You can still get a nationwide PPO anywhere in Virginia, from Norfolk to Bristol. Here's how plumbers and pipefitters who left a shop or a yard to work for themselves are covering their families for less.
Hi, I'm Sam Jaber. I help people with health insurance and nothing else, I'm based in Tampa, Virginia is on my license, and the whole process happens over the phone.
Virginia keeps people who work with pipe busy in two very different worlds. In Hampton Roads, shipyards and the Navy keep pipefitters in demand. Everywhere else, it's service plumbing: water heaters, repipes in older homes, frozen lines in the mountains in January, and new construction around Richmond and the northern suburbs. Many plumbers and fitters eventually leave a shop or a yard to work for themselves. The group plan doesn't follow them, and Virginia's marketplace doesn't look the same in Norfolk as it does in Arlington.
You can still get a nationwide PPO in Virginia, wherever your shop is, by working with me.
Virginia's Insurance Marketplace offers 83 individual medical plans for 2026, and only 4 are PPOs. Those 4 are sold in Alexandria, Arlington, Fairfax City and Falls Church and in parts of Fairfax, Loudoun and Prince William. For a plumber in Suffolk, Lynchburg or Abingdon, the marketplace means HMOs and EPOs. With either, a routine visit outside the network usually isn't paid; only emergencies are. A PPO is built to cover doctors outside its network too, at a higher share of the cost, without a referral.
Private plans that use medical underwriting are the way past that. They run on PPO networks that cover the country, and their price depends on your health instead of the marketplace's rates.
Virginia runs its own exchange, so you enroll through Virginia's Insurance Marketplace, not HealthCare.gov. Your household's yearly income, figured as profit if you're self-employed, then points you down one of three paths. Medicaid covers adults at or under 138% of the federal poverty level, because Virginia took the expansion. Above that, a federal premium tax credit cuts the cost of marketplace plans. Past the credit's ceiling, you pay full price, though Virginia's reinsurance program, run under a federal waiver, is designed to keep individual premiums lower than they'd otherwise be.
For a shop owner, profit means what's left after the truck, pipe, fittings, fixtures, the license, insurance and a helper's pay.
Leaving a job with health coverage gives you a special enrollment window on the marketplace, usually 60 days. If the company is too small to be covered by federal COBRA, Virginia law may give you another bridge: under Virginia Code 38.2-3541, a person continuously insured under the group policy for three months can continue that coverage for 12 months. It keeps the same plan in place while you set up the shop.
That's worth comparing against a marketplace plan and, if you're healthy, an underwritten PPO before you decide.
Next step: Call me while you're still on the company's plan and we'll weigh continuation against your other choices before any deadline slips by.
Between the Medicaid line and the top of the credit, a marketplace plan with the federal credit almost always costs you the least, because the credit can't be applied to private plans.
Outside Northern Virginia, that plan will be an HMO or EPO built on regional providers, which works well for most families who get care near home. We'll check your doctors first. If anyone in the house has a chronic condition or a prescription that can't lapse, the marketplace is the safer home at any income, since its plans have to accept you and can't charge you more for your health.
Freezes and flooded basements can make one month huge. If your income rises past the estimate you gave, update it so you don't owe credit back when you file.
Next step: Pull out last year's taxes and walk me through them, and we'll set an income estimate and pick the plan to match.
A shop with several trucks, or a fitter with steady shipyard contract work, can push a household well above the credit range. Full price on the marketplace then buys an HMO or EPO in most of the state.
For a healthy household, a medically underwritten nationwide PPO is the comparison to make. The insurer asks about your health on the application and decides to cover you, decline you, or cover you minus a specific condition. Good health is what can bring its premium under the marketplace's full rate. Every plan spells out its own benefits, and I'll go through them with you.
Next step: Ring me with your county and your family's ages and I'll quote a nationwide PPO next to the Virginia plans sold there.
A new shop or a slow winter can leave a plumber's household with very little income. Because Virginia expanded Medicaid, a household at or under 138% of the poverty level can qualify, so a thin year doesn't have to mean no coverage.
And keep the categories straight while you build the business: workers' comp is for accidents on the job. A sinus infection or your kids' checkups need a health plan.
Next step: Phone me if your income has dropped, and we'll work out whether Medicaid or a marketplace plan is the right fit for now.
Straight answers, no sales pitch.
Only in part of Northern Virginia, where 4 marketplace PPOs are sold for 2026. A healthy plumber anywhere in Virginia can still get a nationwide PPO outside the marketplace.
Possibly. If the group isn't required by federal law to offer COBRA, Virginia Code 38.2-3541 lets someone continuously insured for three months continue coverage for 12 months.
No. Virginians enroll through Virginia's Insurance Marketplace, run by the State Corporation Commission.
Virginia expanded Medicaid, so adults with household income up to 138% of the federal poverty level may qualify.
Which Virginia county or city you're in, the people on your plan and a rough idea of the shop's profit last year will do. I'll come back with prices for the route that fits, and I'll say so if keeping your current plan is smarter.
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