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Private Health Insurance in Texas

Can you still get private health insurance in Texas? Yes — and in 2026 comparing your options matters more than ever. Texas marketplace rates rose a weighted average of 34.7% this year, right as the enhanced federal subsidies expired. If you don't qualify for a subsidy, the difference between plans — and between routes to coverage — is worth real money. We compare private medical plans side by side with HealthCare.gov marketplace coverage, statewide.

Licensed Texas insurance producer — License 1578842. Verify at nipr.com. Independent and free to work with.

Which Carriers Offer Private Plans in Texas?

For 2026, the Texas individual market is led by Blue Cross Blue Shield of Texas — the only carrier in all 26 rating areas — plus Ambetter, Oscar, UnitedHealthcare, and Cigna, and strong regional plans like Community Health Choice in Houston and Baylor Scott & White Health Plan in North and Central Texas. Aetna exited the individual market nationwide for 2026.

The detail most shoppers miss: the Texas marketplace offers no PPO plans at all — every individual plan sold on HealthCare.gov in Texas is an HMO or EPO. If you want PPO flexibility, you have to look beyond the marketplace (see the employer-level route below).

Texas Metro Guides

Carriers, networks, and hospital access differ sharply between metros. Start with your area:

Houston →

MD Anderson, Houston Methodist, Memorial Hermann, Texas Children's, Baylor St. Luke's — the Texas Medical Center market.

Dallas–Fort Worth →

UT Southwestern, Baylor, Texas Health, Medical City, Children's Health & Cook Children's.

San Antonio →

Methodist Healthcare, University Health, Baptist, CHRISTUS Santa Rosa.

Austin →

Ascension Seton, St. David's, Baylor Scott & White, Dell Children's.

What Does Private Health Insurance Cost in Texas?

+34.7%Texas's weighted average marketplace
rate increase for 2026
$460–$580/moTypical full-price Silver plan, age 40
(varies by rating area)
0 PPOsOn the Texas marketplace —
every plan is an HMO or EPO
+ 2 exclusive private PPO plans — call to view

With the enhanced federal subsidies expired and rates up sharply, many Texas households are paying full price for the first time. Your exact premium depends on your age, ZIP code, and household size — which is why we quote every carrier and every route to coverage before recommending anything.

Beyond ACA Plans: True Employer-Level (ERISA) Group Coverage

In Texas, this option carries extra weight: with no PPOs on the marketplace, true employer-level group coverage is the clearest path to PPO flexibility. Many Texans — especially the self-employed, independent contractors, and small-business owners — qualify for group coverage regulated under federal ERISA and Department of Labor rules. Qualifying as a bona fide employee takes only a few basic requirements — full-time work is not required — and pre-existing conditions are covered, just as with any employer group plan. You get the same kind of group PPO coverage large employers offer, with nationwide networks like Cigna, Multiplan/PHCS, Aetna, First Choice Health, and in some states Blue Cross with national Blue Card, and enrollment is open year-round, not just during open enrollment. Availability is subject to eligibility. Call us to see if you qualify.

Private Plan vs. HealthCare.gov in Texas — Which Is Right for You?

The honest answer: it depends on your subsidy. If you qualify for a meaningful premium tax credit, a marketplace plan through HealthCare.gov is usually the better value. If you get little or no subsidy — the situation many Texas households found themselves in after the enhanced credits expired at the end of 2025 — an off-exchange private medical plan or employer-level group coverage frequently wins on network, price, or both. A five-minute comparison settles it, and our service is free either way.

Private Health Insurance in Texas — FAQ

Are there PPO plan options in Texas beyond the public marketplace?

Yes. Beyond on- and off-exchange marketplace plans, we also offer exclusive private, employer-group (ERISA) PPO options with nationwide networks like Cigna, Multiplan/PHCS, Aetna, First Choice Health, and in some states Blue Cross with national Blue Card. These plans aren’t published on the public marketplace, enrollment is open year-round, and availability is subject to eligibility. Call us to see if you qualify.

Do private plans in Texas cover pre-existing conditions?

Yes. Every ACA-compliant private plan covers pre-existing conditions — no medical questions, no exclusions. ERISA employer-level group plans cover pre-existing conditions as well, just as with any employer coverage.

Are there any PPO plans in Texas's individual market?

Not on the marketplace — every plan sold on HealthCare.gov in Texas is an HMO or EPO. PPO coverage remains available through employer-level ERISA group plans for those who qualify.

When can I enroll?

Marketplace and off-exchange ACA plans: during the annual fall open enrollment period, or year-round within 60 days of a qualifying life event. Employer-level ERISA group plans: enrollment is open year-round for those who qualify. We also have other exclusive, proprietary private healthcare PPO plan options beyond what is published online. Contact us for specific details.

Does it cost more to use an agent?

No. Premiums are identical with or without an agent — carriers pay us, not you. You get the comparison and enrollment help at no cost.

Compare Every Private Health Plan Available at Your Texas ZIP Code

Free comparison from a licensed advisor — marketplace, off-exchange, and employer-level coverage buy-in options.

Call (800) 939-3330 Get My Plan Options

Plus exclusive, proprietary private healthcare PPO options generally not published online — click Get My Plan Options or call us for details.

Rate change figures are 2026 weighted averages from Texas regulatory filings; premiums vary by age, ZIP code, and household size. Employer-level group plan availability subject to eligibility requirements.

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