Public Texas runPlan-year review2026 to 2027
What exactly changed between 2026 and 2027 for this plan?
H5294-014
A broker must review the evidence before deciding next steps. Change flags are not suitability recommendations.
Crosswalk
Renews as H5294-014, smaller service area
CMS file crosswalk_2027.csv, row 5240: Renewal Plan with SAR
Flagged for review
Why
- Service area lost 33 counties: Bastrop, Bee, Brooks, Burnet, Caldwell, Cameron, Colorado, Duval, Goliad, Grimes, Hays, Hidalgo, Jack, Jim Hogg, Jim Wells, Karnes, Kenedy, Kimble, Kleberg, Lee, Mason, Maverick, McCulloch, McMullen, Nueces, Palo Pinto, Refugio, San Patricio, Starr, Webb, Willacy, Williamson, Zapata
The 15 fields, side by side
| Field | 2026 | 2027 | Change | Category |
|---|---|---|---|---|
| Monthly premium | $0.00 a month | $0.00 a month | No change | Premium |
| Medical deductible | $0.00 a year | $0.00 a year | No change | Deductible |
| Maximum out-of-pocket (in network) | $3,400.00 a year | $3,400.00 a year | No change | Maximum out-of-pocket |
| Primary care visit | $0.00 copay a visit | $0.00 copay a visit | No change | Copays |
| Specialist visit | $10.00 copay a visit | $10.00 copay a visit | No change | Copays |
| Emergency room | $150.00 copay a visit | $150.00 copay a visit | No change | Copays |
| Urgent care | $25.00 copay a visit | $25.00 copay a visit | No change | Copays |
| Inpatient hospital stay | $275.00 copay a day | $275.00 copay a day | No change | Copays |
| Outpatient surgery | Not found in the document | Not found in the document | Not found in either year | |
| Drug deductible | Not found in the document | Not found in the document | Not found in either year | |
| Drug tier 1 | Not found in the document | Not found in the document | Not found in either year | |
| Drug tier 2 | Not found in the document | Not found in the document | Not found in either year | |
| Drug tier 3 | Not found in the document | Not found in the document | Not found in either year | |
| Dental allowance | $3,000.00 a year | $3,000.00 a year | No change | Allowances |
| Over-the-counter allowance | $50.00 a month | $50.00 a month | No change | Allowances |
Review items for this plan
HighChange flag needs reviewDrug deductible, 2027
Drug deductible change flag needs review: not found in 2026; not found in 2027Original recorded reason
drug deductible cannot decide shop again: not found in 2026; not found in 2027
MediumNot read from the documentOutpatient surgery, 2026
No row found on any of 24 pagesMediumNot read from the documentOutpatient surgery, 2027
No row found on any of 20 pagesMediumNot read from the documentDrug deductible, 2026
No row found on any of 24 pagesMediumNot read from the documentDrug deductible, 2027
No row found on any of 20 pagesMediumNot read from the documentDrug tier 1, 2026
No row found on any of 24 pagesMediumNot read from the documentDrug tier 1, 2027
No row found on any of 20 pagesMediumNot read from the documentDrug tier 2, 2026
No row found on any of 24 pagesMediumNot read from the documentDrug tier 2, 2027
No row found on any of 20 pagesMediumNot read from the documentDrug tier 3, 2026
No row found on any of 24 pagesMediumNot read from the documentDrug tier 3, 2027
No row found on any of 20 pages