Guarantee Issue Private PPOs: Year-Round Coverage Without Medical Underwriting | RKA
Guarantee issue private PPOs now available in select markets—year-round enrollment, nationwide networks, no medical underwriting required. Perfect if you missed Open Enrollment or need coverage with pre-existing conditions. We check availability in your ZIP.
Guarantee Issue Private PPOs Now Available – Year-Round Coverage Without Waiting for Open Enrollment
Fast take: New guarantee issue private PPO options are available in select markets—year-round enrollment, broad nationwide networks, and no medical underwriting required. If you need coverage outside Open Enrollment and don't have a Special Enrollment Period, this may be your path. We'll verify providers and show clear costs before you commit.
Need coverage now without waiting for Open Enrollment?
We'll confirm if guarantee issue PPOs are available in your ZIP, verify your doctors, and enroll you quickly.
Get Free Quotes Book a CallWhat makes guarantee issue PPOs different
For years, private PPO plans required medical underwriting—health questions that could result in denial or exclusions if you had pre-existing conditions. Guarantee issue private PPOs solve this problem by combining the best features of ACA Marketplace plans (no medical questions, guaranteed acceptance) with the advantages of private PPO networks (broader access, fewer restrictions, year-round availability).
Guarantee Issue
✓ No medical questions
✓ No health exams
✓ Cannot be denied
✓ Pre-existing conditions covered
✓ Coverage starts immediately
PPO Network Benefits
✓ Nationwide provider access
✓ No referrals for specialists
✓ Out-of-network coverage
✓ Major hospital systems included
✓ Travel-friendly coverage
Year-round enrollment
These plans are available outside the standard November-January Open Enrollment period. You can apply and start coverage any month of the year without needing a Qualifying Life Event.
Perfect if you:
✓ Missed the January 15 deadline
✓ Don't have a qualifying life event
✓ Need coverage immediately
✓ COBRA is too expensive
✓ Want to switch plans mid-year
Great for:
✓ Frequent travelers
✓ Multi-state households
✓ Specific doctor requirements
✓ Higher income (no subsidies)
✓ Pre-existing conditions
How guarantee issue PPOs compare
| Feature | Guarantee Issue PPO | ACA Marketplace | Underwritten PPO |
|---|---|---|---|
| Medical questions | None | None | Yes (can deny) |
| Enrollment window | Year-round | Open Enrollment only | Year-round (if approved) |
| Network type | Nationwide PPO | Often HMO/EPO | Nationwide PPO |
| Subsidies | No | Yes (if eligible) | No |
| Pre-existing conditions | May have exclusions & limits | Covered day 1 | Covered if approved & disclosed |
Simple next steps
1. Check availability
Not offered in all states or ZIP codes. We'll confirm immediately if these plans are available in your area.
2. Verify providers
Send your doctor list. We'll check network participation before you commit—even PPOs don't cover every provider.
3. Compare costs
We'll show total annual cost: premiums + deductibles + expected usage across all your options.
4. Enroll fast
Most plans start on the 1st or 15th of the month. We'll time your application to avoid coverage gaps.
Quick FAQs
Are guarantee issue PPOs available in all states?
No—availability varies by carrier and market. We'll check your specific ZIP code and confirm which options exist in your area.
How do premiums compare to Marketplace plans?
Often similar to unsubsidized Marketplace plans, but with PPO flexibility instead of HMO/EPO restrictions. If you qualify for Marketplace subsidies, the subsidized plan will almost always be cheaper.
Can I switch from a Marketplace plan to a guarantee issue PPO mid-year?
Yes, if you're willing to give up subsidies (if you have them). We'll compare total costs—including lost subsidies—before you make the switch to ensure it makes financial sense.
What if I have a serious pre-existing condition?
Guarantee issue means exactly that—no one can be turned down. Pre-existing conditions may have wait periods or exclusions.
For education only; availability and benefits vary by carrier, state, and ZIP code. Always review official plan documents.
Open Enrollment Shock: 2026 Rates & Out-of-Pocket Costs Jump as Subsidy Enhancements Roll Back
2026 Marketplace health insurance rates are out—and they’re higher across the board. Premiums, deductibles, and maximum out-of-pocket costs are all climbing as enhanced subsidies roll back. See how these changes affect families heading into Open Enrollment and explore lower-cost Private PPO options.
Oct 30 • Written by Robert Adams
Open Enrollment Shock: 2026 Rates & Out-of-Pocket Costs Jump as Subsidy Enhancements Roll Back
Fast take: 2026 Marketplace premiums are up, maximum out-of-pocket limits increased, and enhanced subsidies are rolling back. A typical family of four (two 36-year-old adults + two kids) saw the lowest Bronze option jump from $1,267/mo in 2025 (OOP max $9,200) to $1,667/mo in 2026 (OOP max $10,000).
