health Care Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Exclusions: No limit on private duty nursing when medically necessary.

Laboratory Outpatient and Professional Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preventive Care/Screening/Immunization

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Primary Care Visit to Treat an Injury or Illness

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

This category also applies to mental health, substance abuse office visits

Rehabilitative Occupational and Rehabilitative Physical Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Rehabilitative Speech Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Specialist Visit

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Urgent Care Centers or Facilities

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

X-rays and Diagnostic Imaging

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Delivery and All Inpatient Services for Maternity Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Will cover 48-hour hospital stay for uncomplicated vaginal delivery and 96-hour hospital stay for uncomplicated caesarean section.

Dialysis

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Durable Medical Equipment

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Emergency Room Services

$0.00
Tier 1 in-network $0.00
Out-of-network $0.00

Emergency Transportation/Ambulance

$0.00
Tier 1 in-network $0.00
Out-of-network $0.00

Hospice Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preauthorization is required.

Inpatient Hospital Services (e.g., Hospital Stay)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

All usual Hospital services and supplies, including semiprivate room, intensive care, and coronary care units; Preauthorization is required.

Inpatient Physician and Surgical Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Mental/Behavioral Health Inpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preauthorization is required.

Mental/Behavioral Health Outpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preauthorization is required.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Outpatient Rehabilitation Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Outpatient Surgery Physician/Surgical Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Radiation

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Skilled Nursing Facility

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 25.0 Visit(s) per Year

Substance Abuse Disorder Inpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preauthorization is required.

Substance Abuse Disorder Outpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Certain services require preauthorization.

Transplant

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Preauthorization is required.

Transplant Donor Coverage

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Exclusions: Donor expenses for a Participant in connection with an organ and tissue transplant if the recipient is not covered under this Plan.

Mental health & substance use

Behavioral health visits and substance use treatment.

Autism Spectrum Disorders

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Same as Habilitation services above

Mental Health Other

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Clinically-based mental/nervous disorders

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Hearing Aids

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per 3 Years

To restore or correction of impaired speech or hearing loss.

Exclusions: Benefit consists of 1 hearing aid every 3 calendar years

Major Dental Care - Child

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Prenatal and Postnatal Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Routine Eye Exam for Children

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Well Baby Visits and Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Non-Preferred Brand Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Off Label Prescription Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Off label drugs

Preferred Brand Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Prescription Drugs Other

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Oral anticancer medications

Specialty Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Infusion Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Prosthetic Devices

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Replacement Prosthetic Appliances except those necessitated by growth due to maturity of the participant. Also, prosthetics provided for the treatment of the temporomandibular joint and all adjacent or related muscles and nerves. Medically necessary foot orthotics are not subject to a calendar year maximum.

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Brain Injury

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Habilitation and Mental/ Behavioral health OP treatment related to Brain injury and acquired brain injury

Cardiovascular Disease

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Atherosclerosis and abnormal artery structure screening for diabetic enrollees and certain enrollees who have a documented medical risk of developing coronary heart disease

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Benefit consists of 1 pair of glasses (frames with lenses) per calendar year

Habilitation Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Imaging (CT/PET Scans, MRIs)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Inherited Metabolic Disorder - PKU

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Amnio acid-based formulas only

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Mammography

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Including 2D and 3D (breast tomosynthesis) for women age 35 and older on an annual basis

Osteoporosis

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Pediatric Services Other

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

reconstructive surgery for craniofacial abnormalities in a child

Post-Mastectomy Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Mastecctomy or lymp node dissection, minimus stay

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Examples of covered services include: Treatment provided for reconstructive surgery following cancer surgery; Reconstruction of the breast on which mastectomy has been performed.

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Excluded for any services or supplies in connection with routine foot care, including the removal of warts, corns, or calluses, or the cutting and trimming of toenails, in the absence of diabetes, circulatory disorders of the lower extremities, peripheral vascular disease, peripheral neuropathy, or chronic arterial or venous insufficiency.

