You can still get a nationwide PPO in Ohio, even though the marketplace sells only HMOs. Here is how people paid on a 1099 are matching coverage to their income, their health and their work.
Hi, I'm Sam. I'm a licensed broker in Tampa and licensed in 36 states, and I help Ohioans who work on a 1099 put their own coverage together by phone, whether the work is HVAC in Columbus, delivery routes around Toledo or design work in Cincinnati.
Contractors in Ohio face a marketplace made entirely of HMOs, a Medicaid program that reaches further than in many states, and a state continuation law for people walking away from a W-2 job. Here's how those pieces fit for someone paid invoice by invoice.
HealthCare.gov offers Ohioans 189 individual medical plans for this year. All of them are HMOs. Not one is a PPO.
You can still get a nationwide PPO in Ohio. I arrange it off the marketplace as a privately underwritten plan, priced from your health answers, with a network of doctors and hospitals in every state. For a healthy contractor who takes jobs across county or state lines, it's worth a quote.
HealthCare.gov wants net self-employment income for the coverage year, meaning your 1099 totals minus tools, vehicle, materials, software and the other costs of doing the work, and it wants you to update that number as soon as it changes. A spouse's income counts too.
Ohio then sorts you three ways. At the low end, the Medicaid expansion covers adults up to 138% of the federal poverty level. In the middle, the premium tax credit lowers what you pay for a marketplace plan. Past the credit range, you pay full price. Because Medicaid eligibility generally rules out the credit, the line between the first two matters.
If that's you, a HealthCare.gov HMO is generally where you'll pay the least, since the credit doesn't apply anywhere else.
Your choices depend on your county: plans are sold in all 88, by anywhere from 3 to 9 insurers. Since each one is an HMO, confirm your doctors are in the network before deciding on price, and remember that care outside the network is generally covered only in an emergency.
Next step: Gather your 1099s or a rough net, and we'll set an estimate and pick an HMO that includes your doctors.
At full price, an HMO-only shelf is a hard sell for a contractor who moves around. That's when a private nationwide PPO deserves a look.
You'll fill out health questions. The insurer then either writes the policy, turns it down, or writes it with a particular condition left out. Healthy applicants often pay less than the full marketplace rate, and the network goes wherever the job does. Benefits differ by policy, so we'll compare them before you choose.
Next step: Call me and I'll quote a nationwide PPO for your household beside the Ohio HMOs in your county.
Lose a big client and your income can drop into Medicaid range. In Ohio that's a real safety net: the expansion covers adults up to 138% of the poverty level, and you can apply year-round.
Watch the handoff. If a new contract lifts your income above the Medicaid line, the marketplace credit becomes the right path instead, so report the change and switch.
Next step: Call me if your year is thin, and we'll figure out whether Medicaid or a marketplace plan fits and when to switch.
If you had coverage through an insured employer group plan, Ohio law may let you keep it for up to 12 months, provided you were covered three months in a row and meet the statute's other conditions. Federal COBRA may also apply, depending on the employer.
Losing job coverage also opens a special window to join the marketplace. Weigh what continuation would cost you against an HMO with a credit or a nationwide PPO before you decide.
Next step: Call me before your last day, and we'll compare continuation, the marketplace and a nationwide PPO side by side.
Straight answers, no sales pitch.
No medical PPOs. Every one of the 189 individual medical plans is an HMO. Healthy contractors can get a nationwide PPO privately through me.
Yes, if income is low enough. Ohio expanded Medicaid to adults with income up to 138% of the poverty level, and you can apply any time.
Possibly. Ohio law allows continuation of an insured group plan for up to 12 months if you meet its conditions, and federal COBRA may apply too.
Your net self-employment income for the year, after business expenses. Update it as soon as it changes.
All I need to start is your Ohio county, the people who need coverage, and a rough figure for what your 1099 work cleared. I'll point you to Medicaid, a marketplace HMO or a nationwide PPO and put numbers on it.
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