You can still get a nationwide PPO in Tennessee, even though the marketplace sells only EPOs. Here is how 1099 workers plan around a lean year in a state that never expanded Medicaid.
Hi, I'm Sam. I'm a Tampa-based broker licensed in 36 states, and Tennesseans paid on a 1099, whether you hang drywall in Murfreesboro, repair HVAC in Chattanooga or edit video in East Nashville, can work with me by phone.
This page focuses on one Tennessee problem: the slow year. A client pauses, a contract ends early, and your income heads toward the floor. In a lot of states that floor has Medicaid under it. In Tennessee, for many contractors, it doesn't.
Before the lean-year question, the network one. Tennessee's marketplace sells 158 individual medical plans this year, all EPOs, with no PPO among them.
You can still get a nationwide PPO in Tennessee, through me. It's a private plan that prices you after health questions and covers doctors across the country, which suits contractors who chase work beyond their home county. When income rebounds and you're healthy, it's often the better buy.
Three facts set the floor. First, Tennessee has not adopted the ACA Medicaid expansion. Second, KFF lists TennCare's income limit for parents at 105% of the federal poverty level; for adults who aren't parents, there's no expansion route at all. Third, the marketplace tax credit generally doesn't begin until income reaches 100% of the poverty level.
Put those together and a single contractor with no children whose year lands under the poverty line can qualify for neither TennCare nor the credit. A parent at that income may have a TennCare path. That's the difference this page is about.
This is the contractor most at risk. Your estimate for the year decides everything, and HealthCare.gov wants net self-employment income: 1099 receipts minus tools, vehicle, materials and other real costs, updated as soon as it changes.
Be realistic, not optimistic and not pessimistic. If you have work lined up for the back half of the year, it counts. A truthful projection that lands just above the poverty line opens the credit; one that lands below it may leave you without help. We'll build that projection together from what's actually on your calendar.
Next step: Before you enroll in a slow year, walk me through the contracts you have and expect, and we'll see where the year honestly lands.
Parents have a different floor in Tennessee. KFF lists TennCare's limit for parents at 105% of the poverty level, so a household with kids and very low income may qualify for TennCare rather than the marketplace. As income climbs past that limit, the credit takes over.
Next step: Tell me who's in the household and what the year looks like, and I'll help you figure out whether TennCare or a marketplace plan fits.
Once the year recovers past the credit range, you'd be paying full price for an EPO. A healthy contractor usually does better with an underwritten nationwide PPO, where the insurer accepts you, declines you, or accepts you with one condition excluded based on your answers.
Next step: When the jobs pick up again, call me and I'll price a nationwide PPO against your county's EPOs.
The number you give HealthCare.gov should come from evidence, not hope or fear. Here's what goes into it:
If that honest total lands near the poverty line, the difference between just above and just below it matters a great deal in Tennessee, so it's worth a careful look together rather than a quick guess. And when new work arrives, report it so your credit stays accurate.
Straight answers, no sales pitch.
It depends on your household. Tennessee hasn't adopted the Medicaid expansion; KFF lists TennCare's parent limit at 105% of the poverty level, and adults without children generally have no income-based route.
The marketplace credit generally starts at 100% of the poverty level, so very low income can leave a contractor without children ineligible for both. Plan the year with me before enrolling.
Net self-employment income for the coverage year, after business expenses, updated when it changes.
No medical PPO. All 158 individual medical plans are EPOs. Healthy contractors can still get a nationwide PPO through me.
Give me your county, who needs a plan, and your honest guess at what the 1099 work will net this year. I'll tell you what you qualify for and what it costs before you enroll.
The guide for every state, and other work I help with