You can still get a nationwide PPO in Florida. Here is how doctors who own their practice are dealing with a marketplace that got more expensive and offers very little PPO choice.
Hi, I'm Sam Jaber, a licensed health insurance broker in Tampa. Florida is where I live and where most of my clients are, though I'm licensed in 36 states and all of my work is done by phone.
Physicians here tend to call me with two complaints. The marketplace price for their family went up sharply this year. And when they look for a PPO, so they aren't tied to one hospital system, the choices are thin and expensive. Both are real, and neither one is the end of the conversation.
Let me put this first, since it's what most doctors want to know: you can still get a nationwide PPO in Florida, and for a healthy household it's usually the comparison worth making.
The reason so many physicians assume otherwise is the marketplace shelf. Florida's marketplace does have a PPO in every county, but only one company sells it, and it carries a steep premium over everything else. Line it up against the least expensive plan with any other kind of network in the same county and the marketplace PPO costs 138% more in Pinellas, 121% more in Alachua and 113% more in Leon. Across the state's counties, the typical gap is about twice the price.
There is a second kind of PPO that never shows up on HealthCare.gov. Private plans that use medical underwriting are built on PPO networks spanning the country, and they're priced on your health instead of the marketplace's rate tables. For a physician who wants doctors in more than one system, that's where we start.
Florida residents buy marketplace coverage through HealthCare.gov, and the help available there is a premium tax credit based on your household income for the coverage year. The cutoff sits around four times the federal poverty level and rises with household size.
Most established practice owners are well past it. That matters more in Florida this year than usual, because Florida's regulator reported that approved 2026 rates for individual plans rose 34.1% on average, counting enrollment and leaving subsidies out. Without the credit, a physician's family pays that increase in full.
The exception is the year you open your own office, when build-out costs and slow collections can pull your net down a long way. Pick the description below that matches you.
This is the typical Florida physician I talk to. No tax credit, a full marketplace price that jumped this year, and a marketplace PPO that costs roughly double the alternatives in your county.
For a healthy household, a medically underwritten plan on a nationwide PPO network is the natural next step. You answer health questions for each person on the application. The insurer decides whether to accept everyone as they are, decline someone, or accept with a specific condition left out. Being healthy is what allows the price to come in below the full marketplace rate.
You'll also want to know what each plan pays for, since these plans set their own benefits. We'll go through that line by line, and we'll confirm the colleagues and hospitals you'd actually use are in the network, whether that's here in Florida or near family up north.
Next step: Call me and I'll price a nationwide PPO for your household next to the marketplace plans in your county, so you can compare them directly.
If a family member is managing an ongoing diagnosis, the marketplace stays the safer home, even at full price after the 34.1% increase. Marketplace plans have to accept everyone and can't charge more for a health history. An underwritten plan can't promise that.
In Florida the choice then narrows to two kinds of marketplace plans. Most of what's sold here is HMO or EPO coverage built around Florida networks, which is fine if your family's care is local. If a specialist who matters sits outside those networks, the marketplace PPO may be worth its price for your family in particular.
Next step: Send me the specialists and medications your family relies on and I'll match them against the plans sold in your county.
When you give notice, your employer coverage usually ends with the job. That loss opens a special enrollment period, generally 60 days, to choose a HealthCare.gov plan. If you're thinking about an underwritten nationwide PPO instead, the application needs time for review, so start well before your final day.
Your first year on your own may be the one year your net falls inside the credit range. If that happens, a marketplace plan with the credit is usually the most affordable choice, and your income estimate becomes the thing to get right. If collections pick up faster than you expected, part of the credit can come back when you file.
Next step: Call me a few weeks before your last day and we'll arrange coverage that starts as the hospital plan ends.
Three things set Florida apart. The full-price increase this year was large, and doctors are usually the ones paying full price. The marketplace PPO exists but costs far more than the alternatives in most counties. And Florida has not adopted the Medicaid expansion, while the credit generally starts at the federal poverty level, which rarely touches a physician's household but can catch a new owner whose first year is extremely thin.
Put together, a healthy Florida physician has more reason than most to price a nationwide PPO outside the marketplace, and a family with health needs has more reason to choose its marketplace plan carefully.
Straight answers, no sales pitch.
Yes. One insurer sells a marketplace PPO in every Florida county, but it typically costs about twice the least expensive plan with another network type in the same county.
Because the full price rose. Florida's regulator reports an average approved rise of 34.1% for 2026 individual coverage, before subsidies, and a physician earning above the credit range pays it all.
Yes. If your household is healthy, private underwritten plans built on nationwide PPO networks are available through me in Florida and the other states where I'm licensed.
Sometimes it's a useful bridge, but choosing to drop COBRA early doesn't open a new enrollment window. Call me before you decide so we can plan the switch around your start date.
Which Florida county you live in, who needs to be covered, and roughly what the practice netted last year. I'll show you which path fits and price it for your county, and if the plan you already have is the better choice, you'll hear that from me.
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