A nationwide PPO is still an option in Montana. For heating and cooling owners around Billings, though, Yellowstone County's marketplace PPO may be close enough in price to make sense. Here's how I'd compare the choices.
Hi, I'm Sam. I'm licensed to sell health insurance in Montana, and I handle every client conversation over the phone.
Think of a Billings HVAC contractor with four vans serving Lockwood, Laurel, the Heights and the West End. The long Montana winter keeps heating repairs coming well into spring, while dry summer heat brings plenty of AC work. When temperatures suddenly plunge, all four vans might be dispatched to homes without heat. The owner purchases health coverage for his family, and with that kind of schedule, it's worth comparing plans carefully rather than simply renewing the old one.
Nationwide PPO insurance remains available in Montana regardless of the marketplace choices, and I can help you put that coverage in place.
Yellowstone County also has marketplace PPOs with a relatively modest price difference. Its 2026 selection includes 25 PPOs, 9 POS plans and 8 EPOs from 3 insurers. For an unsubsidized 40-year-old comparing silver plans, the lowest PPO premium is 10% above the lowest POS or EPO premium. Across much of rural Montana, PPOs actually cost 5% less than those alternatives. EPOs generally cover outside-network care only for emergencies, POS policies require specialist referrals, and PPOs allow direct visits to doctors inside or outside the network, with a higher share of outside costs. Nationwide private PPO premiums are determined through medical underwriting.
HealthCare.gov calculates your tax credit using projected household earnings for the coverage year. As an HVAC owner, your net self-employment income is revenue after subtracting expenses for vans, tools and equipment, parts, refrigerant, licenses and insurance. Make your best projection when enrolling, then update it when business runs above or below expectations.
Marketplace pricing in Montana also reflects its state reinsurance arrangement. Called the Montana Reinsurance Program, it operates under a federal waiver authorized for the 2025 through 2029 plan years.
When you qualify for a tax credit, use HealthCare.gov because that's the only place it applies. In Billings, paying the PPO's additional 10% before credits provides access to out-of-network benefits and specialists without referrals. That can be worthwhile when a doctor you need isn't in the POS or EPO networks. If your family already likes its network providers, choosing the lower premium may be better.
When heating work slows, profits can drop substantially. Montana's expanded Medicaid program covers eligible adults with income at or below 138% of the federal poverty level.
Next step: Give me your zip code, household ages and last year's profit. I'll calculate Yellowstone County marketplace prices after your tax credit.
An HVAC operation with four vans and plenty of service contracts may put its owner's household above the tax credit range. In that case, every HealthCare.gov plan is priced without assistance. If your family is healthy, I'd also quote a medically underwritten nationwide PPO. The insurer asks health questions and can accept the application, reject it or accept it with one previous condition excluded. That screening can mean premiums below full marketplace prices for healthy households, with coverage that remains useful on a trip to Casper for parts or while vacationing outside Montana. We'll review each policy's benefits together before you commit.
Next step: Call me with everyone's ages and your county. I'll show you nationwide PPO prices next to Yellowstone County's marketplace premiums without credits.
Straight answers, no sales pitch.
Yes. For 2026, Yellowstone County offers 25 marketplace PPOs. The lowest costs 10% more than the lowest POS or EPO for an unsubsidized 40-year-old on silver.
Yes. Federal approval allows the Montana Reinsurance Program to operate for plan years 2025 through 2029.
A POS generally costs less when you use network doctors and requires your primary doctor to refer you to specialists. PPOs let you visit doctors directly, including outside the network at a higher cost.
You may qualify. Montana expanded Medicaid to adults with income at or below 138% of the federal poverty level.
Tell me your county, who needs insurance and roughly what last year's business profit looked like. I'll price Yellowstone County's marketplace coverage against a nationwide PPO and explain which one I'd choose.
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