You can still get a nationwide PPO in Montana, and a Missoula plumber has a marketplace PPO within reach too. Here's how Western Montana plumbers are choosing coverage.
Hi, I'm Sam Jaber. Health coverage is my whole business, I'm based in Tampa with a Montana license, and I do all of it by phone, which beats driving anywhere in a Missoula January.
Think of a plumber from Lolo with two trucks covering Missoula and up the valleys. Older houses in the University district and the Northside keep him in galvanized lines and tired drains, and new homes going up around the edges of town bring rough-ins and trim-outs. Then winter sets in, long and cold, and the calls shift to frozen and split lines, boilers and heat tape. He's been buying his family's coverage himself for years and wants to get it right this time.
The main point first: you can still get a nationwide PPO in Montana, and lining one up is my job.
Missoula's marketplace puts a PPO within reach as well. The county's 2026 list runs to 22 PPOs, 9 POS plans and 8 EPOs, sold by 3 insurance companies, and at age 40 on silver before subsidies the least expensive PPO is 9% above the least expensive non-PPO plan. EPOs pay outside their networks only in emergencies, POS plans want a referral before a specialist visit, and a PPO skips the referral and helps with out-of-network doctors at a higher share. A nationwide PPO bought privately is priced after underwriting.
How much credit you get depends on your family's earnings in the coverage year, and a shop owner's earnings means profit: receipts after the trucks, pipe and fittings, fixtures, thaw and jetting equipment, licensing and insurance. Give a careful estimate and correct it when winter work changes the picture.
Sign-ups for 2027 coverage open November 1 and close January 15; anything submitted after December 15 starts in February. In Missoula that runs right into freeze season, so book the hour early.
A bitter winter plus a busy building season can take the shop's profit beyond the credit range, and then every plan on HealthCare.gov costs its full sticker price. Healthy families should also look at private nationwide PPO coverage, which uses medical underwriting: you answer health questions, and the insurer says yes, yes with one old condition excluded, or no. That screening often brings the premium under the marketplace's unsubsidized price, and the network follows you to Spokane, Seattle or a summer trip anywhere. I'll walk through what each plan pays first.
Next step: Ring me with your zip and everyone's ages, and you'll get a nationwide PPO number to compare with Missoula's full-price plans.
A chronic illness or a must-have medication in the family means staying with the marketplace in any year, since its plans accept every applicant at standard rates. The careful part is checking specialists and medications against each network, and with specialists sometimes a long drive away, a PPO can be the right home. And remember workers' comp, for any helper you employ, only pays for injuries at work.
Next step: Give me the names of your doctors and medicines, and I'll find the Missoula networks that include them.
Straight answers, no sales pitch.
Yes, 22 of them for 2026, at 9% more than the least expensive POS or EPO plan for a 40-year-old on silver with no subsidy.
Through HealthCare.gov, from November 1 to January 15 for 2027 plans. Get your application in by December 15 if you want coverage from New Year's Day.
Yes. Since July 1, 2026, most expansion members ages 19 to 64 must document at least 80 hours a month of qualifying activity.
For expansion adults, 138% of the federal poverty level.
Send your county, who's going on the plan and the shop's profit last year. You'll see Missoula County's marketplace plans priced beside a nationwide PPO, plus my straight recommendation.
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