You can still get a nationwide PPO in Florida. Here is how therapists and counselors who went solo are finding coverage in a market where prices rose and the safety net has a gap.
Hi, I'm Sam Jaber. I work as a licensed health insurance broker out of Tampa, I hold licenses in 36 states, and I do all of it by phone, which suits clinicians who already spend their days on telehealth.
Florida therapists and counselors who leave an agency or a group practice run into the same three surprises. The group plan stays behind. The full marketplace price went up a lot this year. And the marketplace's only PPO costs far more than its other plans. I'll take those one at a time.
I'll start with the good news. You can still get a nationwide PPO in Florida through me, and a healthy clinician should at least see the number.
What you see on HealthCare.gov makes it look otherwise. Of the 410 marketplace medical plans in Florida's file this year, 14 are PPOs, all from a single insurer. In the Panhandle, that PPO costs 98% more than the lowest-priced plan built on a different network in Escambia and 102% more in Okaloosa. Across Florida's counties, the usual gap is about twice the price.
Private plans that use medical underwriting are built on PPO networks that reach across the country and are priced on your health. That's a different shelf, and it's the one I'd check for a healthy therapist over the subsidy line.
Your path starts with one test: does your household's income earn you a premium tax credit through HealthCare.gov? That credit looks at the coverage year's income, which for a solo practice is what's left after your office, your EHR and billing service, your liability coverage and continuing education. The cutoff is roughly four times the poverty level, a bit higher for every person you add.
A lot of solo clinicians land near that line, and in Florida this year it decides a lot. The state regulator reported a 34.1% average increase in approved 2026 rates for individual plans, measured before any subsidy and weighted by enrollment. Under the line, the credit cushions most of it. Above the line, nothing does.
Then a HealthCare.gov plan is usually the most affordable choice, because the credit only works on marketplace plans.
Private practice income doesn't arrive evenly. Cancellations, slow insurance panels and holiday weeks all move it. If you end up earning more than you estimated, some of the credit can be owed back at tax time. Update your income on HealthCare.gov when your caseload changes.
Most Florida marketplace plans are HMOs, so we'll also make sure the plan you choose includes the providers your household uses.
Next step: Send me last year's figures and your current caseload and we'll set an estimate you trust and pick a plan around it.
With no credit, you pay the full Florida price, increase and all. For a healthy household, a medically underwritten nationwide PPO usually deserves a look.
You'll answer health questions on the application for each person. The insurer can accept, decline, or accept with a particular condition left out. Good health is what lets that price come in under the full marketplace rate. These plans also set their own benefits, so I'll walk through what any plan covers before you sign.
Next step: Call me and I'll lay a nationwide PPO quote beside the marketplace options for your county.
You know how much continuity of care matters. If someone on your plan manages a chronic illness, a mental health condition or a daily prescription, the marketplace is usually the safer home, even above the line. Marketplace plans can't turn anyone away or charge more for health history. Underwritten plans can.
In Florida, the remaining choice is between the local HMO and EPO plans and the higher-priced marketplace PPO. We pick based on where your providers are.
Next step: Share the providers and medications that matter and I'll check them against the plans in your county with you.
Leaving a job with benefits usually ends that coverage, and losing it opens a special enrollment period, generally 60 days, to choose a marketplace plan.
The thin first year needs care in Florida, for a reason most people don't see coming. Florida never expanded Medicaid, while marketplace help usually begins only once income reaches the poverty level. Earn less than that and you can fall through the middle, with no Medicaid and no credit. When your projection sits near that floor, we should plan your enrollment together.
Next step: Call me before your last day at the agency and we'll plan coverage that fits the year you expect.
Straight answers, no sales pitch.
Yes. The marketplace sells one PPO in each county, usually at about twice the price of other plans. If you're healthy, I can also quote you a private plan with medical underwriting on a PPO network that spans the country.
Approved 2026 rates for individual plans in Florida rose 34.1% on average, by the regulator's measure, ahead of any subsidy. The credit soaks up much of that for people who get it, and everyone else pays it.
Use last year's return and your recent months to make a best estimate, then update HealthCare.gov whenever your income shifts.
You may hit a gap. Florida didn't expand Medicaid, and premium help on the marketplace usually begins at the poverty level, so income under that line can leave you eligible for neither. Plan it with me first.
Where in Florida you live, who belongs on the plan, and about what your practice netted last year. I'll show you which path fits and what it costs, and if what you have now is already right, I'll tell you plainly.
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