Open Enrollment is here. If you simply “let it renew,” you’ll likely pay more in 2026—often for less protection. Rate filings show across-the-board increases driven by medical inflation and policy changes. With the enhanced subsidies rolling back, many middle-income families now feel the full price pressure.
What changed for 2026
- Premiums: Double-digit increases are common across Bronze/Silver/Gold.
- Max out-of-pocket: Raised again for 2026 (example above: $9,200 → $10,000).
- Subsidy rollbacks: The expanded tax credits that softened 2024–2025 pricing are fading, raising net costs for many households.
Real-world snapshot (family of 4)
- 2025 lowest Bronze: $1,267/mo • Deductible $6,500 • OOP max $9,200.
- 2026 lowest Bronze: $1,667/mo • Deductible $7,500 • OOP max $10,000.
Same family, same metal tier—meaningfully higher monthly cost and higher exposure before the plan pays fully.
Don’t renew blind. We compare ACA vs. Private PPO side-by-side and confirm your doctors.
Moves to make now
- Price the real year: Premium + expected usage (copays/coinsurance) + deductible + OOP risk.
- Check doctors & meds: Verify network and formulary before you enroll.
- Compare ACA vs. Private PPO: If you qualify medically, PPOs can cut total cost and OOP exposure.
We’ll verify your doctors/prescriptions, model 2026 costs, and enroll you correctly—no pressure, just answers.
Quick FAQs
Will 2026 increases hit me immediately?
Yes—your 2026 premium and OOP limits apply based on your effective date. We’ll confirm your exact numbers.
Are Private PPOs available in my state?
Often, yes (underwriting required). We’ll pre-screen and confirm networks.
Can you confirm my doctors are in-network?
Yes. That’s step one before we quote anything.
For education only; eligibility, benefits, and availability vary by carrier and state. Always review official plan documents.
Robert Adams
RKA Insurance Advisors • Private & Marketplace Health Coverage
561-806-9913 •
info@RKAinsuranceadvisors.com •
Book an Appointment
Government Shutdown & ACA Subsidies: What It Means for You
Federal subsidy delays could impact millions of Americans if a government shutdown continues. Learn how to protect your coverage and compare PPO alternatives before Open Enrollment 2026.
Open Enrollment 2026
Oct 1 • Written by Robert Adams
Nov 1, 2025 → Jan 15, 2026 (most states)
Coverage starts Jan 1, 2026
Coverage starts Feb 1, 2026
Premium hikes already on the horizon
According to insurer filings and multiple reports, 2026 premiums are projected to rise 10–18% on average, with some state requests topping 30%. That can mean hundreds more per month for unsubsidized families—and thousands annually. See the map below for where requests are running hottest.
If subsidies pause (shutdown/lapse), what actually happens?
- No one is “kicked off” a plan mid-month. Carriers still bill the full premium; the advance-credit portion can be delayed.
- Net premium could temporarily jump until payments resume or are reconciled at tax time.
- Eligibility doesn’t vanish. Credits reconcile on your tax return; amounts due can be settled then.
- Timelines matter. Short pauses may be smoothed by carriers; longer gaps create real cash-flow strain.
How to protect your wallet now
- Lock in your coverage window. Enroll early so your start date and network are set.
- Model the true annual cost. Premium + expected usage (copays/coinsurance + deductible + max OOP).
- Verify doctors & meds first. Keep your physicians in-network and Rx tiers on-formulary.
- Compare Marketplace vs Private PPO. If you don’t qualify for large subsidies, PPOs can beat exchange nets for access.
- Have a back-up payment plan. Be ready to bridge a month if a subsidy delay hits to avoid cancellation.
Not sure which option fits your family?
We’ll compare ACA vs PPOs, check doctors, and give you a clean cost forecast so you can enroll with confidence about 2026.
Get Free Quotes Book a CallQuick FAQs
Will a shutdown cancel my plan?
No — coverage continues, but billing may shift.
How much more could I pay?
Some families could see hundreds more per month unsubsidized if subsidies pause.
Can a Private PPO be cheaper than Marketplace?
Yes — depending on income, network, and benefits, PPOs may beat ACA net cost.
What if my subsidy is delayed?
Have a bridge plan (savings, credit, or employer coverage) to avoid cancellation risk.
Robert Adams • President & Licensed Agent • NPN 19540130
Licensed in AL, CO, DE, FL, GA, IA, IL, IN, KY, KS, LA, MD, MI, MO, MS, MT, NC, NE, NV, OH, OK, SC, SD, TN, TX, UT, VA, WI, WV, WY
For education only; eligibility and benefits vary by carrier and state. Always review official plan documents.