Can I keep my doctor with private PPO health insurance?

Yes. We verify your doctors are in-network before you enroll. Our licensed advisors only recommend health insurance plans that include your providers when available.

What is a private PPO health insurance plan?

Private PPO plans are off-exchange health insurance options available only through licensed agents like RKA. They often include broader nationwide networks and different cost structures than marketplace plans.

Do I qualify for health insurance savings?

Many households qualify for income-based premium tax credits on marketplace health insurance plans. Our licensed advisors estimate your monthly contribution and compare marketplace vs private PPO options.

When can I enroll in health insurance?

Private PPO health insurance plans are available year-round. Marketplace plans have Open Enrollment periods and Special Enrollment windows. Speak to one of our licensed advisors to verify what you're eligible for.

Private PPO • Miami, Florida

Health Insurance for Self-Employed Miamians: Private PPO vs. Marketplace

Fast take: Miami runs on self-employment — real estate, hospitality, international trade, creative and gig work — and a lot of that income lands above the ACA subsidy line. If you're paying full price on a Miami-Dade marketplace plan, you may be overpaying for a narrow HMO network. We compare private medically-underwritten PPO plans against the marketplace for your exact situation, verify your Miami doctors first, and tell you honestly which one wins.

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Miami-DadeWe cover all of Miami-Dade County

Above 400% FPLNo marketplace subsidy — the income cliff is back

Year-roundPrivate PPO plans enroll any month — no window

Why Miami's self-employed get hit hardest

Few places are as self-employed as Miami. Brickell consultants and finance pros, Coral Gables and Doral business owners, Wynwood and Little Havana creatives, real estate agents across Kendall and Aventura, hospitality and tourism workers on Miami Beach, and a deep 1099 and gig economy — much of this income is irregular and often above the subsidy threshold. That combination is exactly where the ACA marketplace stops helping: no subsidy, full-price premiums, and frequently a narrow HMO or EPO network that limits where you can get care.

Now that the enhanced subsidies have expired, the 400% federal-poverty-level cliff is back — so more Miami households are paying unsubsidized rates than in recent years. That's the moment to compare every option, not re-enroll on autopilot.

Marketplace vs. private PPO in Miami

Miami-Dade marketplace (ACA)

Strong value if your income qualifies for a subsidy
Guaranteed issue — covers pre-existing conditions and maternity
Often HMO/EPO with networks built around one system
Full-price premiums above the subsidy line
Enroll only during open enrollment

Private nationwide PPO

Priced on your health, not your income
Broad nationwide PPO network — no referrals
Helpful if you travel internationally or split time out of state
Enroll any month of the year
Medically underwritten — not everyone qualifies

Miami care networks matter. Before you switch anything, we verify your doctors and hospitals — whether that's Baptist Health South Florida, Jackson Health System, University of Miami Health (UHealth), Mount Sinai Miami Beach, or Nicklaus Children's for your kids. A broad PPO can keep more of these in-network than a regional marketplace HMO, but it always depends on the specific plan, which is why we check yours.

Who this fits in Miami

Self-employed, 1099, or small-business owners paying $500+/month unsubsidized
Real estate agents, consultants, creatives, hospitality and trade professionals
Healthy households above the subsidy line who want a bigger network
Snowbirds or frequent travelers who need coverage beyond South Florida
If you have significant health history or qualify for a strong subsidy, the marketplace is usually the better call — and we'll tell you so

See your Miami options — in about 60 seconds

We compare private PPO and Miami-Dade marketplace plans for your exact situation, verify your doctors, and show clear costs — free, no obligation.

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Frequently asked questions

Is this marketplace (ACA) insurance?

No. We're an independent, licensed Florida brokerage — not affiliated with HealthCare.gov. We compare private, off-marketplace PPO plans against your marketplace options. If you qualify for a meaningful subsidy, we'll tell you honestly the marketplace is probably your better deal.

Can I keep my Miami doctors on a private PPO?

Often yes — private PPOs use broad national networks that include many South Florida providers. But it always depends on the specific plan, so we verify your exact doctors and hospitals (Baptist, Jackson, UHealth, Mount Sinai, and others) before you enroll.

Who qualifies for a private plan?

Private plans are medically underwritten — they generally fit people in reasonably good health above the subsidy line. Those with significant pre-existing conditions are usually better served by a guaranteed-issue marketplace plan.

Can I enroll outside open enrollment?

Usually yes. Marketplace plans require open enrollment or a qualifying life event; private underwritten plans can be applied for any time of year, subject to health qualification.

Does it cost anything to work with you?

No. A licensed independent advisor is paid by the carriers, so comparing your options and enrolling costs you nothing.

Reviewed by Robert Adams

President & Licensed Agent, RKA Insurance Advisors · NPN 19540130 · (561) 806-9913

For educational purposes only. RKA Insurance Advisors is an independent, licensed health insurance brokerage, NPN 19540130, and is not affiliated with HealthCare.gov or any government agency. Plan availability, pricing, networks, and eligibility vary by carrier, plan, and county and are subject to change — confirm your specific doctors, prescriptions, and plan documents before enrolling. Private plans are medically underwritten and not ACA-compliant; not all applicants qualify. We do not offer Medicare. This content is not insurance, legal, tax, or financial advice.