You can still get a nationwide PPO in Tennessee, even though the state's marketplace sells EPO medical plans and nothing else. Here's how builders riding the Middle Tennessee boom are covering their families for less.
Hi, I'm Sam Jaber. My whole practice is health insurance, my office is in Tampa, Tennessee is one of my licensed states, and the work happens by phone.
If you build in Middle Tennessee, you know the story. Nashville kept growing, and the building followed it outward into Williamson, Rutherford, Wilson, Sumner and Maury counties: subdivisions, townhomes, custom houses, and an endless line of remodels in the older neighborhoods closer in. A lot of superintendents and lead carpenters took that wave as their cue to start their own companies. This page is about the health insurance side of that move, because Tennessee's marketplace has a shape most builders don't expect.
Through me, you can still get a nationwide PPO in Tennessee, wherever in the state you live.
You won't find one on HealthCare.gov. Tennessee's marketplace has 158 individual medical plans for 2026, from 6 insurers, in all 95 counties, and every single one is an EPO. An EPO pays for care outside its network only in an emergency. A PPO is the type that still pays when you choose an out-of-network doctor, with you covering more of the bill, and it doesn't make you get a referral. (Dental PPOs show up on the site; for medical, there are none.)
Private plans with medical underwriting run on national PPO networks, and their price depends on your health.
For an established Middle Tennessee contractor, the question usually isn't whether to buy coverage. It's whether to keep paying full marketplace price for a plan you barely use.
Your household's profit for the year decides whether the federal premium tax credit helps at all, and for a builder profit is what's left once lumber, subs, trucks, equipment, permits and insurance are paid. Firms running several houses at once tend to land above the credit's reach, and that's where Tennessee's EPO-only marketplace starts to pinch.
This is the scenario this page is built around. A busy Williamson or Rutherford County builder, a healthy spouse, a couple of kids in sports, and a marketplace bill that buys an EPO limited to one network.
For that family, the comparison to make is a medically underwritten nationwide PPO. The insurer reads your answers to a health questionnaire, then offers coverage, declines, or offers it with one past condition excluded. Clean answers are the reason the premium can come in under the marketplace's full rate. You also get a network that follows your family to a lake house in Kentucky, a tournament in Alabama or a college campus out of state. Each policy lists its own benefits, and I'll walk you through them line by line.
Next step: Tell me your county and your family's ages, and I'll put a nationwide PPO quote beside the Tennessee marketplace EPOs you can buy.
Smaller remodelers and newer firms often land here. In that range, a HealthCare.gov plan with the credit nearly always costs you less than anything bought privately, because the credit doesn't travel off the marketplace. We'll make sure the EPO you pick includes your family's doctors. And if a big closing pushes your year past the estimate you gave, update it, or the extra credit settles up on your tax return.
Next step: Go through last year's return and this year's signed contracts with me, and we'll pick an estimate and an EPO that fits.
A chronic condition or a daily prescription in the household is the one situation where I'd tell a full-price builder to stay on HealthCare.gov. Its plans can't refuse you or price you on your health; underwritten plans can. Then it's a matter of finding the EPO whose network has your specialists.
Next step: Send me your doctors and prescriptions and I'll check which Tennessee EPOs in your county cover them.
Starting out can mean a year of little profit, and Tennessee is a tough state for that. It hasn't adopted the Medicaid expansion; TennCare takes parents only up to 105% of the poverty level and generally excludes adults without children. The marketplace credit usually starts at the poverty line, so a very lean household can fall between them. Talk it through before you enroll.
Also, workers' comp covers job-site injuries only. It won't pay for the flu or a checkup.
Next step: Call me before you apply in a lean year and we'll find the option you actually qualify for.
Straight answers, no sales pitch.
Not for medical coverage. For 2026, all 158 individual medical plans on the Tennessee marketplace are EPOs. A healthy contractor can still get a nationwide PPO outside the marketplace.
An EPO covers care outside its network only in an emergency. A PPO covers out-of-network care too, at a higher cost, without a referral.
Usually not. Tennessee hasn't adopted the Medicaid expansion; TennCare covers parents only up to 105% of the poverty level and generally not adults without children.
No. It covers injuries on the job only. You still need a health plan for illness, checkups and your family.
Let me know your county, who you want on the plan and a rough profit figure from last year. I'll put prices on the route that suits your family, and I'll say plainly if you'd do better keeping what you have.
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