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Tennessee real estate investors

Here's how real estate investors in Tennessee are saving money on their health insurance this year

Tennessee's marketplace doesn't sell PPOs, only EPOs. But I can still arrange a nationwide PPO privately. Here's how a property sale affects your insurance choices and how to prepare before closing.

Sam Jaber, licensed health insurance broker

Hi, I'm Sam Jaber. I'm licensed to broker health insurance in 36 states, Tennessee included. Whether you own Memphis duplexes or short-term rentals near the Smokies, I can help you arrange coverage over the phone.

For Tennessee property investors, the year a rental sells can be very different from an ordinary year of collecting rent. Rental earnings alone might leave your household eligible for marketplace premium assistance. But when a property closes, the gain increases your annual income and may eliminate that assistance. Credits you've already received could then become money you must repay. Because Tennessee's marketplace offers only EPOs, a sale year is also an important time to compare private nationwide PPO coverage. Planning around that transaction before enrollment can help you understand both the insurance choices and the potential tax credit consequences.

You can still get a nationwide PPO in Tennessee

This year, Tennessee's marketplace has 158 individual medical plans available. Every plan is an EPO, with no PPO choices.

I can help you get a nationwide PPO privately in Tennessee. You'll complete a health questionnaire that determines underwriting and pricing. The network includes out-of-state physicians, which is useful when your family or investment properties are outside Tennessee.

How a sale shows up in your health insurance

Marketplace premium tax credits are based partly on your net rental income. Rental activity is generally reported on Schedule E, where expenses such as repairs, management fees, loan interest and depreciation reduce the amount counted. During a year when you're simply holding properties and collecting rent, that net figure may remain relatively modest. Selling a property changes the picture. The gain becomes part of household income in the year the sale closes and may move you well beyond the range where premium assistance is available.

If you collected advance credits based only on expected rent, any excess is reconciled with your tax return. For tax years after 2025, repayment isn't capped. Failing to report a closing could leave you responsible for the entire difference.

Scenario 1 of 3

You know a sale is coming

I'd start planning your health insurance while the property is being prepared for sale, before you enroll for the coming year. If the expected closing gain will put your household beyond the marketplace tax credit range, taking advance credits that you'll need to repay may not make sense. For healthy households, a private nationwide PPO deserves a price comparison. The carrier reviews your medical questionnaire and can approve coverage, decline the application, or approve it while excluding one condition. If someone in your family has an ongoing medical condition, tell me about it before ruling anything out. That condition matters to underwriting, but it doesn't decide the entire comparison by itself. I'll price both marketplace and private coverage for the year you're expecting the property to sell.

Scenario 2 of 3

The sale closed mid-year, and you were taking the credit

Report the closing promptly to HealthCare.gov. Lowering advance credits for the months left in the year can reduce your tax repayment.

Scenario 3 of 3

A holding year

Without a property sale, your household income may remain low enough to qualify for marketplace premium tax credits. In that situation, a subsidized EPO is generally the more affordable option. Just verify that your doctors participate in its network, since nonemergency out-of-network treatment usually isn't covered. A major renovation year can create a different problem by leaving you with almost no taxable income. Tennessee hasn't expanded Medicaid, so you need to account for that limited safety net. Keep your renovation receipts organized so you can accurately track the expenses affecting your income.

Timing the sale and the coverage

Here's how to plan your insurance around the year's transactions:

  • Listing in spring with a summer closing expected? Include the gain when choosing coverage for the entire year
  • Could the sale close in January instead? Have your preparer determine which tax year includes the gain, since that affects the coverage year
  • Receiving premium credits when the deal closes? Tell HealthCare.gov about the change during that month
  • Selling one property every few years from a larger portfolio? Your best coverage may change in sale years, then change back during holding years

This doesn't alter your tax liability. The goal is to choose health insurance based on your actual annual income, so a successful property closing doesn't leave you surprised by a premium credit repayment next spring.

Where the Tennessee figures come from

  • Tennessee's individual marketplace runs on HealthCare.gov; Tennessee is one of the states in the federal 2026 QHP Landscape file Source
  • All 158 individual medical plans on the Tennessee marketplace for 2026 are EPOs; none is a PPO Source
  • Net rental income and most IRA and 401(k) withdrawals count toward household income for marketplace savings Source
  • Rental income and expenses are generally reported on Schedule E Source
  • There is no cap on repaying excess advance premium tax credit for tax years after 2025 Source
  • Tennessee has not adopted the ACA Medicaid expansion Source

Questions real estate investors ask me

Straight answers, no sales pitch.

Does selling a rental affect my marketplace savings in Tennessee?

Yes. Your property's gain increases household income in the sale year and may put you beyond the premium credit threshold.

What if I already took the credit before the sale closed?

Report the income change immediately. Excess premium credits must be repaid without a cap for tax years after 2025.

Is there a PPO on the Tennessee marketplace?

No. Tennessee's 158 marketplace individual medical plans are all EPOs. I can arrange a private nationwide PPO for healthy investors.

Can I deduct premiums against rental income?

Check with your tax preparer. Business profit determines the self-employed deduction, while rental activity is generally listed on Schedule E.

Selling something this year?

Let me know your county, expected closing date, rental earnings and everyone needing insurance. I'll compare plan costs and explain how selling affects your choices.

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