Marketplace Alternative

If you've looked at the individual health insurance market lately, you already know the challenge. Premiums for many unsubsidized families keep climbing, deductibles can be high, and the coverage can feel expensive compared to how often you actually use it. For healthy earners who don't qualify for large Marketplace subsidies, marketplace plans can sometimes feel misaligned with their needs and budget.

Presidio Health Insurance is a fully insured, private health plan — regulated by the Texas Department of Insurance — created for people who want predictable costs, honest coverage, and a plan that reflects their values. It is not Affordable Care Act-qualified coverage, not a health sharing ministry, and not a government program; it's an off-exchange alternative designed for medically underwritten, generally healthy Texans who want simpler structure and potentially lower premiums than many unsubsidized Marketplace bronze plans, depending on their situation.

Important: Presidio is not minimum essential coverage under the Affordable Care Act. If you choose Presidio instead of a Marketplace plan, you may lose access to Marketplace premium tax credits and certain mandated benefits. Presidio eligibility, rates, and benefits are subject to underwriting guidelines and policy terms.

A Different Approach to Health Insurance

Presidio is built around a simple idea: if you're healthy and rarely use your coverage, your plan should reward you with fair pricing and straightforward benefits — not punish you with complexity.

This is private, values-aligned health insurance, designed to give you:

• A clear structure (no stacked deductibles and tier games).
• Lower premiums for many healthy, unsubsidized members.
• Nationwide access to providers through a primary PPO network.

Instead of copying the Marketplace model, Presidio uses a zero-deductible, coinsurance-driven design with defined maximum out-of-pocket (MOOP) limits for accident and sickness. It's intentionally simple so you can understand exactly how your plan works before you ever file a claim.

How Presidio Can Lower Your Premium

In many cases, Presidio's monthly premium is lower than comparable unsubsidized Marketplace bronze plans for healthy individuals who meet underwriting criteria.

For example, as of July 2026, a single 40-year-old male in Dallas County, Texas may pay significantly less per month with Presidio than with the lowest-cost unsubsidized bronze plan available on Healthcare.gov for the same time period. Actual savings vary by age, zip code, tobacco status, family composition, and plan selection, and Marketplace plans may include benefits and subsidies that are not available with Presidio.

Presidio is not right for everyone; it is specifically engineered for healthier applicants who value predictable cost-sharing and are comfortable with medical underwriting. The best way to understand what your premium and savings could look like is to run a customized quote with a licensed broker.

What Makes Presidio Different

Presidio was built around nine key features that are designed to work together, not against you:

• Zero Deductibles. Your coverage starts at dollar one. You pay coinsurance until you reach your maximum out-of-pocket (MOOP), then the plan pays 100% of covered charges for the rest of the year.
• Simple 50% Coinsurance. You and Presidio share the cost at 50/50 for covered services until you hit your MOOP, then covered services are paid at 100%. No shifting tiers or hidden splits — just a consistent structure.
• MOOP Rollover Rewards. If you don't reach your MOOP in a plan year, a portion of what you paid toward it may roll over to reduce your MOOP the following year. Healthy members are rewarded for low utilization instead of penalized.
• Broad, Non-Aggregate Coverage Limits. Presidio's structure is designed without an aggregate policy maximum. Covered accident and sickness benefits are designed to protect your household against significant medical expenses, subject to the specific terms, limits, and exclusions of your plan.
• Guaranteed Renewable (Subject to Terms). As long as you pay your premiums and comply with policy terms, your coverage can be renewed year after year. There's no annual open enrollment window and no requirement to reapply each year. Initial enrollment is subject to medical underwriting.
• Nationwide Provider Access. You have access to a primary PPO network of providers and hospitals across the country. You can also seek out-of-network care, but those claims may be subject to usual and customary limits and could result in higher out-of-pocket costs or balance billing.
• Private Insurance. Presidio is regulated by the Texas Department of Insurance and guided by Christian ethics. Certain services — such as abortion and specific contraceptives — are not covered, while other benefits are structured to support life-affirming, family-centered care. You don't need to be Christian to enroll, and eligibility is not based on religion.
• 24/7 Virtual Care. You can talk to a doctor anytime, anywhere through virtual care options. Many preventive virtual visits start at a low, flat fee, helping you address everyday health needs without an office visit.

How the Plan Works

Presidio keeps the benefit structure straightforward:

• Annual Deductible: $0
• Coinsurance: 50% for covered services until you reach your MOOP, then 100% for the rest of the plan year
• Sickness MOOP: Typically ranges from $2,500 to $10,000 per individual, and $5,000 to $20,000 per family, depending on the plan option you choose
• Accident MOOP: Typically ranges from $2,500 to $10,000 per individual, and $5,000 to $20,000 per family, with separate limits from sickness
• Annual & Lifetime Maximums: No aggregate policy maximum on covered benefits, subject to outlined terms, limitations, and exclusions

For most covered services — office visits, specialist care, pharmacy, outpatient services, emergency care, and urgent care — you'll see the same basic pattern: you pay 50% coinsurance until your applicable MOOP is met, then covered charges are paid at 100% for the rest of the year. Accident and sickness benefits have separate MOOPs, so a major injury doesn't necessarily push you to the same limit as an illness.

Pregnancy and maternity have their own structure. In many cases, pregnancy in the first year is subject to a separate pregnancy deductible and specific rules, including possible waiting periods and exclusions for pre-existing pregnancies. Your plan's outline of coverage will spell these details out.

Built With Your Values in Mind

One of the things that sets Presidio apart is that it is unapologetically values-driven. Many families don't want their premiums used to fund services they morally oppose, and they want coverage that respects both their health and their beliefs.

Presidio is faith-aligned and family-first. Its benefit design is guided by Christian ethical principles, with a focus on caring for mothers, fathers, children, and the unborn, while still offering modern, comprehensive medical coverage for accidents and sickness. You do not have to share Presidio's religious beliefs to enroll, but you should be comfortable with its ethical framework and the services that are excluded or limited as a result.

Is Presidio Right For You?

Presidio is currently available in Texas and is generally a strong fit for healthy individuals and families who:

• Are unsubsidized or lightly subsidized on the Marketplace.
• Want lower premiums and a simpler structure than many Marketplace bronze plans, without joining a health sharing ministry or buying a short-term plan.
• Prefer medically underwritten coverage with defined MOOPs over high deductibles and complex plan tiers.
• Value coverage that aligns with Christian ethics and family-centered care.

Presidio is not appropriate for everyone. If you have significant ongoing health needs, expect frequent high-cost claims, or rely heavily on Marketplace subsidies and essential health benefits, a Marketplace plan may still be your best option. The only way to know for sure is to compare your choices side by side.

All Presidio plans contain exclusions, limitations, waiting periods, and specific eligibility criteria. Availability, cost, and details of coverage depend on your age, health history, zip code, and plan selection. This content is for informational purposes and is not a complete description of coverage.

To see whether Presidio is a fit for you, and to understand how it compares to your Marketplace or employer plan, work with a licensed health insurance broker — that's where our team comes in. We'll:

• Review your current coverage and costs.
• Walk through Presidio's benefits, exclusions, and underwriting.
• Compare premium and out-of-pocket scenarios for your household.
• Help you enroll correctly if it's the right fit, or confirm that staying put makes more sense.