2026 Special Enrollment.
You May Qualify for Lower-cost Coverage Based on Carrier Updates.

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for You?

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PLAN TYPE OVERVIEW

Private PPO – Off-Marketplace Plans

Private PPO (Preferred Provider Organization) plans are health insurance options offered outside of the government marketplace. PPO plans are issued by national and regional carriers, and may offer broader provider networks and flexible access to care.
Private PPO coverage is typically selected by individuals who :
• Want access to a wide network of doctors and specialists
• Prefer the ability to see specialists without referrals
• Do not qualify for ACA subsidies or are above income limits
• Need coverage outside of Open Enrollment
• Are self-employed or seeking independent coverage options

What Private PPO Plans Include

Private PPO plans typically offer comprehensive medical coverage, which may include:
✓ Doctor and specialist visits
✓ Hospital and emergency services
✓ Prescription drug coverage
✓ Preventive care and wellness services
✓ Mental health and substance use treatment
✓ Nationwide or multi-state provider networks (depending on plan).
➤ Coverage details, deductibles, and benefits vary by carrier and state.

How Private PPO Pricing Works

Unlike ACA marketplace plans, private PPO coverage is not subsidized by the government.
• Premiums are based on age, location, and plan design
• Some plans may use medical underwriting, depending on state rules
• Costs and eligibility vary by carrier and state regulations
• Enrollment is available year-round, not limited to Open Enrollment
➤ A state-licensed EverAid advisor can help you review available plans and estimate potential savings before enrollment.

Who Private PPO Plans May Be Right For

Private PPO coverage may be a good option if you:
‍
✓ Want broad provider access and flexible care.
✓ Are above ACA subsidy income limits.
✓ Missed Open Enrollment and need immediate coverage.
✓ Are self-employed or running a small business.
✓ Prefer off-exchange plan designs and networks.
➤ These plans provide flexible, non-government marketplace coverage for individuals and families who want expanded provider choice and year-round enrollment access.

See PPO plans & prices available in your area

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