You can still get a nationwide PPO in Ohio, even though every medical plan on the Ohio marketplace is an HMO. Here's how general contractors, builders and remodelers here are covering their families for less.
Hi, I'm Sam Jaber. I'm a licensed health insurance broker in Tampa, Ohio is one of the 36 states I'm licensed in, and I do all of my work by phone, so the conversation fits around your job sites.
Building in Ohio runs on the calendar. Spring through fall is the push: foundations, framing, roofs, additions. Then winter slows the outside work, and remodels, basements and kitchens carry you until the ground thaws. A contractor's income follows that rhythm, and health coverage has to fit it. There's also something about the Ohio marketplace that most builders only learn when they go looking for a PPO.
You can still get a nationwide PPO in Ohio, through me, even though the Ohio marketplace has none to sell.
For 2026, Ohio's marketplace on HealthCare.gov lists 189 individual medical plans from 11 insurers, covering all 88 counties, and every one of them is an HMO. An HMO generally won't pay for care outside its network unless it's an emergency. A PPO pays when you see a doctor outside the network, at a higher cost, and doesn't need a referral. You may notice dental PPOs on the site; for medical coverage, Ohio has no PPO on the marketplace.
What the marketplace doesn't sell, private underwritten plans do. They run on PPO networks with doctors nationwide and are priced on your health, so a healthy builder can often get one at a price that makes sense.
Ohio is different from many states in one big way: it expanded Medicaid. That gives an Ohio contractor three possible doors, depending on household income for the year.
At the bottom, Medicaid covers adults with household income up to 138% of the federal poverty level, and you can apply any month. Above that line, HealthCare.gov offers a premium tax credit on its HMO plans. Higher still, the credit runs out and you pay full price. For a builder, income means net: after lumber, concrete, subs, trucks, equipment, permits and insurance.
Open enrollment on HealthCare.gov runs from November 1 to January 15, and you need to sign up by December 15 for a January 1 start. Here's how each door looks for a contractor.
A slow season, a big job that fell through, or a first year on your own can leave a household with very little income. In plenty of states that's a trap. In Ohio, it isn't. Because the state expanded Medicaid, a household whose income falls at or under the 138% line can get Medicaid, and you don't have to wait for open enrollment to apply.
The thing to watch is the climb back out. When the spring jobs come in and your income rises, report it, because that's when you'll likely move from Medicaid to a marketplace plan.
Next step: If your year has gone thin, call me and we'll figure out whether Medicaid or a marketplace plan fits you right now.
Above the Medicaid line but under the point where the credit runs out, HealthCare.gov is usually the most affordable coverage you can buy in Ohio. The credit only works on marketplace plans.
Those plans are all HMOs, which suits most families who get their care in one area. We'll make sure your doctors and the hospital you'd actually use are in the network before you choose.
Draws and retainage make a builder's year hard to call. If a big job closes early and lifts your income past your estimate, update HealthCare.gov, or part of the credit can come back at tax time.
Next step: Bring last year's numbers and this season's signed contracts to a quick call, and we'll settle on an income figure and an Ohio HMO that suits it.
Established builders usually earn past the credit range. Then you pay HealthCare.gov's full price for an HMO, which can feel like a lot for a healthy family that wants to choose its own doctors.
An underwritten nationwide PPO is the comparison to make. You answer health questions on the application, and the insurer approves you, declines you, or approves you while leaving out a past condition. That screening is why a healthy household can often pay less than full price on the marketplace. The network is national, which helps if you take jobs across the line in Kentucky, Indiana or Pennsylvania, or your kids go to college out of state.
Each plan sets its own benefits, so we read them before you pick.
Next step: Call me and I'll price a nationwide PPO for your family beside the Ohio marketplace HMOs in your county.
If anyone you cover manages a chronic condition or relies on a daily prescription, the marketplace is usually the right home, full price or not. HealthCare.gov plans can't turn you away or charge more because of your health. An underwritten plan can.
In Ohio that means choosing among HMOs, so the job is finding the network that includes your specialists and the drug list that covers your medications.
Also worth saying for anyone running crews: workers' comp covers injuries on the job. It isn't a health plan and won't pay for an illness or a checkup.
Next step: Send me your doctors and prescriptions and I'll check them against the HMOs sold in your county.
Straight answers, no sales pitch.
Not for medical coverage. All 189 individual medical plans on the Ohio marketplace for 2026 are HMOs. You can still get a nationwide PPO outside the marketplace if you're healthy.
Possibly. Ohio expanded Medicaid, so adults with household income up to 138% of the federal poverty level can qualify, and you can apply any time of year.
Open enrollment on HealthCare.gov runs from November 1 to January 15; sign up by December 15 for coverage starting January 1. Losing other coverage usually opens a window outside those dates.
Start from last year's net profit, adjust for what's signed, and report your best estimate. Update it on HealthCare.gov whenever a large job finishes early or slides into next year.
Give me your county, who needs coverage and a rough idea of what the company netted last year. I'll point you to the path that fits and price it, and if your current plan is already the right one, I'll say so.
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