You can still get a nationwide PPO in Georgia, even where the marketplace offers nothing but HMOs. Here's how AC and heating techs who run their own business in Georgia are keeping health coverage affordable.
Hi, I'm Sam Jaber. I've built my practice around health insurance, I work from Tampa, Georgia is among my licensed states, and the whole process runs by phone, which matters when you're on a roof in July.
In Georgia, summer is the job. Heat and humidity settle in early and leave late, and an air conditioner that quits in an Atlanta August is an emergency for the family inside. Winters are short but still bring heat pump and furnace calls. A tech who can handle that demand often ends up working for himself. The health plan from the old company doesn't follow, and Georgia's marketplace works very differently depending on the county.
Even in Georgia's biggest metro, you can still get a nationwide PPO in Georgia, and I'm how you get it.
Georgia Access, the state's own marketplace, offers 211 individual medical plans for 2026. Only 8 are PPOs, from a single insurer, and they're sold in 71 counties. Fulton, DeKalb, Cobb, Gwinnett, Clayton and Chatham aren't on the list, so an HVAC owner in the heart of Atlanta or in Savannah can buy only an HMO there. An HMO usually covers care outside its network only for emergencies. A PPO covers doctors outside the network too, at a higher cost, and doesn't make you get a referral.
Private plans that use medical underwriting are priced by your health and built on PPO networks that cover the country. They're the comparison a healthy tech should make.
Georgia Access looks at your household income for the whole year, not your best month. For an owner, that's profit, after the van, condensers and parts, refrigerant, tools, licensing, insurance and any tech's pay.
Here's how the ranges work in Georgia. The federal premium tax credit generally starts at the poverty level and lowers the price of marketplace plans for most small business households. Past the top of that range, you pay full price. Below the poverty level, Georgia's only Medicaid option for most adults is Georgia Pathways, which requires work, school or volunteer hours, because the state never adopted the Medicaid expansion.
For a one-truck AC business, this is the usual spot. A Georgia Access plan with the federal credit almost always costs less than anything bought privately, since the credit stays on the marketplace.
If you live in metro Atlanta or Savannah, that means an HMO, which works when your family's doctors are nearby. We'll make sure they're in. And if someone in your house has a chronic illness or a daily prescription, stay on the marketplace whatever your income, because its plans have to accept you and can't charge more for health.
A summer that runs hot into October can push your income past the estimate you gave. Update Georgia Access when you see it coming so the extra credit isn't clawed back when you file.
Next step: Run through last year's return and your maintenance agreements with me, and we'll pick an estimate and a Georgia Access plan together.
A growing AC company with several trucks usually puts the owner's household above the credit range. In metro Atlanta and Savannah, full price buys an HMO and nothing else on the marketplace.
For a healthy family, the plan to quote is a medically underwritten nationwide PPO. You complete a health questionnaire, and the insurer either covers you, declines, or covers you minus one condition. Good health is what can bring the premium under the marketplace's full price. Benefits differ from plan to plan, and we read each one together.
Next step: Send me your county and everyone's ages, and I'll quote a nationwide PPO next to the Georgia Access plans available to you.
A mild summer or a first year without many maintenance customers can leave a household with very little income. Georgia is a hard state for that. Without the Medicaid expansion, the low-income option is Pathways, with its hours requirement, and marketplace credits generally don't begin until income reaches the poverty level. Fall short of both and you may get no help.
If your year looks that thin, plan your estimate and enrollment timing carefully.
Separate from all that: workers' comp, if you carry it, covers on-the-job injuries like a ladder fall or a burn. Illness and your family's care need a health plan.
Next step: Call me before you enroll in a slow year and we'll find the best option you actually qualify for.
Straight answers, no sales pitch.
Not on Georgia Access, where the marketplace PPOs aren't sold in Fulton, DeKalb, Cobb, Gwinnett or Clayton for 2026. A healthy tech anywhere in Georgia can get a nationwide PPO outside the marketplace through me.
Not necessarily. The credit is based on your household's profit for the full year, after business costs, so many owners still qualify.
Be careful. Georgia skipped the Medicaid expansion, so the main low-income program is Pathways, open to adults up to 100% of the poverty line who meet its work, school or volunteer hours rule. Talk to me before you enroll.
No. Georgians enroll through Georgia Access, the state-run marketplace, since plan year 2025.
Share your county, the people you want covered and an estimate of what the business made after expenses last year. I'll show you real prices for the option that suits you, and tell you straight if your current plan is the one to keep.
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