You can still get a nationwide PPO in Texas, even though the marketplace sells none. Here is how agents paid at closing are choosing coverage that fits their commissions and their health.
Hi, I'm Sam Jaber. Real estate agents in Texas reach me by phone from Tampa, where I work as a licensed health insurance broker, and I'm licensed in 36 states, so Houston and a Hill Country ranch town are equally easy.
Two questions matter most for a Texas agent. Where did the PPO go? And what happens to my subsidy when a big December closing lands? Texas answers both differently from most states, so let's take them in order.
Start with the shelf itself. HealthCare.gov lists 834 individual medical plans for Texas this year, and zero of them are PPOs. Agents scroll through HMOs, EPOs and POS plans and conclude a PPO no longer exists for them.
It does. You can still get a nationwide PPO in Texas, and the place to get it is outside HealthCare.gov, with me. These private plans ask about your health up front, set your price from the answers, and connect you to doctors and hospitals across the country without a referral. If you're healthy, it's the comparison that matters most.
The help on HealthCare.gov is a premium tax credit, sized to what your household earns over the coverage year. For an agent, earnings means net: commission after the brokerage split, MLS and board dues, desk fees, signs, photography and miles.
Here's the part that changed. For tax years after 2025, the IRS sets no ceiling on paying back credit you received but didn't qualify for. An agent who estimated a quiet year and then closed four houses in the fall can owe every dollar of the overpayment.
Which of these sounds like you?
Rookie agents and part-timers often belong here, and it's a decent place to be. Because the credit only works on marketplace coverage, buying through HealthCare.gov usually beats anything else on price for you.
Pick by doctor, not just by premium. Every Texas plan on the marketplace is built on an HMO, EPO or POS network, and depending on your county you'll see anywhere from 1 to 10 insurers. Look your physicians up in each plan you're considering.
Then treat the estimate as something you maintain. When a closing lands, log in and revise the year.
Next step: Let's go over last year's return and what's under contract, then settle on an estimate and a plan your doctors actually accept.
Past the credit range, you pay sticker price for plans that all carry network limits. Team leads, top producers and brokers often find that's a poor trade.
A medically underwritten nationwide PPO is the alternative. The insurer reads your health answers and offers coverage, refuses it, or offers it minus a named condition. Healthy agents frequently land below the marketplace's full price this way, and they can see doctors in Dallas, Denver or anywhere else. Every plan writes its own benefit list, which we'll go through together.
Next step: Give me a call and I'll set a nationwide PPO quote against what your county's marketplace plans charge your family.
Chronic conditions change the math. Marketplace insurers must enroll you at a price that ignores your medical history, and underwritten insurers don't have to. So even without a credit, the marketplace is usually home for this household.
What's left is finding the HMO, EPO or POS plan whose network holds the specialists you depend on, and learning its referral rules before you need them.
Next step: Send me the names of your doctors and your prescriptions, and I'll sort out which plans near you cover that care.
Some years barely pay the desk fee. Texas is unforgiving here. It never took the Medicaid expansion, its Medicaid program cuts off parents at 15% of the federal poverty level, and the marketplace credit generally doesn't switch on until 100% of that level. A household stuck between those two numbers may get no help from either side.
Since one contract can rewrite the whole year, a thin year is the moment for a careful estimate, not a hopeful one.
Next step: Before enrolling in a slow year, ring me and we'll figure out what your household can actually get.
No PPO anywhere on HealthCare.gov. No ceiling on credit repayment once the year closes. Medicaid that barely reaches working parents. Put those three together with commission income and the advice gets short: know your real net, revise it when deals fund, and let your health choose between a marketplace plan and a nationwide PPO.
Straight answers, no sales pitch.
Not a medical one. HealthCare.gov's 834 individual medical plans in Texas are all HMO, EPO or POS designs. A healthy agent can still buy a nationwide PPO outside the marketplace with my help.
Then you may owe back the extra credit, and for tax years after 2025 the IRS doesn't cap that repayment. Update HealthCare.gov whenever a big check comes in.
It's unlikely. Texas didn't expand Medicaid and limits parents to 15% of the poverty level, while the credit generally begins at 100%, so a very low year can fall through the gap.
Rarely. Over half of agents nationwide are self-employed and earn commission, so in Texas most agents arrange coverage on their own.
A quick sketch is plenty: where in Texas you live, who's on the plan, and what you kept after splits last year. From there I can say which way a Texas agent in your shoes should go, with real prices attached.
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