You can still get a nationwide PPO in Florida, even where the marketplace version costs the most. Here's how AC and heating techs who run their own business here are keeping coverage affordable.
Hi, I'm Sam Jaber. I run my health insurance practice out of Tampa, I hold licenses in 36 states, and everything happens by phone, so you can call me between service tickets.
HVAC work in Florida isn't like HVAC work up north. Air conditioning isn't a luxury here, it runs most of the year, and a dead unit in July is an emergency. That keeps a good tech busy in more months than in colder states, though summer is still the crush. If you've gone out on your own, the steadier demand helps with a lot of things. Health insurance just isn't one of them, because Florida's individual market had a hard year. Here's how AC techs and contractors here are getting through it.
You can still get a nationwide PPO in Florida, and that's true whether you work in the Panhandle or Miami. For a healthy tech, it often comes in at a price that fits.
On HealthCare.gov, it looks otherwise. Florida's marketplace has one PPO, from one insurer, sold in all 67 counties. Measured against the lowest-priced plan with another network type in the same county, the median gap is 110%. Around Orlando and Miami the gap is wider still: 147% in Orange County, 151% in Seminole, 165% in Miami-Dade and 191% in Osceola.
Outside the marketplace, private plans with medical underwriting run on nationwide PPO networks and are priced on your health instead. If you're healthy, that's the comparison that matters.
Florida residents buy marketplace plans on HealthCare.gov, and the discount comes as a premium tax credit based on your household's income for the year. As an owner, your income is your net, after the van, refrigerant, equipment, parts, licensing, insurance and any tech's pay.
The stakes are higher than normal. Florida's insurance regulator says approved 2026 rate increases for individual plans averaged 34.1%, an enrollment-weighted figure taken before any subsidy. The credit covers much of that if you qualify. If you don't, none of it is covered.
Here are the situations Florida HVAC owners tend to fall into.
Plenty of one-truck AC businesses net an amount that keeps a household inside the credit range. If that's you, a HealthCare.gov plan is usually the most affordable way to get covered in Florida, because nothing sold off the marketplace can use the credit.
Check the network before you choose. The lower-priced plans in most counties are HMOs or EPOs built on local doctors and hospitals, which usually works for a family that stays in one part of the state. We'll confirm yours are included.
Then get the estimate right. A brutal summer that runs into October can push your income past what you guessed, and if you don't update HealthCare.gov, part of the credit may be due back at tax time.
Next step: Send me last year's tax return and your service agreement count, and I'll help you set a realistic estimate and choose a plan that fits it.
If you've built a shop with maintenance agreements and a few trucks, you may be well past the credit range. That means full price after a 34.1% average increase, and a marketplace PPO that typically runs about twice the lowest-priced option in your county.
For a healthy household, an underwritten nationwide PPO is worth pricing. You'll fill out a medical questionnaire, and what you report determines whether the company takes you, passes on you, or takes you minus coverage for something in your history. Being healthy is what can bring the cost below the marketplace's full rate, and the national network covers you when you travel or when family lives out of state.
Plans set their own benefits, so we go through each one before you commit.
Next step: Call me and I'll compare an underwritten PPO for your family with the HealthCare.gov plans in your county.
Bringing on an employee changes your options. If you hire at least one employee who isn't an owner or a family member, your business may be able to use the marketplace's small business option. Helpers paid on a 1099 don't count toward that.
It's also worth knowing that workers' comp is for on-the-job injuries, like a fall from a ladder or a burn from a brazing torch. It isn't a health plan and won't pay for anyone's illness or checkups.
And if this first hire stretches your budget so thin that your own household income drops very low for a year, be careful. Florida has not adopted the Medicaid expansion, and help on HealthCare.gov generally begins at the federal poverty level, so a household below that line can miss out on both.
Next step: Call me before your first hire starts and we'll work out what makes sense for you and the business.
If anyone on your plan manages an ongoing condition or relies on a daily medication, the marketplace is usually the right home, even at full price. A HealthCare.gov plan has to accept you and can't charge more based on your health. An underwritten plan doesn't have to.
In Florida, the choice is often a regional HMO or EPO versus the marketplace's single PPO. If your doctors are close by, the regional plan often does the job for much less. If you see a specialist outside the state, the PPO could justify its cost. We'll go through your doctors and prescriptions together.
Next step: Send me your doctors and medications and I'll show you which plans in your county keep them covered.
Straight answers, no sales pitch.
Yes. Florida's marketplace has one PPO from a single insurer, and in a typical county it costs about twice the lowest-priced plan. If you're healthy, a nationwide PPO outside the marketplace is often the better value.
Steady doesn't mean high. The tax credit is based on your household's net income for the year, so many owners still qualify. If a long summer raises your income, update your estimate on HealthCare.gov.
Florida's insurance regulator reported an average approved increase of 34.1% for individual plans, weighted by enrollment and before any subsidy.
Only injuries that happen on the job. Illness, routine care and your family's medical needs require a health plan.
Let me know your county, who needs coverage and about what the business netted last year. I'll walk you through the option that fits and price it, and I'll tell you plainly if what you have now is the better deal.
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