Ohio's marketplace may be limited to HMOs, but that doesn't prevent you from getting a nationwide PPO. Here's how electricians running their own businesses can find health insurance that works for them.
Hi, I'm Sam. I work exclusively with health insurance, and Ohio is one of the 36 states where I'm licensed. We can handle everything over the phone.
There's no shortage of electrical work around Ohio. Factories and warehouses require repairs and improvements, older properties in Toledo, Cincinnati, Columbus and Cleveland need new wiring and electrical panels, and winter storms create more service calls. Eventually, plenty of electricians decide to pull permits using their own license. That also means giving up the contractor's group health insurance. When they start browsing the Ohio marketplace for replacement coverage, they often find something they didn't expect.
Ohio residents can still buy nationwide PPO coverage. HealthCare.gov doesn't offer it, but I can help you get it.
For 2026, Ohio's marketplace lists 189 individual medical plans across all 88 counties, offered by 11 insurers. Every medical plan is an HMO. These plans generally exclude nonemergency care outside their provider network. PPOs, on the other hand, contribute toward out-of-network treatment at a higher cost to you, and specialist visits don't require referrals. You'll see dental PPOs listed, but there are no medical PPOs on the marketplace.
Nationwide PPO networks are available through private insurers that use medical underwriting to determine premiums. If your household is healthy, I'd compare those options against the Ohio marketplace HMOs.
Ohio's Medicaid expansion creates three possible paths based on household income. At 138% of the federal poverty level or below, Medicaid may be available. Above that threshold, a HealthCare.gov HMO with a premium tax credit may be the better fit. Once earnings move beyond the credit range, marketplace coverage costs full price, making nationwide PPOs worth comparing. If you work for yourself as an electrician, use net income after expenses like fuel, insurance, licensing, tools, the van, wire and electrical devices.
Ohio has a continuation provision that may help if your contractor discharged you. If you had coverage under its insured group plan for at least three months, you may be able to retain it for as long as 12 months. That depends on the discharge not involving gross misconduct and on your not being eligible for Medicare or another group plan. You must arrange and pay for continuation, but it could provide coverage while your electrical business gets established.
Losing employer-provided health insurance also generally gives you a 60-day special enrollment opportunity through HealthCare.gov. We can use that time to weigh continued group coverage against an Ohio HMO or a medically underwritten PPO.
One more distinction: workers' compensation is for work-related injuries. It doesn't replace regular medical insurance.
Next step: As soon as you know when your employment ends, call me. We'll compare continuation coverage with the alternatives while you still have time to act.
Building a customer base can take a new electrical shop a full year. If your household earns no more than 138% of the federal poverty level, Ohio's expanded Medicaid program may cover you. Applications are accepted throughout the year.
As the business grows, monitor your earnings. When household income moves above that Medicaid threshold, marketplace coverage becomes the next step. Make sure you report the increase when it occurs.
Next step: If you're projecting a lower-income year, give me a call. We'll compare Medicaid eligibility with HealthCare.gov coverage to see what works right now.
When household income is above Medicaid eligibility but still qualifies for a premium tax credit, a HealthCare.gov HMO will probably be Ohio's most affordable option. That's because marketplace plans are the only ones eligible for that credit.
Because HMO networks serve local areas, we'll check that your family's physicians participate before enrolling. Your income estimate matters too. A busy storm season or a substantial commercial contract could increase earnings enough to create a tax credit repayment if you don't update HealthCare.gov.
Next step: Set aside fifteen minutes for a call and bring your most recent tax return. We'll work out a reasonable income estimate and find an HMO that fits.
Once an electrical business is well established, household income often exceeds the premium credit limit. HealthCare.gov then charges full price for an HMO. Healthy families wanting broader doctor access should consider another route.
A nationwide PPO with medical underwriting starts with questions about your health. Based on those answers, the insurer may approve coverage, reject the application or approve it while excluding a particular condition. Healthy applicants can sometimes pay less than the marketplace's unsubsidized premium. Since coverage details vary, we'll compare benefits before you commit.
Next step: Give me a call, and I'll compare a nationwide PPO quote with the marketplace HMOs offered in your Ohio county.
Straight answers, no sales pitch.
Yes, through private coverage. Ohio's marketplace offers 189 individual medical plans for 2026, all HMOs. I can quote nationwide PPO coverage if you're healthy.
You may qualify. Ohio permits up to 12 months of insured group plan continuation after a discharge that wasn't for gross misconduct, provided you had coverage for at least three months. Federal COBRA is another possibility. We should compare both against your alternatives.
Ohio's expanded Medicaid program may be the answer. Households earning no more than 138% of the federal poverty level can qualify, and enrollment is available during all twelve months.
No. Losing insurance from your employer generally opens a 60-day HealthCare.gov enrollment period, regardless of when it happens during the year.
I just need your county, who needs coverage and an approximate net income from last year. I'll explain the plans and their prices, including whether keeping what you have now makes more sense.
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