When your Indiana plumbing business starts bringing in steady money, nationwide PPO coverage remains an option. During a slow startup year, the Healthy Indiana Plan may help instead. Here's how plumbers and pipefitters starting shops in Indiana can prepare for both stages.
Hi, I'm Sam Jaber. I'm licensed in Indiana, I focus exclusively on health insurance, and I help my clients choose coverage entirely over the phone.
There's no shortage of plumbing work around Indiana. Indianapolis, Fort Wayne and South Bend have older homes needing water heaters and replacement piping. Freezing temperatures damage lines beneath houses, while growing subdivisions around the cities bring new installations. Once plumbers develop a solid customer base, many decide to start their own businesses. But getting through that first year financially can be difficult. Indiana has a particular coverage program that may help, and an upcoming change to its rules deserves your attention before you rely on it.
When your plumbing business has a reliable income, nationwide PPO coverage is still an option in Indiana. I'll gladly check the price for you.
HealthCare.gov won't have that PPO. Indiana offers 80 individual medical plans for 2026 through 5 insurers serving all 92 counties. The breakdown is 45 HMOs, 33 EPOs and 2 POS plans, without a single PPO. Outside emergencies, HMOs and EPOs generally don't cover care from doctors outside their networks. PPOs do provide that coverage, although your share costs more and you don't need a referral. To get one, you'd look at privately sold nationwide PPOs that use medical underwriting to determine your premium based on your health.
The Healthy Indiana Plan, or HIP, is Indiana's Medicaid expansion program for adults with limited income. You may qualify when household income is no higher than 138% of the federal poverty level. If you own a plumbing shop, what matters is profit after paying for the truck, pipes, fittings, fixtures, licensing, insurance and any helper's wages.
There's an important rule coming. Starting January 1, 2027, most HIP applicants and enrolled adults ages 19 through 64 must complete 80 qualifying hours per month. Those hours can come from employment, job training, part-time education, apprenticeships or community volunteering. If HIP is part of your plan for a slow business year, check ahead of time how you'll need to document the hours you spend operating your shop.
This is exactly the kind of situation I'm addressing. When your household's annual income falls within HIP's limit, the program may cover you while you're building the business. Document your working hours carefully, and ask the state how it will recognize self-employment under the new requirements.
Once profits grow beyond HIP eligibility, make sure you report the income increase. The usual next step is HealthCare.gov coverage with a federal premium tax credit. That assistance is exclusive to marketplace plans and generally gives moderate-income households their most affordable option.
Next step: Tell me what you expect to earn this year. I'll help determine whether HIP or marketplace coverage is the right fit at this stage.
As their businesses mature, plenty of plumbing shop owners eventually exceed the tax credit income range. At that point, they're paying full premiums for marketplace HMOs or EPOs. A healthy family wanting access to doctors across a wider network should also consider a medically underwritten nationwide PPO. The insurance company evaluates a health questionnaire and may approve the application, reject it, or approve coverage excluding one previous condition. Favorable health history can mean a premium below the marketplace's full price. I'll explain the benefits of each option before you make your decision.
Next step: Call me with your Indiana county and everyone's ages. I'll compare a nationwide PPO quote with the plans offered locally.
Straight answers, no sales pitch.
You may qualify during a low-income year. The Healthy Indiana Plan accepts eligible adults earning no more than 138% of the federal poverty level.
Starting January 2027, HIP applicants and members ages 19 to 64 must document 80 monthly hours through work, training, part-time schooling, apprenticeships or community volunteering.
There aren't any marketplace medical PPOs in 2026, only HMO, EPO and POS options. Healthy plumbers can still arrange nationwide PPO coverage privately through me.
Make sure you report your higher earnings. Typically, that means transitioning from HIP to a HealthCare.gov plan supported by the premium tax credit.
Tell me which Indiana county you live in, who belongs to your household and what you reasonably expect the shop to earn this year. I'll price the coverage that makes sense today and help you prepare to change plans as business picks up.
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