Although kynect offers HMOs exclusively, Kentucky contractors can still obtain nationwide PPO coverage through me. Here's how that affects people in Northern Kentucky who regularly travel across the Ohio River for work.
Hi, I'm Sam. I'm licensed in 36 states and help self-employed workers arrange their own health insurance. If you're framing homes in Florence, doing electrical jobs in Covington or handling HVAC installations in Fort Thomas, we can take care of your Kentucky coverage by phone.
Northern Kentucky operates as part of the Greater Cincinnati area. Think about a carpenter living in Independence. Monday's job might be in Blue Ash, Wednesday's in Hyde Park and Friday's back in Union. He receives 1099 income, but because his residence is in Kentucky, he shops for coverage through kynect, the state's exchange. The complication? Every plan kynect sells is an HMO.
For 2026, kynect offers 85 individual medical plans through three statewide insurers. All 85 are HMOs, so there isn't a PPO available on the exchange.
You don't have to purchase through kynect to get covered. I can arrange a privately underwritten nationwide PPO in Kentucky, with premiums determined by underwriting. Its network extends beyond the Ohio River, including providers in Cincinnati, Dayton and Indianapolis alongside those in Kentucky.
With an HMO, care outside the network is generally covered only for genuine emergencies. If you're contracting in Northern Kentucky, I'd want to know whether your kynect plan covers the doctors and urgent care facilities you visit across the river in Ohio. Kenton, Boone and Campbell counties each have two kynect insurers, so we have two provider networks to compare.
Check these providers against both networks:
A kynect HMO could work perfectly well if most of your jobs and medical appointments are in Kentucky. But when most of your working hours are spent in Ohio, provider access deserves more attention than the premium alone.
Your kynect premium credit is based on projected net self-employment earnings for the coverage year. Take your reported 1099 income, subtract business expenses such as tools, truck costs, fuel and materials, and update the figure whenever it changes. Kentucky also expanded Medicaid, and KFF reports the adult eligibility ceiling at 138% of the federal poverty level. If your annual income falls within that limit, Medicaid could be your coverage route instead. Generally, being eligible for Medicaid means you cannot receive a kynect premium credit for those same months.
In that situation, your most affordable choice will probably be a kynect HMO. Compare networks carefully to find one that includes the Ohio providers you regularly need.
Next step: Give me the locations where you usually work and the doctors you visit. I'll check how both kynect networks accommodate them.
Paying an HMO's entire premium when its network might not reach across the river isn't especially appealing. A private PPO may be a better fit. After reviewing your medical information, the insurer can approve coverage, deny the application or exclude a particular condition. Healthy contractors often qualify for premiums below kynect's unsubsidized prices.
Next step: Call me for a private PPO estimate for everyone needing coverage. I'll compare it with both kynect networks offered in your county.
A slower season might bring your projected earnings within Medicaid eligibility. Apply if your honest annual estimate is at or below that threshold. Should spring contracts raise your income beyond it, update your information and transition to kynect coverage.
Next step: If contracts start disappearing, call me. We'll review whether Medicaid or kynect makes sense and figure out when changing coverage is appropriate.
Northern Kentucky contractors often experience quieter winters followed by heavy workloads from spring into fall. Your kynect income estimate should reflect the whole year rather than January alone. Adjust it as your seasonal contracts become clearer. Doing so helps keep your tax credit accurate and reduces unnecessary movement between coverage programs.
Straight answers, no sales pitch.
Only when those providers participate in your specific network. Because kynect offers HMOs, nonemergency out-of-network treatment generally isn't covered. Verify participation before selecting a plan.
For 2026, Kenton, Boone and Campbell counties each have two participating insurers.
No. Every kynect plan is an HMO. I can arrange private nationwide PPO coverage for contractors who are healthy.
Yes. Kentucky adopted Medicaid expansion, and KFF reports an adult income limit of 138% of the federal poverty level.
Tell me your home county, approximately how much work you do in Ohio and your net 1099 earnings from last year. With those details, I can give you a clear picture of your coverage choices.
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