No — and this is one of the most important things to know before you start shopping.

PPO plans are not available in the individual and family health insurance market in Texas. They haven't been for years. The options available to you as an individual or family in Texas include EPO, HMO, indemnity, and short-term plans, depending on your situation.

This matters because some people spend weeks searching for a PPO plan in Texas, can't find one, and assume they're doing something wrong. You're not. They simply don't exist in this market.

This is a serious red flag, and you should be very careful.

Since PPO plans are not available in the Texas individual and family market, anyone marketing one to you as a PPO health insurance plan for individual coverage in Texas is either misinformed or being deliberately misleading. This is a known pattern in the Texas insurance market — certain products, including some indemnity plans, limited-benefit plans, and health-sharing ministries, are sometimes marketed using PPO language to make them sound more comprehensive than they are.

These plans are not the same as major medical insurance. They often have significant benefit limits, exclusions for pre-existing conditions, and may leave you with high out-of-pocket costs if you have a serious medical event. Some are not regulated by the Texas Department of Insurance at all.

If someone offered you a PPO plan for individual or family coverage in Texas, here are some questions to ask before you sign anything:

Is this plan regulated by the Texas Department of Insurance?

Is this an ACA-compliant plan?

Does this plan count as minimum essential coverage?

What are the annual and lifetime benefit limits?

Are pre-existing conditions covered?

If the person selling it can't answer those questions clearly and in writing — walk away. Feel free to call or email me and I'll tell you straight whether what you were offered is legitimate.

An indemnity plan — sometimes called a fee-for-service plan — pays a set benefit amount for covered medical services regardless of what the provider charges or where you receive care. There are no networks, no referrals, and no restrictions on which doctors or hospitals you use. You receive care, submit a claim, and the plan pays its defined benefit toward that cost.

For Texans shopping for individual or family coverage, this is one of the key alternatives to HMO and EPO plans — especially for people who want maximum provider freedom. Contractors who work across different parts of Texas, self-employed individuals who travel, or anyone with specific doctors they want to keep, regardless of network status, often find indemnity plans worth a close look.

The tradeoff is that indemnity plans typically don't cover as comprehensively as ACA marketplace plans, and depending on how they're structured, they may not count as minimum essential coverage. That distinction matters if you're thinking about subsidy eligibility or avoiding a coverage gap.

One more thing worth knowing: some indemnity plans in Texas are marketed using PPO language even though they are not PPO plans and do not provide PPO-level coverage. If you've seen a plan advertised as a PPO for individual coverage in Texas, ask questions before you sign anything — or call me first and I'll give you a straight answer.

Since PPO plans are not available in the Texas individual and family market,

here's what you're actually choosing between:

An HMO requires you to choose a primary care doctor who coordinates your care. You'll need a referral to see a specialist, and you must stay within the plan's network except in emergencies. HMOs generally have lower premiums in exchange for less flexibility.

An EPO does not require referrals to see a specialist, but you must stay within the plan's network for non-emergency care. You get more flexibility than an HMO without the higher cost of a PPO, which isn't available in this market anyway.

An indemnity plan works completely differently from both. There are no networks, no referrals, and no restrictions on which doctors or facilities you use. The plan pays a defined benefit amount toward your covered medical expenses regardless of where you receive care. This can be a strong fit for contractors, self-employed individuals, or anyone who travels frequently and needs flexibility with providers.

Important: because indemnity plans are sometimes marketed in Texas as PPO plans, make sure you fully understand what you're buying before you enroll.

We'll go through every detail during your consultation.

The right choice depends on which doctors matter to you, how you typically use healthcare, and what you're trying to spend each month.

We'll work through all of this together.

Yes. Self-employed individuals can enroll in ACA marketplace plans during the open enrollment period (November 1 through January 15) or during a Special Enrollment Period if you've had a qualifying life event. Depending on your income, you may also qualify for premium tax credits that reduce your monthly cost significantly. We'll check your eligibility before you do anything else.

Losing employer coverage triggers a Special Enrollment Period that gives you 60 days to enroll in a new plan. Don't wait until the last minute — coverage options and pricing can take a few days to sort through, and you don't want to make a rushed decision. Call or book online as soon as your coverage end date is confirmed.

Special Enrollment Period (SEP) lets you enroll in health insurance outside of the standard open enrollment window if you've had a qualifying life event. Common qualifying events include losing employer coverage, getting married or divorced, having a baby, moving to a new state, or losing Medicaid eligibility. If any of these apply to you, you typically have 60 days from the event to enroll.

Possibly. Premium tax credits may be available to people who meet certain income and eligibility requirements and don't have access to affordable employer coverage. The amount varies based on your income, household size, and the plans available in your area. During our consultation, we can review your situation together and give you a clearer picture of what you may be eligible for.

Short-term health plans can cover gaps between jobs, waiting periods before employer coverage kicks in, or other temporary situations. They're generally less comprehensive than ACA plans, and coverage limitations vary by plan — we'll go over exactly what's included and excluded before you decide anything, but for a short, defined period, they can be a practical option. We'll be honest with you about whether a short-term plan makes sense or whether a marketplace plan would serve you better.

No. Brokers are paid by the insurance companies, not by you. Your premium is the same whether you enroll through a broker or on your own — and working with a broker means someone is checking whether your doctors are in network, whether your prescriptions are covered, and whether there's a better fit before you sign anything.