You can still get a nationwide PPO in Michigan, even when the marketplace's version costs half again as much as the plans beside it. Here's how metro Detroit electricians are working it out.
Hi, I'm Sam. I sell health insurance from Tampa, I hold a Michigan license among my 36 states, and every conversation with a client happens by phone, so a call from a plant floor parking lot works fine.
Here's who this page is for. You're a master electrician with a small shop in Sterling Heights. Some weeks you're running conduit and pulling cable for line changes and retooling inside the auto plants around Warren and Sterling Heights, some weeks you're doing service upgrades and basements in Macomb and Oakland. Plant work pays well and arrives in bursts tied to model changeovers. The health plan you had as a union or shop employee is gone, and the bill is now yours.
Whatever the marketplace quotes you, you can still get a nationwide PPO in Michigan through me.
HealthCare.gov does show a PPO in metro Detroit. Macomb, Oakland and Wayne each have 55 HMOs and 9 PPOs for 2026 from 5 insurers, and the PPOs all come from one insurer. Matched within the county for a 40-year-old, silver plans, before subsidies, the lowest-priced PPO costs 52% more than the lowest-priced HMO in Macomb and Oakland, and 51% more in Wayne. An HMO usually pays out of network only in an emergency, while a PPO also pays for outside doctors at a higher share and needs no referral. Underwritten private plans offer that on a national network, with a price based on your health.
Start with income. If the household qualifies for the premium tax credit, the marketplace usually wins on price. If you're past the credit range, you pay full price there, and that's the moment to compare.
The income that counts is the shop's profit for the coverage year, its net self-employment income after wire, gear, the van, tools, permits, your license and your liability coverage. You estimate it at enrollment and update it as soon as it shifts. Plant work makes that tricky, because one changeover job can be a quarter's income in six weeks.
When the retooling contracts keep coming and the household clears the credit range, a 52% markup for a marketplace PPO is a lot to pay for out-of-network coverage. If everyone's healthy, price a medically underwritten nationwide PPO against it. You fill out a health questionnaire, and the insurer approves you, declines you, or approves you minus one condition you've had before. Clean answers can bring the premium in below full marketplace price, and the network reaches past Michigan, which helps when a plant job sends you to Ohio or Indiana for a week. Each plan sets its own benefits, so we'll walk through them first.
Next step: Give me your zip code and who's on the plan, and I'll run a nationwide PPO quote against the metro Detroit marketplace.
In a year with fewer changeovers, the household may land in the credit range. Then the marketplace is usually the most affordable place to buy, since the credit only applies there, and with 55 HMOs in your county, finding one that includes your family's doctors is very doable. If the year turns out thinner still, Michigan's Healthy Michigan Plan, its Medicaid expansion, covers adults with income up to 138% of the federal poverty level. When the next plant contract lands, update your estimate right away.
Next step: Get me last year's return and the jobs you have lined up, and I'll match an estimate to the HMOs your doctors are in.
When the job-based plan ends, HealthCare.gov can give you a special enrollment period, which means you don't wait for fall to pick a marketplace plan. Dropping COBRA early by your own choice won't open one, so don't cancel it hoping to switch. If you're healthy and want the underwritten route, apply a few weeks before your last day, since the review takes time. Workers' comp covers job injuries only, never illness.
Next step: Call me before your last day on payroll and we'll have coverage ready the day the old plan stops.
If anyone on your plan sees a specialist regularly or takes a daily medication, stay with HealthCare.gov whatever your income. Every plan there accepts you and can't charge more for health history. Check that the specialists and the hospital you'd use are in the network you pick.
Next step: Tell me which doctors and medicines matter to you, and I'll find the metro Detroit plans that keep them.
Straight answers, no sales pitch.
Yes, 9 PPOs for 2026, but the lowest-priced silver PPO costs 52% more than the lowest-priced silver HMO there, before subsidies.
The profit you expect the business to make in the coverage year, after expenses. Revise it when a plant contract changes the picture.
Losing job-based coverage can qualify you for a special enrollment period on HealthCare.gov. Voluntarily dropping COBRA does not.
Yes. Through the Healthy Michigan Plan, adults with income up to 138% of the federal poverty level can qualify.
Your county, the people on your plan and a rough net from last year will do. I'll show you the metro Detroit marketplace plans next to a nationwide PPO, priced, and give you a straight recommendation.
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