You can still get a nationwide PPO in Missouri, even though the marketplace sells only EPOs. Here is how a newer agent's coverage should change as the closings start to come in.
Hi, I'm Sam Jaber. I'm licensed in 36 states, I work from Tampa, and Missouri agents, from Chesterfield to Springfield to the Lake of the Ozarks, can set up their own coverage with me over the phone.
This page follows one Missouri agent: someone in the first year or two of selling, whose income starts near zero and climbs as deals close. Missouri expanded Medicaid, so that agent's coverage can legitimately pass through three stages in a short time. Getting each handoff right is how a newer agent keeps costs down without getting a bill at tax time.
One thing doesn't change across those stages: Missouri's marketplace has 117 individual medical plans this year, and all of them are EPOs. No PPO is sold on HealthCare.gov in Missouri.
Later, when the business matures and your health is good, you can still get a nationwide PPO in Missouri, and I'm the one who arranges it. It's a private plan, priced on your health, with a network that works in every state and specialists without a referral.
Under Missouri's expanded Medicaid, an adult whose income stays at or below 138% of the federal poverty level can qualify. A brand-new agent with little income may qualify, and Medicaid takes applications any time of year, not just during open enrollment. While you're eligible for Medicaid, you generally can't receive the marketplace credit, so the two programs don't overlap.
Once your expected income for the year climbs past the Medicaid limit, the marketplace credit becomes your help instead. That's the handoff: report the change, end Medicaid, and choose a HealthCare.gov plan. Every option will be an EPO, and depending on your county there will be between 2 and 6 insurers to choose from, so check your own doctors before comparing price.
The estimate needs care at this stage. A newer agent's pipeline can fill up quickly, and the credit you take is checked against your real income when you file. Since 2026, the IRS sets no limit on clawing back credit you turn out not to have earned. Updating HealthCare.gov as your closings accelerate keeps that from biting.
Apply for Missouri Medicaid if your income for the year is expected to stay at or under 138% of the poverty level. Then watch your pipeline: when a few closings push the year past that line, it's time to move to a marketplace plan.
Next step: Call me in your first months selling, and I'll help you judge which side of the line your year will fall on and when to switch.
This is stage two. At this stage, a subsidized EPO from HealthCare.gov tends to be the least expensive coverage around. Revisit your estimate every quarter, because a newer agent's income tends to rise faster than they expect.
Next step: Send me your closings to date and what's pending, and we'll set an estimate you can defend and a plan with your doctors in network.
Stage three. Beyond the credit range, Missouri's marketplace charges full price for EPOs, which rarely pay for care outside their networks except in emergencies. A private nationwide PPO is often the better buy for a healthy agent: the insurer reviews your health answers and offers the policy as requested, declines, or offers it with a single condition excluded.
One exception: a household member with ongoing medical needs is safer on the marketplace at any price, because those plans enroll everyone without pricing in their health.
Next step: Once you're clearly past the credit range, call me and I'll price a nationwide PPO against the EPOs in your county.
Straight answers, no sales pitch.
If your expected income is at or below 138% of the federal poverty level, possibly. Missouri took the Medicaid expansion, and applications are open all year.
When your expected income for the year rises above the Medicaid limit. Report the change and pick a HealthCare.gov plan.
No medical PPO. All 117 individual medical plans are EPOs. A healthy agent can get a nationwide PPO through me.
The extra credit is repaid at tax time, with no cap for tax years after 2025. Update HealthCare.gov as closings come in.
Tell me how long you've been licensed, what you've closed so far this year, who needs coverage and your county. I'll map out which coverage fits each stage of your year and what it costs.
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