You can still get a nationwide PPO in Louisiana through me, without paying what the St. Tammany marketplace charges for one. Here is how Northshore agents line up coverage with commissions and health.
Hi, I'm Sam Jaber. I'm a broker in Tampa licensed in 36 states, and Louisiana agents can handle their health coverage with me over the phone.
Imagine an agent in Mandeville who sells on both sides of Lake Pontchartrain. Most of her listings are in Covington, Madisonville and Slidell, but a lot of her buyers are New Orleans families moving across the Causeway for schools and space. Spring and early summer are packed with closings, and the holidays are dead quiet. Her brokerage pays her when a deal funds and offers no health plan. She shops on HealthCare.gov as a St. Tammany Parish resident, and the PPO she finds there is priced like a luxury.
St. Tammany Parish has 51 individual medical plans for 2026: 29 EPOs, 14 POS plans and 8 PPOs. The PPO costs a great deal more than the rest. At age 40 and before any subsidy, the least expensive silver PPO is 82% above the least expensive silver EPO. Even next to the silver plan sold by the PPO insurer's own HMO company, it's 75% higher.
You can still get a nationwide PPO in Louisiana through me, without that markup. It's private, priced from a health questionnaire, and its network is national, so a doctor you see while traveling out of state can count as in network.
The amount of help hinges on what your household makes in the coverage year, and it ends above four times the federal poverty level. An agent's number starts from gross commission, less the split, desk fees, MLS and board dues, signs, photography and the tolls and miles across the lake.
Louisiana's floor is solid compared with its neighbors. The state expanded Medicaid in 2016, and KFF lists the adult limit at 138% of the poverty level.
Sticker prices climbed for 2026: KFF has Louisiana's benchmark silver premium for a 40-year-old up 23.3% over 2025.
Enroll on HealthCare.gov; nowhere else accepts the credit. The credit is a set amount keyed to a benchmark silver plan, so choosing the PPO would mean paying its 82% markup yourself. For almost every agent in this range, the better buy is an EPO or POS plan whose network includes your doctors. Outside its network an EPO generally pays only for emergencies, so make sure the doctors and hospital you use are in it.
Next step: Tell me which doctors you use and roughly what you cleared, and you'll see the St. Tammany plans that keep them after the credit.
Once you're over the credit line, the full sticker is yours, and in St. Tammany the marketplace PPO is the costliest sticker on the shelf. This is where many producers go private. You complete a medical questionnaire, and the insurer approves you, approves you with a specific condition carved out, or declines. Approved agents in good health often see premiums under the marketplace's full price, with in-network doctors in every state. Benefits vary, and we go through each plan together.
Next step: Call me for a nationwide PPO quote set beside HealthCare.gov's full prices for your parish.
If rates spike and buyers wait, an agent's year can shrink fast. Should your honest estimate land at or under 138% of the poverty level, Louisiana Medicaid could carry you through. Once deals start funding again, report the income and move to a marketplace plan.
Next step: Before you renew after a slow stretch, call me and we'll figure out where your household lands.
With a chronic condition or a regular specialist in the house, stay on HealthCare.gov even at full price. Marketplace plans must accept everyone, and a diagnosis can't raise the premium. The work is finding the network that keeps your specialists on the Northshore or across the lake.
Next step: Tell me who your specialists are and what you take, and I'll match them to St. Tammany's networks.
Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027, and December 15 is the deadline for a January 1 start.
Straight answers, no sales pitch.
Yes, eight. The least expensive silver PPO costs 82% more than the least expensive silver EPO.
Yes, in 2016. KFF lists the adult income limit at 138% of the federal poverty level.
Yes. A healthy agent can buy one privately through me.
Pick your plan by December 15. The window itself opens November 1 and closes January 15.
Send your parish, the people on your plan and a rough figure for what you netted after the split. You'll see what HealthCare.gov costs you next to a private plan, and which I'd choose.
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