You can still get a nationwide PPO anywhere in Virginia, even where the marketplace sells none. Here is how people paid on a 1099 are matching coverage to their income and health.
Hi, I'm Sam. I'm a Tampa health insurance broker licensed in 36 states, and I help Virginians paid on a 1099 by phone, whether you do electrical work in Chesapeake, IT contracts in Reston or bookkeeping in Lynchburg.
Virginia is a different market from most. It runs its own exchange, Virginia's Insurance Marketplace, with its own enrollment dates. Its marketplace PPO doesn't exist outside a slice of Northern Virginia. And Medicaid covers adults up to 138% of the poverty line, which matters a lot when a client disappears.
On Virginia's marketplace this year there are 83 individual medical plans. Sixty are HMOs and 19 are EPOs. The 4 PPOs belong to one insurer, which sells them in Arlington County, the cities of Alexandria, Falls Church and Fairfax, and pieces of Loudoun, Prince William and Fairfax counties, nowhere else. Live anywhere else and the marketplace has no PPO for you.
You can still get a nationwide PPO anywhere in Virginia. I arrange it as a privately underwritten plan: your health answers set the premium, and the network covers doctors and hospitals nationwide. For a healthy contractor who works in several cities, it's worth comparing.
The marketplace uses net self-employment income: 1099 totals minus tools, vehicle, supplies, software and other business costs, plus any household income such as a spouse's wages.
Then Virginia sorts you. Up to 138% of the federal poverty level, the expanded Medicaid program may cover you, and Medicaid eligibility generally rules out the marketplace credit. Above that, the premium tax credit applies on Virginia's Insurance Marketplace. Past the credit range, you pay full price.
A marketplace plan is usually the best buy here, since the credit only applies to it. Nearly every choice is an HMO or EPO, so make sure your doctors are inside the network before comparing prices.
Watch the calendar too. Virginia sets its own open enrollment, and for 2027 coverage it runs from November 1, 2026 to January 29, 2027, two weeks past the federal deadline.
Next step: Have your 1099 totals and main expenses handy, and I'll turn them into an honest estimate and a plan your doctors belong to.
Full price for an HMO or EPO, or a PPO only if you happen to live in the right Northern Virginia locality, is where many healthy contractors start looking privately.
You'll answer health questions, and the insurer issues a policy, declines, or issues it with a named condition excluded. Clean health answers usually mean a premium below what the marketplace charges at full price, and coverage that travels to every job site. Policies differ, so we'll compare benefits first.
Next step: Phone me for a nationwide PPO quote covering your household, set against the marketplace plans in your locality.
Losing your biggest account can drop your income into Medicaid range, and in Virginia that's a real safety net for adults up to 138% of the poverty level. When new work lifts you above that line, switch to a marketplace plan with the credit and report the change.
Next step: When work slows down, get in touch and I'll help you decide between Medicaid and a marketplace plan, and spot the moment to switch.
If your old employer's plan isn't covered by federal COBRA, Virginia law may let you continue it for 12 months, provided you were covered for at least three months. If COBRA does apply, that's your continuation route. Losing job coverage also opens a special window on Virginia's marketplace.
Price continuation against a marketplace plan and a nationwide PPO before you sign anything.
Next step: A few weeks before you leave the job, call me and I'll lay continuation, a marketplace plan and a private PPO next to each other.
Straight answers, no sales pitch.
Only in parts of Northern Virginia, and from one insurer. Everywhere else there's no marketplace PPO. Healthy contractors can get a nationwide PPO privately through me.
When income is low enough, yes. Virginia's expansion takes in adults earning up to 138% of the poverty level.
For 2027 coverage, from November 1, 2026 to January 29, 2027, on Virginia's Insurance Marketplace.
Possibly. Virginia law allows 12 months of continuation where federal COBRA doesn't apply, and COBRA covers larger employers.
Start with your Virginia locality, the people who need a plan, and a rough figure for what your 1099s netted. I'll steer you to Medicaid, a marketplace plan or a nationwide PPO and price it.
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