Can you get PPO health insurance in your state? Yes. Here's where the marketplace has none.

Sam Jaber, Licensed Health Insurance Advisor · Updated October 2026 · Last reviewed October 1, 2026

NPN 20698748 · Licensed in all 31 states on this page · Licensing details

Yes. Sam Jaber offers nationwide PPO coverage in all 31 states we serve, including the 11 where no PPO medical plans are available through the 2026 marketplace. Just because your state's marketplace doesn't offer a PPO doesn't mean you're out of luck. The marketplace is one way to get insured, but it isn't your only way.

• Find my state
• Why some marketplaces have none
• My income gets me a credit
• I'm priced out and healthy
• Someone in my house has a condition
• Where the numbers come from

If you've checked HealthCare.gov or your state marketplace for PPO coverage and keep seeing HMOs and EPOs instead, there's a reason. In 2026, the marketplace offers no medical PPO in 11 of our 31 states, while another 5 offer PPOs in select counties only. That restriction applies to what's sold through the marketplace, not necessarily to the coverage you can get elsewhere.

Yes: a PPO is available through Sam in every state on this list

HealthCare.gov and the state exchanges in Colorado, Georgia, Illinois, Kentucky, Maryland, Nevada and Virginia can only offer coverage that insurance companies make available through them. If insurers haven't submitted a PPO plan for your county, you won't find one listed there. The marketplace simply cannot offer coverage that no insurer has placed on it.

Outside the marketplace, Sam Jaber can help you access plans using nationwide PPO networks throughout all 31 states where he's licensed on this page. Whether your county offers several marketplace PPOs or none doesn't change that. These networks can include providers and hospitals nationwide, which is particularly helpful when your job takes you across state lines, you live in two states during the year, or your child attends college away from home.

With these plans, medical underwriting is part of the process. You'll answer questions about your health, and the insurer uses those answers to decide whether to approve you. Your income and medical situation help determine which direction makes sense, as the examples below explain.

PPO health insurance by state, 2026

Look up your state below. The two center columns tell you whether the 2026 marketplace offers medical PPO coverage and how many counties have access. The final column shows something different: whether Sam Jaber can help you obtain a nationwide PPO. You'll see yes listed for every state.

Here's the breakdown: 11 states have no marketplace PPO, 5 offer one in select counties, North Carolina has coverage in most counties, and 14 have one in every county. But availability alone doesn't tell you what you'll pay. Some states have marketplace PPO premiums substantially higher than their HMO alternatives, while others don't. Having a PPO available doesn't automatically make it affordable for your household.

For Virginia, we've included both counties and cities in the total because its cities are separate from counties. Marketplace PPO coverage extends to 7 of those areas, all in Northern Virginia, with 3 having only partial availability. Throughout this table, we count a county whenever a PPO is offered anywhere within its boundaries.

Why the marketplace in your state may have no PPO

With a PPO, you can see providers within the network or go outside it for a higher out-of-pocket cost, without needing referrals. HMOs and EPOs typically restrict covered care to network providers, except during emergencies. Insurance companies choose which network structures to offer in each state, and many have stopped offering PPOs through the individual marketplace.

According to a 2025 Robert Wood Johnson Foundation analysis, numerous insurers replaced marketplace PPO coverage with HMO or EPO plans. The analysis described this shift as a compromise insurers made to maintain competitive pricing. It also found that 37% of Americans lived in states without any marketplace PPO option.

When you hear that a marketplace has no PPO, it means insurers didn't offer one there for 2026. It doesn't mean PPO coverage is unavailable everywhere else. Insurers can introduce or discontinue PPO offerings each plan year, so the information in this table is tied to a specific year.

There are two common sources of confusion. First, marketplaces in many states offer PPO dental coverage even when they have no PPO medical coverage, so search results can be misleading. Second, an HMO or EPO might have a broad network within your state but still generally exclude routine treatment outside that network.

If your income gets you a tax credit

Before comparing plans, figure out whether your projected income qualifies for a premium tax credit. For 2027 coverage selected during open enrollment beginning November 1, 2026, the cutoff is 400% of the federal poverty level, or $63,840 for one person. If you're below that threshold, subsidized marketplace coverage will generally cost less, even where no marketplace PPO exists. That's because premium tax credits are available only for plans purchased through the marketplace.

If you qualify, focus on finding a marketplace plan that covers your doctors while making sure your income projection is accurate. You don't want to repay credits when filing taxes. How the subsidy cliff works breaks down what happens when your income approaches that cutoff.

If you make too much for a credit and you're healthy

This is the situation where our state table becomes especially useful. Once your income exceeds the tax credit threshold, you're responsible for the entire premium. In 11 states, marketplace coverage means choosing an HMO, EPO or point-of-service network because no PPO is offered. In Georgia, Iowa, Nebraska, Virginia and Wisconsin, your county determines whether a marketplace PPO is available.

If you're self-employed, healthy and paying full marketplace premiums, consider a medically underwritten plan with a nationwide PPO network. Sam Jaber offers access to these plans throughout the 31 states listed here. Unlike marketplace coverage, insurers evaluate applicants' health before setting eligibility, which can mean lower premiums for healthy buyers. The PPO network can also include doctors beyond your home state, giving you access to providers elsewhere.

Before enrolling, make sure of two things. First, verify that the network includes the doctors and hospitals you use, both locally and in other places you visit. Second, review exactly which benefits are included, since these plans don't follow the marketplace's standard benefit package. Read what medical underwriting means for an explanation of the application process.

If someone in your household has a health condition

The marketplace isn't necessarily your only choice. Whether private coverage makes sense comes down to your circumstances. If your county offers a marketplace PPO, compare it with the HMO as well. Sam Jaber can help you review the different possibilities.

If one family member has a medical condition while the others are healthy, the best coverage choice may not be identical for everyone. It's worth discussing those differences before putting the entire household on one plan.

Where these numbers come from

Our table uses CMS plan-year 2026 data, including the QHP Landscape file covering 24 HealthCare.gov states, dated August 26, 2026, and the State-based Exchange public use files for Colorado, Georgia, Illinois, Kentucky, Maryland, Nevada and Virginia, dated May to June 2026. We identified on-exchange individual medical plans classified as PPOs and counted counties with at least one available PPO. Plans providing dental coverage only were excluded.

• What we're counting: the network classification insurers submitted to CMS for their 2026 marketplace offerings. We're using the insurer's reported network type, not evaluating individual plan benefits. State insurance regulators may categorize those same offerings differently in their summaries.
• What's excluded: coverage offered off the marketplace, including the nationwide PPO plans available through Sam Jaber. The figures also don't tell you anything about premiums.
• County counts: in HealthCare.gov states, we included every county showing marketplace coverage in the data. For state exchanges, we used each state's complete county count, including Virginia's separate cities, consistent with the geographic areas identified in those files.
• Coverage year: these figures apply to 2026. Marketplace offerings may change for 2027, when enrollment shopping begins November 1, 2026.

Source for this table: Health for the Self-Employed, "PPO health insurance by state, 2026." Figures were calculated using CMS QHP Landscape and State-based Exchange QHP public use files covering the 2026 plan year, released October 2026.

Common questions