You can still get a nationwide PPO in Maryland through me. Here is how contractors in Washington County, whose jobs run up and down I-81 into two other states, are choosing coverage.
Hi, I'm Sam. I broker health insurance from Tampa under licenses in 36 states, and a lot of my clients are paid on 1099s and need coverage that fits how they actually work. Maryland contractors can do it all by phone.
Washington County sits where three states meet, and the work doesn't care about the borders. Picture a controls technician who lives in Hagerstown and services conveyor and sorting systems for the warehouses along I-81. On Monday he's at a distribution center outside Chambersburg, Pennsylvania. Midweek he's in Martinsburg, West Virginia. Fridays are usually local. Every company pays him on a 1099, and none offers a health plan, so he buys his own on Maryland Health Connection.
Washington County has 32 individual medical plans on Maryland Health Connection for 2026: 28 HMOs and 4 PPOs. Maryland prices its marketplace plans the same in all four of its rating areas, so the PPO's premium is the same story everywhere. For a 40-year-old with no subsidy, the least expensive silver PPO costs 64% more than the least expensive silver HMO.
You can still get a nationwide PPO in Maryland through me instead, a private, underwritten plan whose network covers Pennsylvania and West Virginia as fully as Maryland.
Outside its network, an HMO generally pays only for emergencies. A PPO keeps paying out of network, with a bigger share left to you. So the useful test for a tri-state contractor isn't the premium first. It's this: if you cut your hand at a site in Chambersburg, is the closest urgent care in your plan's network? Is your doctor? Is the hospital you'd choose?
If your doctors are in Hagerstown and you'd drive home for anything that isn't urgent, a Maryland HMO with the right local network may be all you need.
What Maryland Health Connection counts is your profit from the work over the coverage year: 1099 totals less the truck, fuel, tools, test gear, software subscriptions and similar costs. Revise that figure promptly whenever a large service contract begins or wraps up.
Without the credit, your choices on the marketplace are a local HMO or a PPO priced well above it. A privately underwritten plan often fits a healthy contractor better. You answer medical questions, and the insurer approves you, declines, or approves with a specific condition left out. Healthy applicants often pay less than the marketplace's full rate, and the network reaches all three states and beyond. Benefits differ by plan, so we go through them.
Next step: Call me and I'll compare a nationwide PPO quote with Maryland Health Connection's full prices for your county.
If one warehouse client pulls its contract, the year can fall fast. Maryland expanded Medicaid, and KFF lists the adult limit at 138% of the poverty level. A year that honestly ends up there may point to Medicaid, and being eligible for it generally rules out the marketplace credit for the same months. Many expansion adults will also face a federal work or community-engagement rule beginning by January 1, 2027. Once new contracts arrive, tell Maryland Health Connection and return to one of its plans.
Next step: When a contract falls through, call me before you change anything and we'll sort out where the year is heading.
With a medication you can't skip or a specialist you see on a schedule, stay on Maryland Health Connection even past the credit range. Its plans accept everyone and can't charge more for health. The work is finding the network that keeps your specialist, wherever in the tri-state area they practice.
Next step: Tell me your doctors and prescriptions, and I'll find the Washington County plans that cover them.
Straight answers, no sales pitch.
Generally only for emergencies, unless the provider is in the plan's network.
Yes, four. The least expensive silver PPO costs 64% more than the least expensive silver HMO.
It's possible if the household's income is at or under 138% of the federal poverty level, subject to the federal work rule starting by January 1, 2027.
Yes. If you're healthy, I can set one up privately.
Let me know your county, what share of your jobs are in Pennsylvania or West Virginia, and what your 1099s netted after expenses last year. I'll point you to the right coverage and price it.
The guide for every state, and other work I help with