You can still get a nationwide PPO in Michigan, and in Midland County the marketplace PPO is close enough in price to deserve a real look. Here's how Tri-Cities heating and cooling owners are choosing.
Hi, I'm Sam. Health coverage is the only thing I work on, I do it from a desk in Tampa, Michigan is one of the states I'm licensed in, and we'd handle all of it by phone.
Say you run a heating and cooling company in Bay City with a couple of service vans covering Midland and Saginaw too. Your year has two peaks. July brings AC calls, but the real money is the cold: furnace no-heats, cracked heat exchangers and boiler work from the first hard frost through February. That puts you at your busiest exactly when Michigan picks next year's health plan, and a lot of owners in your spot just let it renew without looking.
One thing never changes: you can still get a nationwide PPO in Michigan, and I'm glad to set one up.
In the Tri-Cities, though, I'd be shortchanging you if I skipped the marketplace's own PPO. For 2026 Midland offers 27 HMOs and 9 PPOs, while Saginaw and Bay offer 33 HMOs and 9 PPOs, all from 4 insurers. Line up the silver plans county by county for a 40-year-old with no subsidy, and the least expensive PPO runs just 9% above the least expensive HMO in Midland, tied for the smallest gap in Michigan, and 21% above it in Saginaw and Bay. The real difference is what happens outside the network. An HMO normally covers that only in an emergency, and a PPO pays toward any doctor, with you carrying a bigger share and no referral needed.
On HealthCare.gov, open enrollment for 2027 coverage starts November 1 and ends January 15, and you need to choose by December 15 for a January 1 start. For a furnace company that's the worst possible timing, which is why I'd rather have this call in October.
The number you'll need is your household's expected net self-employment income for the coverage year: revenue minus equipment, parts, the vans, refrigerant, your license and insurance. Your premium tax credit is built on it, and you're expected to update it whenever it changes. A bitter winter can push it well past your guess, so revise it once you can see the season's size.
Midland is the unusual case. Because the PPO there is priced only 9% above the HMO before any credit, a family receiving the credit pays very little extra per month for the right to go outside the network. That's worth it if your family's care is spread across more than one health system, or if you'd rather not be told where to go. In Saginaw and Bay, where the spread is wider, I'd lean on a simpler test: are your doctors already inside an HMO?
Next step: Ring me in October with your county, who's on the plan and last year's profit, and we'll run the PPO and HMO prices after your credit.
Steady maintenance contracts and a few vans tend to lift a household above the credit range. Past that point you'd buy any marketplace plan, PPO or HMO, with no help at all. A healthy family should weigh a medically underwritten nationwide PPO against that. The insurer asks about your medical history and then says yes, says no, or says yes with a single earlier condition written out. That screening is how a healthy household can end up paying under the marketplace's sticker price, and the network still works when you're in Florida for a week in February. Each plan's benefits are its own, so I'll explain them before you commit.
Next step: Give me your zip code and the birthdays on your plan, and I'll line up a nationwide PPO quote against the Tri-Cities' full-price plans.
Some winters never really bite, and a furnace shop feels it in the books. In a year that light, the Healthy Michigan Plan, Michigan's Medicaid expansion, is open to adults whose income is at or under 138% of the federal poverty level. When someone at home has a chronic illness, the marketplace is the safe place at any income, because no plan there may refuse you or price your health. Midland's narrow PPO gap can let that family member keep seeing doctors outside the network without a big jump in cost.
Next step: Pass me the doctors and prescriptions that matter and I'll test them against the Tri-Cities plans.
Straight answers, no sales pitch.
Yes. Midland County has 9 marketplace PPOs for 2026, next to 27 HMOs.
Very close. For a 40-year-old buying silver with no subsidy, the least expensive PPO is 9% above the least expensive HMO, tied for the smallest gap in Michigan.
Michigan uses HealthCare.gov, where enrollment for 2027 coverage runs November 1 to January 15, with December 15 the deadline for a January 1 start.
Yes, once the season's size is clear. If a hard winter lifts your income, report it so the credit adjusts for the rest of the year.
Pick a quiet October afternoon and send me your county, the people on your plan and last year's profit. We'll go through the Tri-Cities marketplace plans and a nationwide PPO with prices and make the decision before your phone starts ringing.
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