If you’ve been shopping for health insurance on the Marketplace, you might notice something missing—true PPO plans.

Many states, including Florida, have little to no PPO presence on the Marketplace. And where they do exist, these plans often behave more like HMOs—with narrow networks, strict rules, and little to no out-of-network coverage.

What People Expect from a PPO:

• Freedom to choose doctors without referrals

• The ability to see out-of-network providers (and still get partial coverage)

• Fewer restrictions and more nationwide access

That’s what a true PPO is designed to deliver. But here’s the truth:

👉 Most Marketplace plans that claim to be PPOs don’t actually work that way.

What’s Really Available?

✅ Marketplace Plans (in most states including FL):

• Primarily HMO or EPO structures

• Narrow local networks

• No coverage out-of-network (except emergencies)

• May require referrals or preapprovals

✅ Private PPOs (sold off-exchange):

• Access to larger national PPO networks

• True out-of-network benefits

• Usually paired with higher monthly premiums—but greater flexibility

Why This Matters If you’re someone who travels, sees out-of-network specialists, or wants to keep a specific provider, the label “PPO” on the Marketplace might mislead you.

Don’t assume the plan’s title tells the whole story.

How to Get the Coverage You Actually Want

• Don’t just look at the name—read the fine print.

• Ask for provider directories and network maps.

• Work with a licensed broker who can compare Marketplace and private options side by side.

Let’s Make PPO Simple Again We help clients across the country understand what kind of coverage they’re really buying. If having real PPO access matters to you, we’ll help you find it—or help you understand your next-best alternative.

Because label confusion shouldn’t cost you care.

Book a call and let’s walk through your options—clearly and simply.

Read more about your Health Insurance options at our: 

• Health Insurance page (link to page)

• ACA Marketplace page (link to page)

• Self Employed page (link to page)

#simplyforyourbenefit