Kansas offers nationwide PPO coverage outside the marketplace, even though HealthCare.gov only offers EPOs there. Here's what 1099 contractors need to know about managing a slow year when most adults without children have no path to Medicaid.
Hi, I'm Sam. I'm licensed in 36 states and work with self-employed clients who need health insurance. Whether you're a roofer in Olathe, a custom harvester near Salina or a freelance designer in Lawrence, I can help you arrange coverage over the phone.
Let's talk about what happens when business slows down, because Kansas leaves contractors particularly exposed. The state hasn't expanded Medicaid. According to KFF, the income threshold for adults without children is 0% of the poverty level. That means a contractor who's single or part of a couple without children cannot qualify for Medicaid based on income, regardless of how little they earn.
This year, Kansas has 64 individual medical plans available through its marketplace. They're all EPOs, meaning HealthCare.gov doesn't offer a PPO anywhere in Kansas.
I can help you secure a nationwide PPO in Kansas outside the marketplace. If you're healthy and business has stabilized, private coverage based on your health can give you access to providers nationwide. That matters when your contracts take you through Missouri, Oklahoma or Nebraska.
It comes down to these three figures:
For a contractor without children, earning below the poverty line can mean no Medicaid eligibility and no marketplace credit either. Parents may qualify for Medicaid below 38%, but between 38% and 100% of the poverty level, they can also fall into a gap with neither option.
For HealthCare.gov, report your expected net self-employment earnings for the year you'll have coverage, and revise that figure whenever it changes. Start with your 1099 revenue, then subtract legitimate work expenses such as materials, equipment, tools, fuel and insurance.
In Kansas, falling on either side of the poverty line can completely change your coverage options. Above it, you may receive a tax credit. Below it, you could receive nothing. That's why your estimate needs to be accurate, not artificially high. Look at confirmed contracts, dependable seasonal work and income earned by other household members when calculating what the year should bring.
Everything starts with a reasonable income projection. At or above the poverty line, a marketplace EPO with a tax credit will generally cost you the least. Just verify that your doctors participate. Below that threshold, contact me before signing up so we can review what coverage remains available.
Next step: Walk me through the contracts you've completed and the work still scheduled. I'll help you calculate an annual estimate you can reasonably support.
Kansas Medicaid covers parents only up to 38% of the poverty level, according to KFF. That leaves a difficult income gap between the Medicaid cutoff and the poverty line. Once your income rises above the poverty line, marketplace premium credits generally become available.
Next step: Tell me who's in your household and what your earnings look like this year. I'll help determine whether KanCare, marketplace coverage or neither is available.
Seasonal earnings are common across Kansas trades. A harvesting crew, hail-season roofer or landscaper might collect most of their annual revenue during a short stretch. Don't use a quiet February to represent your entire year. Consider your usual annual workload instead. Income that looks low during winter could exceed the poverty line by fall, changing your eligibility. If the expected busy season doesn't materialize, revise your projection when that becomes clear rather than waiting until taxes are due.
When your earnings move beyond the tax credit range, paying the full marketplace price for an EPO may not be worthwhile. Consider pricing a nationwide PPO instead. Private underwriting means the insurer can accept your application, reject it or approve coverage while excluding a particular condition.
Next step: As your workload rebounds, give me a call. I'll compare nationwide PPO pricing with the EPO options available in your county.
Straight answers, no sales pitch.
Medicaid expansion never took effect in Kansas. KFF reports eligibility limits of 0% of the poverty level for childless adults and 38% for parents.
Yes. If your income falls below the poverty line, you generally won't qualify for marketplace premium credits. Kansas Medicaid also doesn't provide an income-based eligibility path for adults without children. That can leave you ineligible for either program.
No. Kansas offers 64 individual medical marketplace plans, all EPOs. If you're healthy, I can help you obtain a private nationwide PPO.
No. HealthCare.gov uses your annual net self-employment earnings after deducting business expenses. Revise your estimate whenever your circumstances change.
Share your county, household details and an honest projection of your 1099 net income this year. I'll walk you through the coverage available before you make any enrollment decisions.
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