You can still get a nationwide PPO in Montana through me. Here is how Billings-based contractors whose clients are spread across three or four states pick between the marketplace PPO and a private one.
Hi, I'm Sam. I'm a Tampa-based health insurance broker with licenses in 36 states, and a lot of my clients get paid on 1099s. Montana contractors can set up coverage with me without leaving the truck.
Picture a crop and soil consultant who lives in Laurel just west of Billings. Farmers and ranchers hire her by the season to scout fields and write fertility plans across south-central Montana, northern Wyoming and western North Dakota. From April through October she's on the road four days a week, staying in small-town motels. Every client pays on a 1099, and none of them provides health insurance. She buys on HealthCare.gov as a Yellowstone County resident.
Yellowstone County has 42 individual medical plans for 2026 from three insurers: 25 PPOs, 9 POS plans and 8 EPOs. In the Billings area the PPO costs a bit more. For a 40-year-old before any subsidy, the least expensive silver PPO is 10% above the least expensive silver POS plan. Across most of rural Montana the pattern flips; in 38 of the state's 56 counties the silver PPO is 5% below the least expensive alternative.
You can still get a nationwide PPO in Montana through me as well. It's underwritten on your health, and its network is meant to treat a clinic in Sheridan, Wyoming, or Dickinson, North Dakota, as in network.
An EPO generally pays outside its network only for emergencies. A PPO keeps paying out of network, with a larger share left to you. For a contractor who spends half the year in other states, the questions are practical. Does the plan pay anything at the urgent care in Gillette? Are the doctors back home in Billings in network? A private nationwide PPO can answer the first question with an in-network yes.
What the marketplace wants is your profit for the coverage year, meaning what clients paid you less your truck, fuel, motels, soil-testing supplies, software and insurance. Seasonal work makes the estimate tricky, so base it on a full year and revise it as contracts firm up.
Montana took the Medicaid expansion, which reaches adults up to 138% of the poverty line according to KFF. Since July 1, 2026, most expansion adults ages 19 to 64 have had to document 80 hours a month of qualifying activity. Months you're eligible for Medicaid generally can't be paired with the marketplace credit.
Use HealthCare.gov; the credit doesn't apply anywhere else. Because the credit is anchored to a benchmark silver plan and doesn't grow with your choice, you'd cover the PPO's extra 10% in Yellowstone County yourself. For someone on the road half the year, out-of-network coverage is often worth that. If you rarely leave the Billings area, a POS or EPO plan may be the better value.
Next step: Send me your travel pattern and your net, and I'll price Yellowstone County's PPO, POS and EPO plans after the credit.
Now the unsubsidized marketplace PPO goes up against a private nationwide plan. On the private side, an underwriter reads your health history and either accepts you, accepts you while excluding a named condition, or turns you down. Contractors in good health often pay below the marketplace's full rate, with in-network care across state lines. We read the benefits of each plan before you commit.
Next step: Call me, and I'll set a nationwide PPO quote beside Yellowstone County's unsubsidized PPOs.
Drought or low commodity prices can shrink a consultant's season. If your year looks like it will land at or below 138% of the poverty level, Montana Medicaid may apply, with its 80-hour monthly documentation rule. When clients return, report your income and move back to a marketplace plan.
Next step: Before you switch programs in a lean year, talk to me and we'll map out your year.
If you depend on daily medication or see a specialist on a schedule, stay with marketplace coverage regardless of income. Marketplace plans take everyone and can't charge more for health. Choose the network that keeps your Billings specialist, and plan refills around your field season.
Next step: Tell me your specialists and medications, and I'll find the Yellowstone County plans that include them.
Straight answers, no sales pitch.
Somewhat. Yellowstone County's lowest-priced silver PPO runs 10% above its lowest-priced silver POS plan.
With a PPO you'll get partial coverage out of network; an EPO generally covers only emergencies there.
Yes. Since July 1, 2026, most expansion adults 19 to 64 must document 80 hours a month of qualifying activity.
Yes. Healthy contractors can buy one privately through me.
Tell me where you live, about how many weeks you spend out of state, and what your 1099s netted after expenses. I'll tell you which coverage fits and what it costs.
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