Wherever you live in Virginia, I can help you obtain a nationwide PPO, including places without marketplace PPO choices. Here's how 1099 workers can select coverage based on earnings and medical history.
Hi, I'm Sam. I help Virginia 1099 workers find health insurance by phone, and I'm licensed in 36 states. My clients include electrical contractors in Chesapeake, IT professionals in Reston, and bookkeepers in Lynchburg.
Virginia handles coverage differently. Its state-run exchange, Virginia's Insurance Marketplace, sets its own enrollment schedule. Marketplace PPO availability is restricted to part of Northern Virginia. The state also extends Medicaid eligibility to adults earning up to 138% of the poverty level, providing an important fallback if contract income drops.
Virginia's marketplace offers 83 individual medical plans this year, including sixty HMOs, 19 EPOs and 4 PPOs. All the PPOs come from one insurer and are available only in Arlington County, Alexandria, Falls Church, Fairfax city, and portions of Loudoun, Prince William and Fairfax counties. If you live outside those areas, you won't find a PPO on Virginia's marketplace.
I can arrange a private nationwide PPO regardless of where you live in Virginia. The insurer uses your medical responses to determine pricing, and participating hospitals and physicians are located across the country. Healthy contractors working between cities should consider comparing it.
For marketplace purposes, calculate net self-employment income by subtracting business expenses, including software, supplies, tools, and vehicle costs, from your 1099 revenue. Then include other household earnings, such as your spouse's pay.
Virginia then evaluates eligibility based on that income. Adults at or below 138% of the federal poverty level may receive expanded Medicaid, which generally prevents them from receiving marketplace credits. Higher earnings can qualify for premium tax credits through Virginia's Insurance Marketplace. Once income exceeds the credit range, premiums are unsubsidized.
Because financial assistance applies only to marketplace coverage, that's usually the more affordable route. Most Virginia marketplace plans are HMOs or EPOs, so confirm your physicians are participating before judging plans by premium alone.
Pay attention to Virginia's separate enrollment calendar. For 2027 plans, Virginia's open enrollment begins November 1, 2026 and ends January 29, 2027. That's two weeks later than the federal cutoff.
Next step: Send me your 1099 income figures and major business expenses. I'll calculate a realistic projection and help find coverage that includes your physicians.
If you don't qualify for credits, you're paying full price for an HMO or EPO, unless your Northern Virginia address qualifies for a PPO. That's when private coverage becomes attractive to many healthy contractors.
First, the insurer reviews your medical answers. It may approve the policy, reject the application, or approve coverage with a specified condition excluded. Healthy applicants typically receive premiums below unsubsidized marketplace pricing, with coverage available wherever projects take them. We'll examine each policy's benefits before deciding.
Next step: Call me for a nationwide PPO quote for your family. I'll put its pricing alongside marketplace options available where you live.
If a major client leaves, your earnings might fall low enough for Medicaid. Virginia covers eligible adults through 138% of the poverty level, making that an important backup. As new contracts raise income above the threshold, report the increase and move to marketplace coverage with a credit.
Next step: Contact me when your contract income declines. I'll help compare Medicaid with marketplace eligibility and identify when changing coverage makes sense.
If federal COBRA doesn't cover your former employer's insurance, Virginia may permit continuation for 12 months, as long as you had coverage for at least three months. Where COBRA applies, use that continuation option instead. Losing employer insurance also qualifies you for a special marketplace enrollment opportunity.
Before agreeing to anything, compare the cost of keeping your former coverage with marketplace insurance and a nationwide PPO.
Next step: Give me a call a few weeks before your job ends. I'll compare continuation premiums, marketplace options, and private PPO coverage.
Straight answers, no sales pitch.
Only certain Northern Virginia areas have marketplace PPOs, all from one insurer. Elsewhere, none are offered. I can arrange private nationwide PPOs for healthy contractors.
Yes, if your earnings qualify. Virginia's expanded Medicaid program covers eligible adults through 138% of the poverty level.
Virginia's Insurance Marketplace opens enrollment for 2027 coverage on November 1, 2026 and closes it January 29, 2027.
Potentially. Virginia provides 12 months of continuation when federal COBRA isn't applicable. Larger employers fall under COBRA.
Tell me your Virginia locality, who needs insurance, and approximately how much your 1099 work earned after expenses. I'll compare pricing and help determine whether Medicaid, marketplace coverage, or a nationwide PPO makes sense.
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