You can still get a nationwide PPO in Nevada, even though Nevada Health Link sells none. Here is what an HMO-heavy exchange means for northern Nevada contractors whose jobs take them over the line into California.
Hi, I'm Sam. I'm a Tampa broker licensed in 36 states, and Nevadans who work on a 1099 can arrange their coverage with me by phone.
Picture a finish carpenter living in Minden. Some weeks he's building in Gardnerville; others he's on a cabin remodel at South Lake Tahoe or a job in Truckee, both in California. His income arrives on 1099s, and his coverage comes from Nevada Health Link because he lives in Nevada. Nearly everything on that exchange is an HMO, and HMOs aren't built for a working week that straddles a state line.
Nevada Health Link has 138 individual medical plans for 2026, made up of 131 HMOs and 7 EPOs. You won't find a PPO.
You can still get a nationwide PPO in Nevada by going private, and I can set it up. It's priced on your health, and its network reaches into California and every other state, so an urgent care in South Lake Tahoe or a specialist in Sacramento is simply in network.
An HMO or EPO generally pays for out-of-network care only in an emergency. For a contractor in Douglas County, Carson City or Washoe County, the question is whether a Nevada plan's network includes the California-side providers you actually use. Washoe has 8 insurers on Nevada Health Link; Douglas County and Carson City have 6. That's enough networks to compare, but you have to check them.
Go through each one for:
If your work and doctors are mostly in Nevada, a Nevada Health Link plan may be plenty, especially with the credit helping on the premium. If half your week is in California, network reach matters more than price.
Nevada Health Link bases help on household income for the coverage year. For a contractor, that's net self-employment income, 1099 totals minus tools, materials, truck costs and other business expenses, updated as soon as it changes. Nevada expanded Medicaid, and KFF lists the adult limit at 138% of the federal poverty level. In a lean winter or a lost-contract year, Medicaid may be your coverage; while you're eligible for it, you generally can't take the marketplace credit.
A Nevada Health Link plan with the credit is usually your most affordable option. Use the checklist to pick the network that reaches your California job sites.
Next step: Send me your main job locations and doctors, and I'll find which Nevada Health Link networks cover them.
Paying full price for a plan whose network may stop at the state line is a weak deal. A nationwide PPO is usually worth pricing: the carrier reads your health answers and either issues the policy, declines it, or issues it with one condition left out.
Next step: Call me for a nationwide PPO quote for your household, set beside the Nevada Health Link plans in your county.
Mountain construction often slows hard in winter. If your realistic estimate for the year drops to 138% of the poverty level or below, Nevada Medicaid may cover you. Once spring jobs push the year past that line, tell Nevada Health Link and switch to a marketplace plan.
Next step: If this year is running thin, call me and we'll sort out whether Medicaid or Nevada Health Link fits right now.
Straight answers, no sales pitch.
Only if the provider is in that plan's network, or in an emergency. Nevada Health Link plans are HMOs and EPOs, so check the network first.
Washoe County has 8 for 2026; Douglas County and Carson City have 6.
No. All 138 individual medical plans are HMOs or EPOs. Healthy contractors can get a nationwide PPO through me.
If income for the year is at or below 138% of the federal poverty level, possibly. Nevada expanded Medicaid.
Tell me your county, where most of your work happens, who's on the plan and roughly what the 1099s netted. I'll match a plan to the places you actually work.
The guide for every state, and other work I help with