You can still get a nationwide PPO anywhere in Virginia, even though the marketplace's PPO plans stop at a few Northern Virginia localities. Here's how heating and cooling techs on their own here are keeping coverage affordable.
Hi, I'm Sam Jaber, a broker who works only in health insurance. I'm based in Tampa, Virginia is one of my licensed states, and I do everything by phone, which fits a day of back-to-back service calls.
Virginia gives an HVAC tech both seasons in full. Summers in Richmond and Hampton Roads are thick and humid, and mountain winters out west get cold enough to keep furnace and heat pump calls coming. Heat pumps are everywhere in the state, so a good tech stays booked most of the year. Many go out on their own once they have the customers. Then the health plan becomes their problem, and Virginia's marketplace treats Fairfax and Roanoke very differently.
You can still get a nationwide PPO in Virginia, in any county or city, through me.
On Virginia's Insurance Marketplace, 4 of the 83 individual medical plans for 2026 are PPOs, sold only in Alexandria, Arlington, Fairfax City, Falls Church and parts of Fairfax, Loudoun and Prince William. In Northern Virginia, where you can buy one, its least expensive version costs 131% more than the lowest-priced plan with a different network. Beyond that area, the marketplace offers HMOs and EPOs, and neither one pays for a routine visit outside its network; only emergencies are covered there. A PPO pays out of network as well, at a higher cost, and needs no referral.
Private plans with medical underwriting are priced by your health and built on national PPO networks. For a healthy tech, they're the option to compare.
You'll enroll through Virginia's Insurance Marketplace, which the state runs instead of using HealthCare.gov. What you qualify for depends on your household's income for the full year, which for an owner is profit: after the van, equipment, refrigerant, parts, the license, insurance and any tech's wages.
Virginia gives you more layers here than most states. Medicaid reaches adults at or under 138% of the federal poverty level, because Virginia took the expansion. Above that line, the federal premium tax credit applies. And starting with 2027 coverage, Virginia Premium Savings adds state-funded help on top of the federal credit for households between 138% and 250% of the poverty level.
Plenty of one-truck HVAC households fall right in this band, and for 2027 coverage it's the sweet spot: the federal credit plus Virginia Premium Savings, both usable only on marketplace plans. If that's you, the marketplace is very likely your least expensive route.
Outside Northern Virginia you'll be choosing among regional HMOs and EPOs, so we confirm your doctors are in the network before you enroll. A brutal July or a cold snap can also push your income above your estimate. Report it as soon as you see it, or the extra help may have to be repaid when you file.
Next step: Go over last year's return and your maintenance contracts with me, and we'll see how much help you qualify for and which plan to use it on.
A mild winter or a cool summer can thin out a small HVAC company's year, and a brand-new business may not have its maintenance base yet. Virginia's Medicaid expansion means a household at or below 138% of the poverty level can get covered instead of going without.
When business returns and income passes that line, report it and plan on moving to a marketplace plan.
One more line for owners: workers' comp, if you carry it, is for injuries on the job, like a fall from a roof or a slip in a crawl space. It doesn't cover illness or checkups.
Next step: Get in touch if your year is running thin, and we'll sort out whether Medicaid or a marketplace plan fits you right now.
A heating and cooling company with steady service agreements can lift the owner's household well past the credit range. Then the marketplace charges full price, for an HMO or EPO in most of the state or a pricey PPO in the north.
A medically underwritten nationwide PPO is the plan a healthy family should price. The insurer reviews your health history on the application, then offers coverage, declines, or offers coverage with one condition carved out. Healthy applicants are why these premiums can come in under the marketplace's full price. Each policy defines its own benefits, which we read together before you choose.
If someone at home has a chronic condition or a daily prescription, stay with the marketplace instead. Its plans take everyone and can't price you on your health; we'd pick the one that keeps your specialists.
Next step: Phone me with where you live and who's on the plan, and you'll get a nationwide PPO quote alongside the marketplace options in your area.
Straight answers, no sales pitch.
Absolutely. The marketplace's handful of PPOs are limited to a few northern localities and priced well above the alternatives there, but healthy techs statewide can buy a nationwide PPO with my help.
Households whose income runs from 138% to 250% of the federal poverty level, beginning with 2027 marketplace coverage. It's paid by the state and stacks with the federal credit.
No. Virginia runs its own marketplace, Virginia's Insurance Marketplace, through the State Corporation Commission.
The marketplace uses your income for the full year. If your household lands at or under 138% of the federal poverty level, Virginia's Medicaid expansion means you can qualify.
Send me your county or city, who you're covering and an estimate of what the business earned after costs last year. I'll show you real numbers for the option that fits, and if your existing plan is the better buy, I'll tell you that too.
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