You can still get a nationwide PPO in Texas, even with zero PPO medical plans on the state's marketplace. Here's how electricians running their own work in Texas are getting the coverage they want for less.
Hi, I'm Sam. I'm a health insurance broker working out of Tampa, I hold a license in Texas and 35 other states, and every conversation happens by phone.
Texas gives an electrician plenty to do. Subdivisions keep going in around every big metro, older houses need panel upgrades, businesses keep building out, and after a hard freeze or a summer storm the calls for standby generators pick up. Plenty of electricians use that demand to go out under their own license. The trouble starts when they shop for health insurance and discover what the Texas marketplace does and doesn't sell.
You can still get a nationwide PPO in Texas. I can set that up for you even though HealthCare.gov won't.
Here's the situation on the marketplace. Texas has 834 individual medical plans listed for 2026, and the count of PPOs among them is zero. What's there are HMOs, POS plans and EPOs. Under an HMO, care outside the network generally isn't covered unless it's an emergency, and an EPO covers out-of-network care only in an emergency. A PPO is the one that still pays when you see a doctor outside the network, at a higher cost and with no referral needed. Dental PPOs do show up on the marketplace, which confuses people; for medical coverage, there isn't one.
Private underwritten plans fill that gap. They sit on PPO networks with doctors nationwide and are priced on your health. For a healthy electrician, the price can be better than you'd guess.
HealthCare.gov is where Texans buy marketplace plans, and the discount there is a premium tax credit that depends on your household's income for the year. Working for yourself, the number is your net: after the van, wire, breakers and parts, tools, licensing, liability coverage and fuel.
Whether that net puts you inside or outside the credit range shapes everything. Pick the description closest to yours.
When the job that provided your health plan ends, that's a qualifying event, and you'll usually have 60 days to pick a HealthCare.gov plan, any time of year. If you choose COBRA, keep it until it runs its course, because quitting it early on purpose won't reopen enrollment.
The first year under your own license can be thin, and Texas is unforgiving there. The state hasn't adopted the Medicaid expansion. Parents qualify for Texas Medicaid only up to 15% of the federal poverty level, and adults without kids who aren't disabled generally don't qualify at all. Credits on HealthCare.gov generally begin only once income reaches the poverty level. Land below that and you can be left with neither, so the income estimate and the timing deserve real care.
One more distinction while you're setting up: workers' comp answers for injuries on a job. Sickness, checkups and your family's care need a health plan.
Next step: Call me a few weeks before your last day at the shop so your new coverage picks up right where the old one stops.
Lots of one-van electricians end up here, especially early on. If you do, HealthCare.gov is very likely where the lowest monthly cost is, since no plan sold elsewhere can use the credit.
Every option you'll see is an HMO, POS or EPO tied to a local network. For most families that get their care in one metro, that works. We'll confirm the doctors you already use are included.
Keep an eye on your estimate as the year goes. A storm season full of generator installs and repairs can push income higher than you guessed, and if you never report it, some of the credit gets taken back when you file.
Next step: Send me last year's tax return and a sense of your backlog, and I'll help you settle on an estimate and a Texas plan to match.
If you've grown into a contractor with a few electricians and steady builders, your household is probably above the credit range. That means HealthCare.gov's full price, and still no PPO on the menu.
For a healthy family, the comparison to make is an underwritten nationwide PPO. You'll answer medical questions, and the insurer decides whether to approve you, decline you, or approve you with a condition carved out. Clean answers are what can bring the price below the marketplace's full rate. Benefits vary by plan, so I go through what each one pays before you commit.
Next step: Call me and I'll lay a nationwide PPO quote for your family beside what HealthCare.gov charges in your county.
A daily prescription or regular specialist visits in your household point to the marketplace, credit or no credit. Plans on HealthCare.gov have to accept you and can't price you higher for your health. Underwritten plans can say no.
In Texas that means choosing among HMO, POS and EPO plans for the one whose network keeps your specialists and whose drug list covers your medications. We'll check each name before you enroll.
Next step: Send me your doctors and prescriptions and I'll show you which Texas marketplace plans in your county cover them.
Straight answers, no sales pitch.
Yes, though not on the marketplace. None of the 834 individual medical plans on the Texas marketplace for 2026 is a PPO. If you're healthy, I can price a nationwide PPO outside the marketplace.
The employer plan usually ends with the job. Losing it generally gives you 60 days to enroll in a HealthCare.gov plan, and dropping COBRA early by choice doesn't count as a new qualifying event.
Probably not. Texas hasn't adopted the Medicaid expansion; parents qualify only up to 15% of the poverty level and most adults without children don't qualify at all. Call me before you enroll.
They can. The credit follows your household income for the whole year, so if storm work raises it after you enroll, update your estimate on HealthCare.gov.
Send a rough figure for last year's net, the county you live in and who you're covering. I'll point out the route that fits and price it, and if your current coverage is already the right one, I'll say so plainly.
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