Florida still has nationwide PPO coverage available. Here's how dentists who own practices can find medical insurance for their families without simply accepting this year's higher marketplace prices.
Hi, I'm Sam Jaber. I'm based in Tampa, licensed as a health insurance broker in 36 states, and I work with Florida families entirely by phone, from the Keys all the way to the Panhandle.
First, let's clear up what we're discussing. I'm talking about medical insurance for your household, not dental coverage. When dentists look for their own health plans, they often end up seeing advertisements for dental benefits. That's not what this page is here to help you buy.
Florida practice owners have faced some difficult insurance choices this year. Marketplace premiums at full price have climbed substantially, and the marketplace's single PPO is considerably more expensive than its alternatives. Let's look at how dentists can approach those costs.
The point I want you to remember is that nationwide PPO insurance remains available in Florida. For a practice owner with a healthy family, it's often the first alternative I'd seriously consider.
HealthCare.gov doesn't offer an appealing PPO price comparison in Florida. There's only one insurer selling marketplace PPO coverage, although it offers that coverage across all 67 counties. Compared with each county's least expensive plan using another network type, the PPO premium is 108% higher in Brevard, 110% higher in Volusia and 103% higher in St. Johns. Looking across Florida counties, the typical difference is approximately double the price.
You can also look beyond HealthCare.gov. Private insurers offer medically underwritten plans using nationwide PPO networks, with premiums determined by your household's medical history instead of marketplace pricing.
I'd begin by checking your household's eligibility for a HealthCare.gov premium tax credit. That calculation uses expected household income during the coverage year. For a dentist who owns the office, the relevant amount reflects income after business expenses, not the practice's gross production. The credit generally ends around four times the federal poverty level, with a higher threshold for larger families.
Owners of established practices commonly earn more than the credit allows. For them, Florida's 2026 marketplace increase is particularly painful. The state regulator reported an average approved rate increase of 34.1% for individual coverage, weighted by enrollment and calculated before subsidies. Without a credit, the owner faces the entire full-price increase.
Buying a practice or becoming a partner can temporarily change your finances. Equipment purchases and loan payments may substantially reduce personal income for a year or two. Let's look at which situation describes you.
Here, you're dealing with full marketplace premiums and a marketplace PPO priced at about twice what the other county plans cost.
I'd start by getting a quote for a medically underwritten nationwide PPO. Everyone applying provides medical information. Based on those answers, the insurer may approve coverage, refuse it, or approve it while excluding a specific condition. When the whole family is healthy, that underwriting process can produce premiums below the marketplace's full price.
We also need to examine the benefits because private plans don't all cover the same things. Before choosing, we'll review what each policy pays and verify that your family's doctors participate, including physicians near wherever your children attend school.
Next step: Give me a call. I'll quote a nationwide PPO and put it alongside your county's marketplace plans so you can see the pricing differences yourself.
If practice financing or buy-in expenses bring household income into the eligible range, HealthCare.gov coverage with a premium credit will usually cost you less. You cannot apply that credit to a plan purchased outside the marketplace.
Florida families should watch two things. One is income projection: when practice earnings exceed your estimate, you might have to repay some premium assistance at tax filing. The other is the lower income boundary. Florida hasn't expanded Medicaid, and marketplace credits generally begin at the federal poverty level. If income falls far enough, a household may qualify for neither program. Talk with me before enrolling if you're projecting an unusually low first-year income.
If you're moving from an associate position with employer benefits into practice ownership, the loss of that insurance generally gives you a special enrollment period of 60 days.
Next step: Send me the annual financial forecast prepared by your accountant or lender. I'll help turn it into a reasonable income estimate and select coverage accordingly.
Running a practice without employees means purchasing your own insurance as a self-employed Florida resident. People working for you as contractors don't count as employees. When you hire at least one employee who isn't an owner or family member, small-business health coverage may become available under a different set of rules. You can still keep your household's insurance separate.
Straight answers, no sales pitch.
Yes. We're discussing medical insurance that covers physician care, hospitals and medication. Dental coverage, whether for your household or patients, is a different product.
Yes, but only one insurer offers it statewide. In a typical Florida county, that marketplace PPO costs roughly twice as much as the lowest-priced plan with a different network structure.
Florida's regulator reported that approved individual-market premiums increased an average of 34.1% for 2026 before subsidies. Practice owners outside the credit range pay the full increase.
That's one advantage of nationwide PPO networks. For healthy Florida households, I can quote privately underwritten coverage with access to providers across the country.
Tell me which Florida county you're in, who needs insurance and approximately how much you took home from the practice last year. I'll compare the coverage and prices that fit. If keeping your existing plan makes more sense, I'll tell you that too.
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