You can still get a nationwide PPO in Georgia, even in metro Atlanta where Georgia Access sells none. Here's how general contractors, builders and remodelers across Georgia are covering their families for less.
Hi, I'm Sam Jaber, and health insurance is all I do. I'm based in Tampa, Georgia is one of the states I'm licensed in, and every bit of my work happens on the phone, which suits builders with a full calendar.
Georgia has kept contractors busy for years. Subdivisions keep marching outward from Atlanta into Forsyth, Cherokee and Henry, the Savannah area keeps growing behind its port, and older homes in Macon, Augusta and Athens keep remodelers booked. Running your own outfit in any of those places also means buying your own coverage, through a marketplace Georgia now runs itself. And if you live in the core of metro Atlanta, that marketplace has no PPO for you at all.
You can still get a nationwide PPO in Georgia, through me, whether you're in Marietta, Savannah or a small town in the north Georgia hills.
Here's what Georgia Access shows for 2026: 211 individual medical plans, of which 203 are HMOs and 8 are PPOs. Those 8 come from a single insurer and are sold in 71 counties. Fulton, DeKalb, Cobb, Gwinnett, Clayton and Chatham aren't among them. So a builder in Atlanta's core counties or in Savannah can only buy an HMO on the marketplace, and an HMO generally pays nothing for care outside its network unless it's an emergency. A PPO is the type that covers out-of-network doctors, at a higher share of the cost, and doesn't make you get a referral first.
Private medically underwritten plans fill that gap. Their PPO networks reach nationwide, and the premium tracks your health, which can make them a good buy for a healthy family.
Georgians enroll through Georgia Access instead of HealthCare.gov, and what's available depends on your household's income for the year. For a builder, that's profit, after lumber, concrete, subs, trucks, equipment, permits and insurance.
Georgia's ladder has a weak bottom rung. The state hasn't adopted the Medicaid expansion. Instead, Georgia Pathways offers Medicaid to adults up to 100% of the federal poverty level, but only if they meet a work, school or volunteer hours requirement. The marketplace's premium tax credit generally starts at the poverty level and covers the middle. At the top, the credit runs out and you pay full price.
A first year on your own or a run of lost bids can leave a builder's household with very little income, and in Georgia that's a riskier place to be than in many states. Without the Medicaid expansion, the bottom option is Pathways, with its hours requirement, and the marketplace credit generally doesn't begin until household income reaches the poverty line.
If your year is trending that low, the income estimate you give Georgia Access and the timing of your application matter a lot. Talk it through before you file anything.
Next step: If this year looks thin, ring me before you apply and we'll work out which option you actually qualify for.
For most small builders, this is home. Between the poverty line and the top of the credit, a Georgia Access plan with the federal credit almost always costs less than anything sold privately, since the credit can't follow you off the marketplace.
In metro Atlanta and Savannah that means an HMO, which works well when your family's doctors are nearby. We'll check yours are in the network first. If someone at home has an ongoing condition or a medication they can't skip, the marketplace is also the safer home at any income, because its plans can't turn you away or charge more for your health.
Closings and draws make a builder's income jumpy. If a big house sells early and lifts your year, report it so the credit doesn't get reconciled against your refund.
Next step: Walk me through last year's return and your signed jobs, and we'll choose an income estimate and a Georgia Access plan together.
Established builders usually earn past the credit range. In Atlanta's core counties, full price buys only an HMO. Outside them, the one marketplace PPO may be an option, worth comparing against private plans.
For a healthy household, a medically underwritten nationwide PPO is the plan to price. The insurer reads your health history and either offers coverage, declines, or offers it with a specific condition carved out. Good health is how these premiums can land below the marketplace's full price. Every policy writes its own benefit list, and we go through it together. The national network helps too if you take jobs in Alabama, Tennessee or the Carolinas.
And keep job-site coverage separate in your head: workers' comp deals with injuries at work, never with illness or your family's doctor visits.
Next step: Give me your county and everyone's ages, and I'll set a nationwide PPO quote beside the Georgia Access plans sold where you live.
Straight answers, no sales pitch.
Not in Fulton, DeKalb, Cobb, Gwinnett or Clayton, or in Savannah's Chatham County. For 2026, Georgia Access's 8 PPOs are sold in 71 other counties. A healthy contractor anywhere in Georgia can still get a nationwide PPO outside the marketplace.
No. Georgia Pathways covers adults up to 100% of the federal poverty level who meet an hours requirement, which is narrower than the expansion other states adopted.
No. Since plan year 2025, Georgians buy marketplace coverage through Georgia Access, the state's own exchange.
No. Workers' comp covers injuries on the job. A health plan is what pays for illness, checkups and your family's care.
Name your county, who belongs on the plan and roughly what the firm cleared last year. You'll get prices for the route that suits you, and a plain answer if the coverage you have now is already the right call.
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