You can still get a nationwide PPO in Ohio, even though the state's marketplace sells HMO medical plans only. Here's how furnace and AC techs who run their own business in Ohio are keeping coverage affordable.
Hi, I'm Sam Jaber. I'm a health insurance broker in Tampa, Ohio is one of the 36 states where I'm licensed, and I work with every client over the phone, so you can call between a no-heat call and a condenser swap.
HVAC in Ohio has two rushes. When the first hard cold arrives, furnaces that limped through last year finally quit, and the phone doesn't stop until spring. Then the humid summer brings the air conditioning calls. The shoulder months are for tune-ups and installs. Techs who go out on their own learn to live with that cycle, and they also learn that health insurance gets complicated once the employer plan is gone, especially in a state where the marketplace sells only one kind of plan.
Even in Ohio, you can still get a nationwide PPO. I can price one for you; HealthCare.gov can't.
The Ohio marketplace lists 189 individual medical plans for 2026, from 11 insurers across all 88 counties, and all of them are HMOs. An HMO generally covers no care outside its network unless it's an emergency. A PPO covers out-of-network doctors at a higher cost and doesn't make you get a referral. If you see PPO listings, they're dental; there's no PPO medical plan on Ohio's marketplace.
Private plans that use medical underwriting are priced on your health and built on PPO networks spanning the country. For a healthy tech, that's the comparison to make.
Whatever happens in January and July, the marketplace looks at your household's income for the whole year. As an owner, that's net: after the van, equipment, refrigerant, parts, the license, insurance and any tech's wages.
Because Ohio expanded Medicaid, that yearly figure sends you one of three ways. Households at or under 138% of the federal poverty level can get Medicaid. A step above, the marketplace's premium tax credit lowers the cost of an HMO. Past the credit's upper limit, you pay the whole premium yourself.
A warm winter can gut a heating business's best months, and a new company may not have its service agreements built yet. If your household income lands at or below 138% of the poverty level, Ohio's expansion means Medicaid is open to you, and you can apply any month.
Plan for the rebound. When a hard cold snap brings the calls back and your income climbs over the line, report it, since you'll likely shift to a marketplace plan.
Next step: Call me if this year is running lean and we'll work out whether Medicaid or a HealthCare.gov plan fits you now.
Above the Medicaid line, a HealthCare.gov HMO with the credit is usually your most affordable option in Ohio, since that credit can't be spent anywhere else.
The networks are local, so we'll confirm your family's doctors and hospital are included. And since both peaks can surprise you, report a bigger year when you see it coming. An outdated estimate can mean paying back some of the credit when you file.
Next step: Walk me through last year's taxes and your service agreement count, and we'll set an estimate and pick an HMO together.
Payroll changes your choices. As a one-person company, you buy on the individual marketplace. Once you hire at least one employee who isn't an owner or a family member, your business may qualify for SHOP, the small business side of the marketplace. Helpers paid as contractors don't count toward that.
Whether SHOP makes sense depends on your budget and what your own household needs. Sometimes it's right to set something up for the crew; sometimes the owner's family is better off on its own plan for now.
And workers' comp only covers injuries on the job, like a fall from a ladder in an icy driveway. It isn't health insurance.
Next step: Before your first hire's start date, call me and we'll map out the setup that works for the business and your family.
A heating and cooling company with steady contracts usually puts the owner over the credit range. Full price buys an Ohio HMO. A healthy family may prefer a national network.
An underwritten nationwide PPO starts with health questions. The insurer approves you, declines you, or approves you with a condition excluded. When you're healthy, that's what can bring the price below the marketplace's full rate. Benefits differ by plan, so we read them first.
If someone at home manages a chronic condition or relies on a daily medication, skip the underwritten route and stay with the marketplace, where your health can't be held against you. Then the job is finding the HMO that keeps your specialists.
Next step: Call me and I'll compare a nationwide PPO quote with the Ohio HMOs available in your county.
Straight answers, no sales pitch.
Yes, outside the marketplace. Every one of the 189 individual medical plans on the Ohio marketplace for 2026 is an HMO. If you're healthy, a nationwide PPO is available through me.
The marketplace uses your income for the full year. If it drops to 138% of the federal poverty level or less, Ohio's Medicaid expansion means you can qualify, and you can apply any time.
They can. With at least one employee who isn't an owner or relative, your business may qualify for the marketplace's SHOP coverage. 1099 helpers don't count.
No. It covers injuries on the job only. Illness, checkups and your family need a real health plan.
Let me know your county, who's on your plan and a rough figure for what the business made after expenses last year. I'll show you the path that fits and its price, and if your current plan is already the smart choice, I'll say so.
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