I can help you get a nationwide PPO in Delaware, even outside the marketplace. Let's look at how a Sussex County real estate agent in her early sixties, whose business focuses on retirees, can cover the remaining years before she's eligible for Medicare.
Hi, I'm Sam Jaber. I help people choose health insurance, and I'm licensed as a broker in 36 states. Delaware real estate agents can work through their coverage choices with me entirely by phone.
Consider a 62-year-old agent based in Milton. Much of her business comes from buyers who are around her age or older, leaving Baltimore, northern New Jersey and the Philadelphia suburbs for retirement communities serving people 55-plus around Long Neck, Millsboro and Milton. Sales are going well, but closings aren't predictable because retirees move according to their own timelines. She left corporate employment several years earlier, which means she has no employer-sponsored coverage. Medicare remains three birthdays away. Most of her physicians practice in Lewes, while her cardiologist is over the Maryland border in Salisbury.
For 2026, Delaware's three counties have access to the same marketplace selection: 40 individual medical policies offered by three insurance companies. One insurer provides all 17 EPOs, another offers 15 PPOs, and the remaining company sells 8 HMOs. PPO coverage comes at a premium. For someone age 40 before subsidies, the lowest-priced silver PPO is 6% above the lowest-priced silver HMO and 18% above the lowest-priced silver EPO.
I can also help you apply for a private nationwide PPO in Delaware, with the price determined through medical underwriting. At age 62, that comparison deserves some attention, and I'll explain clearly which choice makes more sense for your circumstances.
Age has a substantial effect on marketplace premiums, with adult pricing allowed to vary by as much as 3 to 1. Someone in her sixties is near the expensive end of that scale. Delaware's unsubsidized premiums also increased significantly: KFF reports that the average benchmark silver premium for a 40-year-old increased 29.4% between 2025 and 2026.
Because premiums are higher at your age, the tax credit can provide more value than it would for a younger agent. Eligibility generally covers household income between 100% and 400% of the federal poverty level for the coverage year. For you, that means commissions after brokerage splits and expenses such as dues, advertising and travel between Lewes and Long Neck.
If you qualify for the credit, your main 2027 comparison will be between the two insurers identified by the Insurance Department for next year. The company responsible for the lowest-priced silver EPOs during 2026 isn't included. Looking at the remaining companies' 2026 prices, the silver PPO carried a 6% premium over the silver HMO.
An HMO generally restricts nonemergency coverage to its participating providers. A PPO can contribute toward out-of-network care, although your share of the bill is higher. Since your cardiologist practices in Salisbury, we should verify whether that office participates before comparing premiums. If the HMO includes your cardiologist, it will probably be the better value with the credit. Otherwise, paying extra for the PPO may make sense.
Next step: Send me the names of your physicians, especially your cardiologist in Salisbury, and your expected commissions for next year. When the 2027 policies become available, I'll compare both insurers' offerings with your premium credit included.
If your household's closings bring income above four times the poverty level, the premium credit disappears. Paying the entire marketplace premium at your age can be expensive. That's when we should compare a private nationwide PPO. The insurer evaluates your medical history and can approve coverage, approve it with one excluded condition, or reject the application. Healthy agents often receive quotes below unsubsidized marketplace premiums. I'll explain the benefits of each option before you make a commitment.
Next step: Once you've received most of this year's closing commissions, give me a call. We'll compare a private nationwide PPO quote against marketplace coverage without subsidies.
You're allowed to remain on marketplace insurance until Medicare begins. Just remember that your marketplace policy won't automatically terminate when Medicare starts. You'll need to cancel it yourself at that point so you aren't continuing to pay for coverage you no longer need.
Straight answers, no sales pitch.
Yes. Looking at 2026 prices before subsidies, Delaware's lowest-priced silver PPO carries a premium that's 6% higher than the lowest-priced silver HMO.
The Delaware Insurance Department identified two insurers in its announcement of 2027 rates. The insurer responsible for all the marketplace EPOs in 2026 wasn't included.
Yes. Marketplace coverage can continue right up to Medicare eligibility, but you'll need to cancel the policy yourself once your Medicare coverage begins.
Yes, provided your medical history meets the insurer's requirements. I'll quote a private nationwide PPO alongside marketplace coverage so you can compare the two.
Let me know your date of birth, whether anyone else needs to be insured and approximately how much you'll keep from commissions this year. I'll compare Delaware marketplace coverage with a private nationwide PPO for the remaining years before you turn 65.
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