Treatment for Temporomandibular Joint Disorders

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Out-of-network 100.00%

Any non-surgical (dental restorations, orthodontics, or physical therapy) or non-diagnostic services or supplies (oral appliances, oral splints, oral orthotics, devices, or prosthetics) provided for the treatment of the temporomandibular joint and all adjacent or related muscles and nerves.Though state law only mandates coverage for temporomandibular joint (TMJ) disorders for large group plans and HMOs, the benchmark plan covers TMJ. Therefore, it is considered part of the EHB package for Texas.

Variant attributes

Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs · Variant 71837TX0010008-02

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Zero Cost Sharing Plan Variation

HIOS Product ID

71837TX001

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

71837TX0010008-02

Plan Marketing Name

Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs

Plan Variant Marketing Name

Sendero Health Preferred Bronze / $0 PCP / $0 Specialist / $0 Generic Drugs

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

71837

Issuer Marketplace Marketing Name

Sendero Health Plans, Local Nonprofit

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

TXN001

Out of Country Coverage

No

Out of Service Area Coverage

No

Service Area ID

TXS001

State Code

TX

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

1

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

$0

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$0

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

TXF001

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$0

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

EHB Percent of Total Premium

1

First Tier Utilization

100%

Import Date

10/28/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

Yes

New/Existing Plan

Existing

Notice Required for Pregnancy

Yes

Is a Referral Required for Specialist?

Yes

Plan Effective Date

1/1/2026

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Specialist Requiring a Referral

Cardiology, Cardiovascular (Heart, Blood Vessels),ENT (Ears, Nose, Throat),Hematology (Blood),Oncology (Cancer),Otology (Ears),Genetics (Inherited Diseases, Birth Defects),Pulmonology (Lungs, Breathing),Gastroenterology (Stomach, Digestion),Neurology (Brain, Nervous System), Allergist (Allergies),Chiropractor (Bones, Joints),Rheumatologist (Joints, Muscles, Tendons),Urology (Urinary Tract),Surgery (Operations),Radiology (X-Rays),Podiatry (Feet, Toenails),Optometrist (Eyes, Glasses),Otolaryngology (Ear, Nose, and Throat),Orthopedics (Bones and Joints),Ophthalmology (Eyes), Neurosurgery (Operations of the Brain, Spinal Cord),Nuclear Medicine (Testing, e.g.,. MRI, CAT scan),Nephrology (Kidney), Endocrinology (Glands),Dermatology (Skin),Cardiothoracic Surgery (Operations of the Heart and Chest),Ambulatory Medicine (General Non-emergency Care),Immunology (Immune System),Infectious Diseases (Viral/Bacterial Infections),Neonatology/Perinatology (Fetus and Newborns),Oral-Maxillofacial Surgery (Jaw and Mouth),Physical Medicine (Rehabilitation),Plastic Surgery (Corrective Surgery),Retrovirology (Viral Diseases, AIDS),Adolescent Medicine (Teenagers),Sports Medicine (Sports Injuries),Nutrition/GI (Eating, Digestion),Colon/Rectal Surgery (Bowels),Thoracic Surgery (Chest Surgery),Hepatology (Liver),Vascular Surgery (Operations of the Blood Vessels)

Plan ID

71837TX0010008

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

$0 per group

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

$0 per person

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

$0

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$0 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$0 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$0

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

$0 per group

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

$0 per person

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$0

Unique Plan Design

No

Wellness Program Offered

Yes

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Texas?

Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs (71837TX0010008) is a Expanded Bronze HMO from Sendero Health Plans, Inc. in Texas for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs HSA-eligible and does it include dental or vision coverage?

It is HSA-eligible, so you can pair it with a Health Savings Account to lower taxes.

Dental add-ons: Child.

Vision add-ons: Child.

Does Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Is there out-of-country coverage for Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs?

No, out-of-country services are not covered for this plan.

Does Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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