Does Your Family Need Health Coverage, and You Don’t Want to Wait Until Open Enrollment?

Here’s why working with a private health insurance advisor might be the better move

Let’s face it—life doesn’t always line up with a government enrollment calendar. If your family needs health insurance now, waiting around for open enrollment in the fall might not be an option. Whether you’ve lost coverage, moved, or simply want better benefits, it’s frustrating to feel like your hands are tied. But here’s the good news: You don’t have to wait.

You may be able to get a private PPO health insurance at any time of year. Unlike marketplace plans which have very limited windows for enrollment (unless you have a qualifying event), private plans simply require that you apply for them to begin the underwriting process. And with the help of a trusted health insurance advisor, you can find tailored coverage that fits your family’s needs without going through the red tape of the marketplace. Let’s break down how it works—and why it might be a much better fit than waiting for a one-size-fits-all plan during open enrollment.

What Is Open Enrollment, and Why Do People Wait?

Open enrollment is the annual period when individuals can enroll in health insurance plans through the federal or state marketplace. For most families, this happens between November 1 and January 15.

• Why it matters: Outside of this window, you're only allowed to enroll in a marketplace plan if you qualify for a “Special Enrollment Period” due to a major life change—like losing a job or having a baby.

• The downside: If your situation doesn’t meet one of those criteria, you’re stuck waiting. And waiting without coverage can be stressful and risky.

That’s where private PPO plans come in.

What Are Private PPO Health Insurance Plans?

Private PPO (Preferred Provider Organization) plans are available outside the marketplace and don’t follow the same enrollment deadlines. These plans offer more flexibility, broader networks, and better provider access—especially in states like Texas where many families are looking for more options than what’s available through the ACA marketplace.

• No enrollment windows: You can apply any time of year—no need to wait months to get started.

• Customized coverage: Private PPO plans often allow for more personalized coverage based on your family’s needs.

• Nationwide access: With many private PPOs, you’re not locked into local-only care, which is helpful for families who travel or have kids away at college.

Why Families Are Choosing Private PPO Plans Over the Marketplace

There’s a reason more families are skipping the marketplace and going the private route. It’s not just about timing—it’s about control, flexibility, and real value.

• Wider doctor networksMarketplace plans can be limited in who you can see, especially in Texas. Many families find that their favorite pediatricians or specialists aren’t in-network. Private PPOs typically give you access to larger networks, both in-state and nationwide, so your family doesn’t have to switch providers.

• No referrals requiredPPO plans often allow you to go directly to a specialist without getting a referral first. That can save you time and extra co-pays—especially helpful if your child sees a specialist regularly.

• Stronger out-of-network coveragePrivate PPO plans usually provide at least some reimbursement for out-of-network providers. That means if you’re traveling or need to see someone outside your usual area, your plan can still help cover the costs.

• Better fit for mixed needsEvery family is different. Maybe one parent needs more coverage, while the kids are healthy and rarely visit the doctor. A private PPO can often be customized so you're not paying for things you don't need—but you still have the protection where it matters.

How a Health Insurance Advisor Helps You Get the Right Plan

Sorting through options on your own can feel overwhelming. That’s where a licensed advisor comes in. Instead of guessing at which plan is “good enough,” an advisor walks you through your options and helps you find one that truly works for your family’s situation.

• Personalized plan matchingAn advisor learns about your family, your doctors, medications, and your budget—and then recommends a plan that fits. It’s not about selling you something. It’s about finding what works for you.

• Help with paperwork and enrollmentIf you’ve ever tried to sign up for a plan on the marketplace, you know it can be a maze. Advisors make the process simple. No confusion. No delays. Just coverage you can feel confident in.

• Local knowledgeA health insurance advisor based in Texas understands the provider networks in Houston, Katy, Sugar Land, The Woodlands, and beyond. That local experience matters when it comes to matching you with doctors who actually take your plan.

What Happens If You Wait for Open Enrollment?

Some families decide to wait it out and take the risk. But here’s what you might be facing if you go without coverage for too long:

• Gaps in care: Skipping appointments, putting off prescriptions, or hoping that nothing serious happens is a stressful way to live—especially when you have kids.

• Out-of-pocket surprises: Even a minor ER visit can cost thousands if you don’t have coverage. Private PPO plans protect you from those unexpected financial hits while you wait.

• Fewer choices during open enrollment: The marketplace offers limited plans based on your zip code. When the time comes, you may find that your options don’t align with what your family really needs.

When Is the Best Time to Get Coverage?

Right now! Or more specifically, before you "NEED" it. If you and your family don't have any major medical issue happening at the moment, then you're in the prime time to apply for private plans. What you don't want to happen is to have a medical emergency, and then try to get approved for insurance while immediately needing treatment.

If your family needs coverage today—or even if you’re just exploring better options—there’s no reason to wait for the next government enrollment window. A private PPO health insurance plan can be a smart, flexible, and immediate solution that keeps your family protected year-round.

Let’s Make Sure You’re Covered

At Budd Health Advisors, we work with families across Texas and this great country to find flexible private PPO plans that offer real protection—without the wait. Whether you’ve just lost coverage, moved to a new area, or you’re just tired of the marketplace guessing game, we’re here to help.

Visit www.buddhealthins.com to explore your options, or follow us on Facebook @ www.facebook.com/buddhealthadvisors for ongoing tips and updates. Or, if you're ready to get your family covered today, book a free consultation with Budd Health Advisors and let’s walk through your options together. There's no pressure—just helpful answers and coverage that fits.

Let's Go!