You can still get a nationwide PPO in Florida, even with marketplace prices up sharply. Here's how plumbers and pipefitters who run their own shop in Florida are covering their families for less.
Hi, I'm Sam Jaber, and I'm a licensed health insurance broker based in Tampa. I'm licensed in 36 states and do all my work by phone, which suits a trade where most calls get taken from the truck anyway.
Florida is good territory for a plumber. Older homes need repiping, new construction never really stops, and storms leave behind water damage that keeps phones ringing. What Florida isn't kind to right now is the person buying health insurance on their own. If you opened your own shop and walked away from a group plan, here's how plumbers in this state are handling it.
Start here, because it surprises people: you can still get a nationwide PPO in Florida, and if you're healthy it may cost less than you've been led to believe.
People think it's out of reach because of what they see on HealthCare.gov. Florida's marketplace has one PPO from a single insurer, offered in every county. Set it beside the lowest-priced plan with a different network in your county and it costs at least 50% more in 64 of the state's 67 counties, with a median gap of 110%. Seeing that once is usually enough to make someone give up.
That's only the marketplace's PPO, though. Private underwritten plans use PPO networks that span the country, and they're priced on your health. For a healthy plumber and family, that can change the whole picture.
Here in Florida you buy marketplace coverage through HealthCare.gov, and any help with the premium comes as a tax credit based on your household's income for the year. For a shop owner, the income that counts is net, after the truck, parts, fittings, permits, licensing, liability coverage and your helper's pay.
That number has extra weight this year. The state's insurance regulator reported that individual plan rates approved for 2026 rose an average of 34.1%, weighted by enrollment and before subsidies. With the credit, you're protected from much of that increase. Without it, you pay it all.
Find the description that fits.
If your household falls within the range where the tax credit applies, HealthCare.gov is usually where you'll find the most affordable coverage in Florida. The credit only works on marketplace plans, so anything outside it starts at a disadvantage for you.
In most Florida counties the lower-cost options are HMOs and EPOs tied to regional doctors and hospitals. If your family lives and gets care close to home, that's often a good fit. We'll just make sure the providers you use are in the network.
Income estimates trip up plumbers, too. A wet season full of water-damage calls can make your year bigger than expected, and if you never update your estimate, some of the credit can come back to you as a bill at tax time.
Next step: Send me last year's tax return and I'll help you set an estimate you can stand behind, then match it to a plan in your county.
Losing coverage from a Florida employer gives you a special enrollment period, generally 60 days, to choose a HealthCare.gov plan any time of year. If you take COBRA instead, don't cancel it early on purpose, because that won't open a new window. Letting it run out does.
The first year of a new shop can be lean, and Florida adds a wrinkle. Since the state hasn't adopted the Medicaid expansion, very low income doesn't open the door to Medicaid for most adults here, and the premium tax credit on the marketplace usually starts only once income reaches the poverty line. A brand-new shop with very little profit can land in that gap, so the estimate and the timing need care.
Also, workers' comp protects against injuries on the job. It is not health insurance, and it won't help when you or your kids get sick.
Next step: Call me a few weeks before you leave and we'll set up coverage that starts the day your company plan ends.
If your shop runs a few trucks and does steady business, your household may be past the credit range. Now you're paying full price, after the average 34.1% increase, and if you want a PPO on the marketplace, you're looking at a plan that typically costs about twice the lowest-priced option.
For a healthy family, this is where an underwritten nationwide PPO earns a look. You fill out health questions on the application, and the insurer can approve you, turn you down, or approve you while excluding a past condition. That process is the reason a healthy applicant can often pay less than the marketplace's full rate.
Each plan pays benefits its own way, so I walk you through what's covered before you decide.
Next step: Call me and I'll put an underwritten PPO quote for your family next to what HealthCare.gov charges in your county.
If anyone in your household has an ongoing health condition or a prescription they can't miss, stay with the marketplace, even at full price. HealthCare.gov plans can't refuse you or raise your price because of your health. An underwritten plan can do both.
Then the Florida question becomes which network. A regional HMO or EPO usually costs much less and may keep every doctor you use. If you rely on a specialist in another state, the marketplace PPO could be worth the extra cost. We'll go through your doctors and prescriptions one by one.
Next step: Send me your doctors and medications, and I'll check them against the HealthCare.gov plans available where you live.
Straight answers, no sales pitch.
There's one, offered by a single insurer in every county, and it costs at least 50% more than the lowest-priced alternative in 64 of 67 counties. Healthy plumbers often find better value in a nationwide PPO outside the marketplace.
Florida's regulator approved an average increase of 34.1% for 2026 individual plans, weighted by enrollment and before any subsidy. If you earn too much for the tax credit, you pay that increase in full.
Often, yes. The self-employed health insurance deduction is limited to your business's net profit and doesn't apply in months you could have joined an employer-subsidized plan. Your tax preparer can confirm the details.
Probably not on income alone. Florida hasn't adopted the Medicaid expansion, and marketplace credits usually begin at the poverty line, so a very low first year can leave you between the two. Talk to me before you enroll.
Your county, the people on your plan and a rough idea of what the shop cleared last year is all I need. I'll show you the path that fits and what it costs, and if you're already on the right plan, I'll tell you to keep it.
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