I can help you arrange a nationwide PPO in West Virginia. Here's how a rental property investor in his late fifties, with cabins around Fayetteville, weighs insurance against rental earnings, a potential property sale and lengthy trips to see specialists.
Hi, I'm Sam Jaber. I hold broker licenses in 36 states, and I help West Virginia property owners arrange their own health insurance over the phone.
Consider a 58-year-old investor outside Fayetteville. He has four New River Gorge cabins that attract rafters, rock climbers and bridge-day visitors from spring through fall. He also rents three properties long-term in Oak Hill. He gave up salaried employment years back to manage the rentals full time, leaving him and his wife responsible for buying coverage. His cardiologist practices in Charleston, roughly an hour away on winding roads, while his wife visits a specialist in Beckley. Someone has now offered to buy a cabin, and he needs to understand how accepting that offer could change their health insurance.
For 2026, Fayette County residents can choose from 37 individual medical plans, the same selection offered throughout West Virginia. Two insurers participate: one sells all 15 PPOs, and the other sells all 22 HMOs. Prices are surprisingly close. For a 40-year-old buying silver coverage without a credit, the PPO is actually 3.5% less expensive than the HMO.
I also offer access to a private nationwide PPO in West Virginia, with pricing determined through medical underwriting. At 58, it's important to compare carefully, and I'll be upfront about which option makes more sense for you.
Being older makes premiums especially important. Marketplace insurers can charge adults different rates by age, within a maximum 3-to-1 ratio, and people in their late fifties are near the upper end. Your county also affects pricing. Fayette County's lowest-cost silver plan is 16% more expensive than the corresponding option in Berkeley and Jefferson counties.
Your income is the part you can influence. Marketplace calculations use rental profit after subtracting cleaning, platform charges, property maintenance, insurance, taxes and depreciation from bookings and rent. Premium credits depend on modified adjusted gross income and end above four times the federal poverty level. Selling a cabin means including the gain in that year's income.
Premium credits can make a substantial difference for an older couple. They help bridge the distance between an expensive benchmark premium and the amount your income says you should contribute. Locally, the silver PPO is generally attractive because it costs less than the HMO and contributes toward out-of-network treatment. An HMO normally won't pay for that care unless it's an emergency.
What matters most is where your specialists participate. If both your Charleston cardiologist and the Beckley specialist accept the PPO insurer's network, the decision is straightforward. But if either doctor participates only with the HMO insurer, we need to reconsider.
Next step: Give me your previous Schedule E and the names of both specialists. I'll compare Fayette County HMO and PPO prices after applying your credit.
Profit from selling a cabin might move your household beyond the credit threshold for that year. If you already received advance premium credits, the final amount gets reconciled on your tax return. For years after 2025, all excess credit must be returned. Once you're sure the sale will happen, update HealthCare.gov and prepare to pay full price if your income exceeds the limit.
When both spouses are healthy, it's worth putting a private nationwide PPO quote next to the full marketplace premium for the sale year. The insurer reviews medical history and can accept the application, accept it with one excluded condition or reject it. Healthy couples often qualify for premiums below unsubsidized marketplace rates. We'll examine the benefits before choosing.
Next step: Get in touch before agreeing to the sale. I'll compare marketplace coverage with private options using the income expected for that year.
Straight answers, no sales pitch.
In most cases, yes. A property's sale gain generally increases modified adjusted gross income for that year, potentially reducing or eliminating premium credits.
Yes. HealthCare.gov looks at rental profit, meaning the rent you collect after subtracting the expenses associated with those properties.
The PPO costs less. Throughout West Virginia, including Fayette County, the lowest-priced silver PPO is 3.5% below the lowest-priced silver HMO.
Yes, provided you qualify medically. I can quote private nationwide PPO coverage and compare it with the Fayette County marketplace choices for your household.
Share your location, both ages, the rental profit on last year's Schedule E and whether you expect to sell. I'll compare the coverage prices for that year and explain what I'd recommend.
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