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. In every one of the 31 states we serve, Sam Jaber can get you a nationwide PPO plan. That includes the 11 states where the 2026 marketplace sells no PPO medical plan at all. The marketplace is one place to buy coverage, not the only one, so a marketplace with no PPO doesn't mean you can't have one.

• 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 went looking for a PPO and found only HMO and EPO plans on HealthCare.gov or your state's own marketplace, you're not imagining it. For 2026, 11 of the 31 states we serve have no PPO medical plan on the marketplace at all, and in 5 more a marketplace PPO is sold in only some counties. That's a limit of the marketplace, not a limit on you.

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

The marketplace, whether that's HealthCare.gov or the state-run exchange in Colorado, Georgia, Illinois, Kentucky, Maryland, Nevada or Virginia, sells the plans insurers choose to put on it. When no insurer files a PPO for your county, the marketplace has nothing to show you. It can't sell you a plan it doesn't carry.

Sam Jaber works with plans sold outside the marketplace that run on nationwide PPO networks, and he is licensed to offer them in all 31 states on this page. It makes no difference whether your county's marketplace has a PPO, a few, or none. Doctors and hospitals across the country can be in network, which matters if you travel for work, split the year between two states, or have a child at college somewhere else.

These plans are medically underwritten: the application asks about your health, and approval depends on the answers. So the right path for you depends on your income and your health, and the scenarios further down walk through each one.

PPO health insurance by state, 2026

Find your state. The middle two columns show what the 2026 marketplace sells: whether any PPO medical plan is on it, and in how many counties. The last column is the answer that matters, whether you can get a nationwide PPO through Sam Jaber, and it's yes in every row.

Added up: no marketplace PPO in 11 states, a PPO in only some counties in 5, in most counties in North Carolina, and in every county in 14. Even "every county" only means a PPO is on the shelf. In some of those states the marketplace PPO costs far more than the HMO plans beside it, and in others it doesn't, so its being there says nothing about whether it fits your budget.

Virginia's row counts its counties and its cities together, since Virginia's cities stand outside any county; its marketplace PPO reaches 7 of them, all in Northern Virginia, and 3 of those only in part. A county counts in this table if a PPO is sold in any part of it.

Why the marketplace in your state may have no PPO

A PPO pays for care from doctors in its network and also, at a higher cost to you, from doctors outside it, without a referral. HMO and EPO plans generally pay only inside their network, apart from emergencies. Insurers decide which of these network types to file in each state, and on the individual marketplace many have moved away from PPOs.

A 2025 analysis from the Robert Wood Johnson Foundation found that many insurers dropped their marketplace PPOs and replaced them with HMOs or EPOs, a change described as the tradeoff for keeping plans competitively priced. Nationally, it found 37% of residents lived in a state with no marketplace PPO.

So "no PPO on the marketplace" describes what insurers filed for 2026, not what you can buy. It also changes from year to year, since an insurer can add or drop a PPO for the next plan year, which is why the table carries a date.

Two things trip people up when they search. Many states with no PPO medical plan do sell PPO dental plans on the marketplace, so a search can return "PPO" results that turn out to be dental only. And a large HMO or EPO network inside your state still generally won't pay for routine care outside it.

If your income gets you a tax credit

Start with the one question that sorts everything else: does the income you expect qualify you for a premium tax credit? For coverage starting in 2027, chosen in open enrollment from November 1, 2026, the line is 400% of the federal poverty level, which is $63,840 for a single person. Under it, a marketplace plan with the credit is usually where you'll pay the least, even in a state whose marketplace has no PPO, because the credit works only on marketplace plans.

In that case the work is choosing the marketplace plan whose network includes your doctors, and getting your income estimate right so none of the credit comes back at tax time. How the subsidy cliff works explains what happens near the line.

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

This is where the table matters most. Above the credit line you pay the whole premium yourself. In the 11 states with no marketplace PPO, that full price buys an HMO, EPO or point-of-service network. In Georgia, Iowa, Nebraska, Virginia and Wisconsin, whether a marketplace PPO is even an option depends on your county.

For a healthy self-employed buyer in that spot, the usual next move is an underwritten plan on a nationwide PPO network, which Sam Jaber can offer in all 31 states on this page. Because the insurer reviews each applicant's health, it isn't pricing for everyone the way a marketplace plan has to, and that is how a healthy buyer can come out under the full marketplace price. The network reaches doctors in other states the same way it reaches the ones near home.

Two things to settle before you sign. Check the network for the doctors and hospitals you actually use, at home and wherever else you spend time. And read the benefit list, because it's the plan's own rather than the marketplace's standard set. Our guide to what medical underwriting means walks through the application.

If someone in your household has a health condition

Then a marketplace plan is usually the safer home, PPO or not. Marketplace plans have to accept you and can't charge more because of your health, while an underwritten plan can decline an application or exclude a condition you already have. Choose the marketplace plan that keeps your doctors and covers your medications, and if your county has a marketplace PPO, weigh what it adds against what it costs next to the HMO.

When only one person in the household has a condition and everyone else is healthy, the answer can differ from person to person, so talk it through before choosing one plan for everyone.

Where these numbers come from

The table counts plans in CMS's own plan-year 2026 files: the QHP Landscape file for the 24 states on HealthCare.gov (file 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 counted individual-market, on-exchange medical plans whose network type is filed as PPO, and the counties where at least one of them is sold. Dental-only plans are left out.

• What it measures: the network type each insurer filed with CMS for its 2026 marketplace plans. That is the insurer's own label, not a review of each plan's benefits, and a state regulator's summary can describe the same plans differently.
• What it doesn't measure: plans sold outside the marketplace, which is where the nationwide PPO plans Sam Jaber offers are sold. It says nothing about price either.
• Counties: for HealthCare.gov states, every county with a marketplace plan in the file. For the state-run exchanges, each state's full count of counties (in Virginia, counties plus the cities that sit outside them), which matches the counties those files list.
• Plan year: 2026 only. The 2027 marketplace, open for shopping from November 1, 2026, can differ.

To cite this table: Health for the Self-Employed, "PPO health insurance by state, 2026," counted from the CMS QHP Landscape and State-based Exchange QHP public use files for plan year 2026, published October 2026.

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