You can still get a nationwide PPO in Florida. Here is how agents paid at closing are dealing with a marketplace that jumped in price and a coverage gap that can catch a slow year.
Hi, I'm Sam Jaber. I'm a health insurance broker in Tampa, and Florida is my home market. Real estate agents here buy their own coverage, get paid when deals close, and this year faced a marketplace that got noticeably more expensive. I'm licensed in 36 states and everything is done by phone, so it doesn't matter whether you sell in Pensacola or Palm Beach.
This page is about one state. The rules for getting covered are mostly federal, but the prices, the networks and the safety net under a bad year are particular to Florida, and they change which choice makes sense for an agent here.
Start with this, because it surprises people: you can still get a nationwide PPO in Florida through me, and for a healthy agent it can come in at a price that makes sense.
Agents usually give up on the idea because of what they see on the marketplace. Florida's marketplace does carry a PPO in every county, but a single insurer sells it, and it's a sliver of the shelf: 14 of the 410 plans in the state's file this year. Compare it, county by county, against the least expensive plan built on any other network, and the gap is wide. In Hillsborough the marketplace PPO runs 138% more, in Orange 147% more, and in Miami-Dade 165% more.
Outside the marketplace, medically underwritten private plans run on nationwide PPO networks and set their price from your health. If you're healthy, that's the comparison worth making.
Your path depends on whether your household income qualifies for the premium tax credit. Floridians apply through HealthCare.gov, and the credit is figured from your household's income for the coverage year. For an agent working for yourself, that means commission after your brokerage split, dues, fees, marketing and car costs.
Getting this right carries extra weight in Florida right now. The state insurance regulator reported an average approved increase of 34.1% for 2026 individual plans, weighted by enrollment and measured before any subsidy. For people who receive the credit, it soaks up much of that. People who don't receive it pay the whole thing.
There's also a floor to watch for, covered below. Find the case that fits your year.
If your net lands in the credit range, buying through HealthCare.gov is usually your least expensive way to be covered. Nothing sold outside the marketplace can use the credit, so for this agent the marketplace generally comes out ahead on price.
Two Florida details to plan around. First, most of what you'll see is HMO coverage: 316 of the state's 410 marketplace plans are HMOs. That suits an agent who lives and works in one metro, but confirm your doctors are in the network before choosing on price alone. Second, commission timing. A cluster of closings late in the year can push your income above the estimate you gave, and the difference comes due at tax time. Update HealthCare.gov after a big month.
Next step: Send me last year's numbers and what's pending, and I'll help you set an estimate and choose a plan whose network includes your doctors.
Above the credit range, Florida's full-price increase lands on you directly, and the marketplace plan that gives you PPO freedom is the one that costs roughly double. For many established agents, team leads and brokers, this is the point to look outside the marketplace.
With an underwritten nationwide PPO, you fill out a health questionnaire and the insurer chooses to approve you, decline you, or approve you with a condition excluded. A healthy applicant can often get a price below the full marketplace rate, with a network that isn't tied to one Florida county. Benefits differ by plan, so we read each one before you decide.
Next step: Call me and I'll compare a nationwide PPO with the marketplace plans in your county for your household, one next to the other.
If ongoing care is part of your life, the marketplace remains the right place, even at full price. It can't decline you or charge you more because of your health. An underwritten plan makes no such promise.
In Florida that usually turns into a choice between the PPO and the lower-priced plans built on HMO or EPO networks. When your specialists are local and in network, a Florida HMO can be the sensible pick. If you need a particular doctor the HMOs leave out, the PPO's price may be justified for you. We settle that with your doctors and prescriptions on the table.
Next step: Tell me which doctors you see and what you take, and I'll check which plans in your county include them.
New licensees and agents in a cold stretch can end up with a year that barely covers expenses. In many states, a very low income opens the door to Medicaid. Florida is one of the states that has not expanded Medicaid. On top of that, the marketplace credit generally begins at 100% of the federal poverty level. A household that falls below that line can qualify for neither program.
For an agent, that makes the number you give HealthCare.gov especially important, because your income is a forecast and one closing can move it a long way.
Next step: Before you enroll in a lean year, get me on the phone and we'll go over what you qualify for and how to build a careful estimate.
A Florida agent deals with three things at once: a full-price increase that was large this year, a marketplace PPO that exists everywhere but costs about twice as much as the alternatives, and no Medicaid expansion beneath the lowest incomes. Commission income sits on top of all three, so the year you forecast has real consequences.
The approach itself stays simple. Pin down your net income first. After that, your health tells us whether the marketplace or a nationwide PPO is the better home.
Straight answers, no sales pitch.
Yes. Every Florida county has exactly one marketplace PPO choice, and in a typical county it runs around double the least expensive plan built on another network type. If you're healthy, a nationwide PPO priced through underwriting is the other route, and I can quote it for you.
The state's insurance regulator put the 2026 average approved increase for individual coverage at 34.1%, before subsidies. People receiving the tax credit are shielded from a large part of it. Earn past the credit range and you carry the increase yourself.
Don't assume so. Florida didn't take the Medicaid expansion, and below the poverty line the marketplace credit generally isn't available either, so a very low year can leave you between the two programs. Talk to me before you enroll.
Usually not. More than half of agents nationally are self-employed and paid on commission, so in Florida most agents buy their own, through HealthCare.gov or a private plan.
Which Florida county you sell in, who needs coverage, and roughly what you kept after your split last year. I'll tell you where you land and price the options for your county, and if your current plan is the better deal, I'll say so.
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