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How Texas Realtors Should Compare Health Insurance Plans
Agents compare premiums and stop. Here's the order that actually protects you.
1. Out-of-pocket maximum
The most you can spend in a year on covered care. This is the number that matters in a bad year. Marketplace plans in Texas cap around $9,200 individual; private PPOs commonly $6,000–$9,000.
2. Network — and where it works
Is your doctor in it? Is the hospital you'd actually go to in Harris County in it? Does it work in another state? HMO vs. PPO decides this. Cigna, Aetna and PHCS PPO PPOs are national.
3. Deductible
How much you pay before the plan pays. Healthy agents usually do best with a mid-range deductible and lower premium, plus an HSA.
4. Premium
Only now. And compare net of subsidy if you qualify, net of the self-employed deduction either way. Texas has no state income tax, so the self-employed health insurance deduction only reduces your federal bill — which makes the premium itself the number to attack.
5. Enrollment flexibility
Marketplace: once a year. Private: any month. If your income is volatile, flexibility has value.
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.
Our quoting tool shows every private plan in Texas with deductible and out-of-pocket max side by side. Or check your options and we'll compare both markets for you.