Private PPO, off-exchange & HealthCare.gov plans for you, your spouse and your kids — compared side by side for 2027
▶Watch: Private PPO vs. ACA Marketplace — which is right for your family (50 sec)
Is your family overpaying for health insurance in Texas? If your household earns more than $132,000 (family of four), HealthCare.gov gives you no federal premium help for 2027 — and you pay full price for every person on the plan. Texas insurers have filed double-digit rate increases for 2027, and the Texas marketplace offers no PPOs at all. That's exactly where families overpay, and where employer-level group PPO coverage can change the math.
For 2027 coverage, federal premium tax credits stop completely once household income passes 400% of the federal poverty level. Find your household size:
| Household size | No federal premium help above |
|---|---|
| 2 (you + spouse, or parent + 1 child) | $86,560 |
| 3 | $109,280 |
| 4 | $132,000 |
| 5 | $154,720 |
| 6 | $177,440 |
Thresholds use the 2026 federal poverty guidelines, which apply to all 2027 marketplace coverage. Income means your household's projected 2027 modified adjusted gross income (MAGI).
ACA premiums are charged per person — each adult by age, plus each child under 21 (up to the three oldest). A family of four pays four premiums stacked together.
Below 400% FPL the subsidy shrinks your family premium to a share of income. Above it, the full sticker price lands on you — often the biggest bill in the household budget.
Every Texas marketplace plan is an HMO or EPO, so out-of-network care is generally not covered. With kids, pediatricians, pediatric specialists and a children's hospital in-network matter more than almost anything else.
Usually the best value if your family is under the cliff and qualifies for a meaningful subsidy — or if your children qualify for CHIP or Medicaid. Every plan is an HMO or EPO.
The same carriers and ACA protections, bought directly. Worth comparing when your family gets little or no subsidy.
True group coverage for the self-employed, contractors and small-business owners that covers your spouse and children. Nationwide PPO networks such as Aetna, First Health and Multiplan/PHCS, pre-existing conditions covered, and year-round enrollment. Subject to eligibility.
Before you enroll, we confirm your pediatrician, specialists and nearest children's hospital are in-network. Start with your area:
Texas Children's Hospital, Memorial Hermann, Houston Methodist.
Children's Health Dallas, Cook Children's, UT Southwestern.
CHRISTUS Children's, Methodist Children's, University Health.
Dell Children's Medical Center, St. David's, Baylor Scott & White.
Ages of you, your spouse and each child, your ZIP code, and your estimated 2027 household income.
Your pediatrician, family doctor, specialists and preferred hospital — checked against every network we quote.
HealthCare.gov plans, off-exchange ACA plans, and employer-level group PPO options — total family cost, deductibles and networks on one page. One call, one comparison, no cost to you.
It depends on each family member's age and your rating area — Texas has 26. Each adult is priced by age and each child under 21 is charged a premium (up to the three oldest). Texas insurers have filed double-digit average increases for 2027. We quote your exact family at your ZIP code across every carrier and route.
Only if your household income is at or below 400% of the federal poverty level: $86,560 for two, $109,280 for three, $132,000 for four, $154,720 for five, and $177,440 for six. Above that, no federal premium tax credit is available for 2027 coverage.
Not on the marketplace — every individual plan sold on HealthCare.gov in Texas is an HMO or EPO. Families who want PPO flexibility can look at employer-level (ERISA) group PPO coverage, which covers your spouse and children with nationwide networks for those who qualify.
Every ACA-compliant plan covers pre-existing conditions with no medical questions, and employer-level (ERISA) group plans cover pre-existing conditions as well, just as with any employer coverage.
We check your pediatrician, specialists and preferred children's hospital against each plan's network before you enroll — especially important in Texas, where marketplace HMOs and EPOs generally don't cover out-of-network care.
HealthCare.gov open enrollment runs November 1, 2026 through January 15, 2027 — enroll by December 15 for coverage starting January 1. A new baby, adoption, marriage or loss of coverage opens a 60-day special enrollment window, and employer-level group plans enroll year-round for those who qualify.
No. Premiums are identical with or without an agent — carriers pay us, not you. The family comparison and enrollment help are free.
Get Your Family's 2027 Texas Health Quote
Free side-by-side comparison from a licensed advisor — HealthCare.gov, off-exchange and employer-level PPO options for your whole household.
Get My Family's Options Call (800) 939-3330
Prefer to talk first? Book a 15-minute family plan review.
Subsidy thresholds use the 2026 HHS poverty guidelines, which apply to 2027 coverage. 2027 rate filings are preliminary and subject to regulatory review. Employer-level group plan availability subject to eligibility requirements. Premiums vary by age, ZIP code, and household size.
