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ACA vs. Private Health Insurance for Texas Realtors
Realtors in Texas ask us this more than any other group. Here's the direct comparison for a commission-based income.
ACA (HealthCare.gov)
Priced on income, which for you means after-expense MAGI. If you qualify for a subsidy, it's unbeatable. The risks: a strong year pushes you over the cliff and you repay subsidies at tax time; most plans are HMO and tied to one hospital system; enrollment is only Nov 1 – Jan 15.
Private shared-network PPO
Priced on age and health — your income is irrelevant. National PPO on Cigna, Aetna and PHCS PPO, no referrals, enroll any month, month to month. The risk: underwriting. A serious pre-existing condition can be declined.
Decision guide for agents
Under the subsidy line after deductions → ACA. Over the line and healthy → private PPO, usually $300–$500 a month less. Over the line with a significant condition → ACA at full price, or a small-group plan if your brokerage or spouse opens one.
The Texas angle
Texas has the highest uninsured rate in the country, and because Medicaid wasn't expanded, adults under the poverty line fall into a coverage gap with no subsidy at all. Texas has no state individual mandate and no state penalty for going without coverage.
Check your options and we'll show both markets for your ZIP.