Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives)
by WellPoint in Texas
How we get our data
Our insurance data is sourced directly from the CMS ACA Marketplace (HIOS), the federal database that insurers are required to report to. We process that data to surface standardized out-of-pocket cost estimates based on three SBC scenarios defined by CMS: having a baby, managing diabetes, and treating a fracture. We update our data annually with each new plan year and link to the original SBC documents so you can verify costs directly with the insurer.
Learn more about our dataDeductible (Individual)
$4,000
Max Out-of-Pocket
$9,550
Actuarial Value
70%
Service Areas
1
About This Plan
Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) is a Silver POS plan offered by WellPoint in Texas for the 2026 plan year with an actuarial value of 70%. The in-network deductible for an individual is $4,000, and the maximum out-of-pocket cost is $9,550.
Compared to the median across 80 other Silver plans in Texas, this plan's estimated out-of-pocket costs are: having a baby ($7,870 — right at the median); managing diabetes ($1,620 — 11% below the median); treating a fracture ($2,700 — 8% above the median).
This plan includes disease management programs for Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management.
Cost Scenarios
What you'd pay out-of-pocket for three common medical situations with this plan.
Normal delivery
Having a Baby
Type 2, routine care
Managing Diabetes
ER treatment
Simple Fracture
Deductibles & Out-of-Pocket Maximums
| In-Network | Out-of-Network | |||||
|---|---|---|---|---|---|---|
| Individual | Per Person | Per Group | Individual | Per Person | Per Group | |
| Deductible | $4,000 | $4000 per person | $8000 per group | $20,000 | $20000 per person | $40000 per group |
| MOOP | $9,550 | $9550 per person | $19100 per group | Not Applicable | per person not applicable | per group not applicable |
Coinsurance after deductible: 20.00%
Plan Features
Disease Management Programs
Official Documents
Similar Plans
Connect Silver DFW 3000 Indiv Med Deductible
Cigna Healthcare · HMO
Connect Silver 3000 Indiv Med Deductible
Cigna Healthcare · HMO
University Community Care Plan by Community First - Silver Plan Standard
Community First · EPO
Silver Simple PCP Saver
Oscar Insurance Company · EPO
Silver Simple PCP Saver Guided Care
Oscar Insurance Company · HMO
Need Help Choosing?
Our AI navigator can help you compare this plan against others based on your specific health needs and budget.
Disclaimer: Our AI navigator provides information collected from trusted sources only and does not constitute licensed insurance advice.
Written by Jayant Panwar | Last reviewed: Q1 2026 | Last updated: January 2026
Insurance Disclaimer: This information is for educational purposes only and does not constitute insurance advice or a recommendation to enroll in this plan. SBC scenarios show standardized cost estimates for normal delivery, routine diabetes care, and emergency fracture treatment — your actual costs will vary based on providers, services, and your specific plan benefits. This is a CMS marketplace plan; other insurance options may be available in Texas. Consult your insurance company for accurate cost estimates and with your healthcare provider for medical decisions.
Data source: CMS ACA Marketplace (HIOS), 2026 plan year. See our data methodology and editorial policy. Found an error? Report an inaccuracy.