Maryland builders can still purchase a nationwide PPO. For contractors on the Eastern Shore, where projects follow the beach season, it's worth comparing the numbers. Here's how to approach coverage when your business runs on that schedule.
Hi, I'm Sam Jaber. Health insurance brokerage is what I do. I'm licensed in Maryland and work with all my clients by telephone.
Imagine a contractor living in Berlin, just inland from Ocean City. His crews renovate and build coastal properties throughout Worcester County, from vacation homes to condos, and occasionally take custom projects around Salisbury in Wicomico. Everything revolves around Memorial Day because property owners need construction finished before renters arrive. That makes fall and winter especially busy, while the middle of summer can be slower. He operates two crews, has earned a solid reputation across the Eastern Shore and personally handles the annual decision about his health insurance.
You haven't lost access to nationwide PPO coverage just because you're in Maryland. I can help you arrange that kind of policy.
Maryland Health Connection does offer PPO coverage, but the premiums deserve attention. In 2026, Worcester and Wicomico have 4 PPOs and 28 HMOs offered by 3 insurers. Rates are consistent across Maryland's four rating areas, so location doesn't change the comparison. For unsubsidized silver coverage at age 40, the least expensive PPO is 64% above the least expensive HMO. HMOs typically pay for out-of-network treatment only during emergencies. PPOs also contribute to non-network visits without referrals, although patients pay more. Private, medically underwritten PPO coverage can use nationwide networks, with health affecting the price.
First, let's determine whether your household qualifies for help paying premiums. Maryland Health Connection offers the federal premium tax credit and an additional program for 2026 called Maryland Premium Assistance. That state benefit can supplement the federal credit for residents of any age whose income is no higher than 400% of the federal poverty level.
The income calculation for both programs starts with your expected net self-employment earnings for the coverage year. That's the company's profit after expenses for pilings, lumber, subcontractors, equipment, permits, insurance and your truck. Submit your projection to the marketplace and adjust it as contracts change. A busy fall preparing properties for the coming season can make a substantial difference.
Once your income exceeds the assistance limits, you're responsible for the full marketplace premium, and its PPO is priced 64% above the HMO alternative. That's a good reason for healthy households to compare a medically underwritten nationwide PPO. The carrier reviews a medical questionnaire before accepting, declining or offering coverage with a particular past condition excluded. Favorable health answers can produce a premium below Maryland Health Connection's full price. The network can also serve your family during trips to Delaware beach communities, Philadelphia games and other destinations. We'll compare the actual benefits carefully because policies aren't identical.
Next step: Call me with your county and the ages of everyone needing coverage. I'll compare a nationwide PPO quote with the marketplace plans offered along the Shore.
Straight answers, no sales pitch.
Yes. Maryland offers 8 marketplace PPOs statewide for 2026, including 4 available in every county, such as Worcester and Wicomico.
No. Rates remain uniform across Maryland's four rating areas in 2026. For a 40-year-old without subsidies, the lowest-priced silver PPO is 64% more expensive than the lowest-priced silver HMO throughout the state.
Maryland Premium Assistance is a 2026 state benefit that supplements federal tax credits for monthly premiums. Residents of any age may qualify with income no higher than 400% of the federal poverty level.
Yes. Maryland adults earning no more than 138% of the federal poverty level may be eligible.
Share your county, the people needing coverage and an approximate figure for last year's business profit. I'll compare a nationwide PPO quote against Maryland Health Connection rates, including available state assistance, and give you my straightforward opinion.
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