You can still get a nationwide PPO in Florida. Here is how chiropractors who run their own practice are deciding between the marketplace and a private plan in a year when prices climbed.
Hi, I'm Sam Jaber, and I'm a licensed health insurance broker in Tampa. I'm licensed in 36 states and work by phone, but Florida is home, and a lot of the chiropractors I help practice here.
Chiropractors are in an interesting spot. Many of you earn close to the line where marketplace help stops, so a good year and a slow year can send you down completely different paths. Add a Florida marketplace that got more expensive this year, and it pays to know exactly where you stand before you pick a plan.
If you're healthy, you can still get a nationwide PPO in Florida, and it's often a better deal than people expect.
Most chiropractors I talk to have already looked at the marketplace and decided a PPO wasn't realistic. I understand why. Florida's marketplace PPO comes from one insurer, and in most counties it sells at a hefty markup over the other networks. Matched against the least expensive plan with any other network type, it costs 91% more in Manatee, 83% more in Lake and 77% more in Marion. In the typical Florida county, it's about twice the price.
Private plans with medical underwriting are a separate option. They use PPO networks with providers across the country and are priced on the health of the people applying. That's the comparison I'd make for a healthy chiropractor over the line.
The whole decision hinges on whether your household qualifies for the premium tax credit on HealthCare.gov. That credit is figured from your household income for the coverage year, and for a clinic owner the income that counts is net: what's left after rent, staff, equipment and billing. The cutoff is around four times the federal poverty level and moves up with each person in your household.
Here's why that line carries extra weight in Florida right now. Approved 2026 rates for individual coverage rose an average of 34.1%, by the state regulator's enrollment-weighted measure, before subsidies. Under the line, the credit absorbs much of that. Over it, you pay all of it.
Pick the situation below that matches your year.
For a lot of chiropractors, this is the right description. When your household qualifies, a HealthCare.gov plan is usually where your dollar goes furthest, because the credit can't be used anywhere else.
Watch two things. First, the estimate you give HealthCare.gov. A stronger year than you projected means some of the credit may come back at tax time, so update your income when visit volume changes. Second, the network. Most of the plans on Florida's marketplace are HMOs, so we'll check that the doctors your family sees are actually in the plan you choose.
Next step: Send me your last return and this year's numbers so far, and we'll set an estimate and choose a plan that keeps your doctors.
Once you clear the line, the credit is gone and the full price applies, including this year's increase. For a healthy family, that's often more than the coverage feels worth.
A medically underwritten plan on a nationwide PPO network is the option to price next. You answer health questions for everyone on the application, and the insurer accepts, declines, or accepts with a specific condition carved out. When everyone is healthy, that's how the price can come in below the full marketplace rate.
Each plan sets its own benefits, so before you choose, I'll explain what the one you're considering pays for.
Next step: Call me and I'll put a nationwide PPO quote next to the marketplace plans in your county.
If you or someone on your plan has an ongoing diagnosis or a medication you can't skip, I'll usually point you back to the marketplace, full price included. There, nobody can be turned away or charged more because of their health. An underwritten plan can do both.
In Florida, that leaves a choice between the more affordable HMO and EPO plans and the marketplace PPO. If your care is local and your doctors are in network, a Florida HMO or EPO can work well. If a specialist you need is outside those networks, the marketplace PPO may be worth its higher price for you.
Next step: Tell me your doctors and medications and I'll go through each plan type in your county with you.
A first year can be lean. Before you assume a low year means the most help, know how Florida works. The state has not adopted the Medicaid expansion, and the tax credit generally starts at the federal poverty level. A household that lands below that level may qualify for neither, which surprises a lot of new owners.
If your projection is close to that floor, your estimate and the timing of your enrollment matter a great deal.
Next step: If your first year looks very thin, call me before you enroll and we'll figure out what you qualify for.
Straight answers, no sales pitch.
Yes, one insurer sells a marketplace PPO in every Florida county. In the typical county it costs about twice as much as the least expensive plan with another network type.
The state regulator reported an average approved increase of 34.1% for 2026 individual plans, before subsidies. Chiropractors above the credit range pay that full price.
Be careful. Florida has not adopted the Medicaid expansion, and the tax credit generally starts at the federal poverty level, so a very low year can fall in the gap between the two. Call me before you enroll.
Yes. If you're healthy, I can price private underwritten plans on nationwide PPO networks for Florida residents.
The county you live in, who you need to cover, and a ballpark of what the clinic netted last year. I'll tell you which side of the line you're on and price both paths, and if your current plan is the better fit, I'll say so.
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