You can still get a nationwide PPO in Maryland, and an electrician who wires jobs in Maryland, DC and Virginia in the same month has good reason to want one. Here's how DC-area electrical contractors are choosing.
Hi, I'm Sam. I sell health insurance from Tampa, Maryland is on my license, and I do this work by phone, which helps when you're between a job in Silver Spring and one across the river.
Say you're a master electrician in Prince George's County who used to run jobs for a large contractor that builds out federal offices and labs. Now you sub on that same kind of work yourself: tenant fit-outs in Bethesda and Rockville, panel and lighting work in DC, a data hall or two in Northern Virginia. In a normal month your work crosses three jurisdictions. Your family's doctors are in Maryland, and your own day can end anywhere on the Beltway.
The short answer first: you can still get a nationwide PPO in Maryland. I set them up regularly.
Maryland Health Connection lists 39 HMOs and 4 PPOs for 2026 in both Montgomery and Prince George's, from 4 insurance companies. Price is the problem. Maryland's plans carry identical rates across its four rating areas, and on a silver plan for a 40-year-old with no subsidy, the least expensive PPO comes to 64% more than the least expensive HMO. HMOs generally won't cover care outside their network except emergencies, and for someone whose workweek spans Maryland, DC and Virginia, that's worth checking carefully. A PPO pays toward outside doctors too, at a higher share, with no referral. The nationwide kind comes from medically underwritten private plans priced on your health.
Help with premiums depends on household income for the coverage year, which for you is net self-employment income: billings minus wire, gear, the van, tools, permits, license renewals and insurance. You estimate it when you enroll and adjust it whenever it moves.
Federal-side work can be lumpy, a big award one quarter and a pause the next, so the estimate deserves a check-in midyear. For context, KFF's figures put Maryland's 2026 benchmark premium about 13.4% above 2025.
Inside the help range, the state marketplace almost always comes out ahead on price, since premium help only works there. With 39 HMOs on the list, the job is narrowing to the ones whose networks include your family's doctors, and, because your day crosses the line so often, knowing where an in-network urgent care sits along your usual routes. When a large contract lands, update the estimate so the help adjusts.
Next step: Send me last year's return and the doctors you use, and I'll sort the Montgomery and Prince George's HMOs down to the ones that fit.
Above the help range, the HMOs bill full price and the PPO bills 64% more on top. For a healthy household, the plan to compare is a medically underwritten nationwide PPO. The insurer reviews your answers to a medical questionnaire and offers coverage, offers it with one prior condition excluded, or declines. Healthy applicants can often get a premium under the marketplace's full rate this way, and the network doesn't care whether you're in Bethesda, on Capitol Hill or out in Loudoun County. Benefits vary by plan, and I'll lay them out plainly.
Next step: Give me your zip and who's going on the plan, and I'll price a nationwide PPO for you against Maryland Health Connection's full rates.
Maryland Health Connection says certain life events let you enroll outside open enrollment, and losing the plan that came with a job is the one we'd confirm for you. Underwritten plans take time to review, so start a few weeks before your last day. Workers' comp, which you'll set up for any helper you hire, pays for job injuries only, never illness.
Next step: Call me a few weeks before you leave so the new coverage starts when the old plan ends.
A long-term illness or a medication that can't lapse means staying on Maryland Health Connection whatever you earn, because its plans accept everyone at a price that ignores health history. And if a slow stretch drags the household down far enough, Maryland's Medicaid expansion covers adults up to 138% of the federal poverty level.
Next step: Give me the names of the doctors and medicines you rely on, and I'll find which Maryland plans keep them.
Straight answers, no sales pitch.
Yes, 4 PPOs are sold there for 2026, but the lowest-priced silver PPO costs 64% more than the lowest-priced silver HMO for a 40-year-old, before subsidies.
Only if the doctor is in its network, or in an emergency. Check the network before you rely on it across state lines.
KFF's figures show the state's average benchmark premium about 13.4% higher than in 2025.
Yes. The income line for adults is 138% of the federal poverty level.
Your county, who's on the plan and roughly what the shop netted last year is enough. I'll price Maryland Health Connection, including any state help, next to a nationwide PPO, and tell you which I'd take.
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