You can still get a nationwide PPO in Louisiana, and a New Orleans plumber whose days run from century-old shotguns to new raised homes can sort out coverage in one call. Here's how plumbers around the city are deciding.
Hi, I'm Sam Jaber. I've built my practice around health insurance alone, I work from Tampa, I hold a Louisiana license, and every client I serve, I serve by phone.
Think about a plumber from Gentilly who runs a truck all over New Orleans and across the parish line into Metairie. One morning it's a slab leak under a ranch house in Jefferson; the afternoon is a full repipe in a century-old shotgun double in the Bywater, where the drain lines have been patched by three generations of handymen. Some weeks bring new raised homes in Lakeview. It's good, steady work, and for years he has bought his own health plan without anyone walking him through it.
The point I always make first: you can still get a nationwide PPO in Louisiana, and I'll put one together for you.
In Orleans and Jefferson, the marketplace's own PPO costs a lot more than the alternatives. The 2026 menu in each parish is 16 EPOs, 14 POS plans and 8 PPOs, with no HMOs. For a 40-year-old buying silver without a subsidy, the least expensive PPO runs 82% above the least expensive EPO or POS plan; St. Tammany and St. Charles show the same 82%. An EPO covers out-of-network care only for emergencies, while a PPO pays part of the cost of seeing a doctor outside its network, no referral needed. Private nationwide PPOs are a separate route, with a price set after a medical review.
Whether you get the premium tax credit depends on your household's income for the coverage year, which for a shop owner is net self-employment income: profit after the truck, copper and PEX, fittings, fixtures, the jetter, your license and insurance. You file an estimate and keep it current.
Timing matters too. HealthCare.gov opens 2027 enrollment on November 1 and closes it January 15, and the cutoff for a January 1 start is December 15. Pick a slow morning early in November.
Then HealthCare.gov is usually the best value, because the credit only works there. In Orleans and Jefferson that means choosing between 16 EPOs and 14 POS plans, so start with the network your family's doctors and your hospital belong to. A truly thin year has a floor here, since Louisiana expanded Medicaid to adults with income up to 138% of the federal poverty level.
Next step: Send me last year's return and the names of your doctors, and I'll show you which New Orleans EPOs and POS plans keep them, priced after your credit.
A good run of repipes and new construction can lift a household past the credit range, and then HealthCare.gov charges its sticker price for everything, with the PPO costing far more still. For a healthy family, the plan to compare is a medically underwritten nationwide PPO. It begins with a health questionnaire, and based on your answers the insurer covers you, covers you with one old condition set aside, or says no. That's how healthy applicants can often pay less than the marketplace's full rate, and the network reaches you on a trip to the Gulf Coast or a visit with family in Houston. We'll go through what each plan pays first.
Next step: Phone me with your parish and the ages on your plan, and I'll quote a nationwide PPO against the New Orleans marketplace.
If a family member has a chronic illness or relies on a daily prescription, stay with HealthCare.gov at any income. No plan there can turn you away or price your health. The careful part is checking every specialist and medication against the EPO and POS networks, which is exactly what I'll do. Workers' comp, if you carry it for a helper, only covers on-the-job injuries.
Next step: Give me the doctors and medicines your family depends on, and I'll check them against the Orleans and Jefferson plans.
Straight answers, no sales pitch.
No. For 2026, Orleans and Jefferson each have 16 EPOs, 14 POS plans and 8 PPOs, and no HMOs.
The least expensive silver PPO costs 82% more than the least expensive silver EPO or POS plan for a 40-year-old, before subsidies.
Louisiana shops on HealthCare.gov, which takes 2027 enrollments from November 1 through January 15. To start coverage January 1, sign up by December 15.
In a lean year, possibly. Louisiana's expansion covers adults with income up to 138% of the federal poverty level.
Send me your parish, the family members to cover and what the shop made last year. I'll price the New Orleans marketplace plans beside a nationwide PPO and tell you what I'd do in your place.
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