Health insurance for self-employed plumbers: the network is the decision
Working for yourself you will compare plans on the monthly figure, because that is the number the marketplace puts in front of you. For a plumber the number that decides whether the plan was any good is the network — specifically whether the hospital you would be taken to sits inside it.
What you are actually insuring against
The realistic claims for plumbers are back and shoulder injuries, and the occasional serious burn or laceration. None of that involves choosing a hospital calmly in advance. You go to the nearest capable facility, or the ambulance decides for you, and afterwards the only question is whether that facility was in the network attached to your plan.
Which is why buying on premium alone is the expensive mistake here. A plan sixty dollars a month cheaper that excludes the trauma centre nearest your usual jobsite is not cheaper.
Where the fallback exists, and where it does not
The PPO is the only common plan type that pays meaningfully toward a hospital outside its own network. Across the metros covered here it is sold in every county in Birmingham, Charleston, Charlotte, Detroit, Grand Rapids and Greenville and others — and not at all in Austin, Cincinnati, Cleveland, Columbus, Dallas-Fort Worth and Houston and others.
In a no-PPO market a wrong guess about your network has no cushion. In a PPO market it is expensive rather than ruinous. Same premium, very different exposure, and the marketplace listing will not spell that out for you.
The five-minute version
- Work out which hospital you would actually be taken to from your usual jobsite, not from your house.
- Check that hospital against the plan network, not the carrier name.
- If you work across a wide area, weight a PPO heavily wherever one exists.
- Check your own doctors separately from the hospital.
- Re-check at every renewal. Contracts change and nobody writes to warn you.
Which plans cover the hospital nearest your work?
Put in your ZIP and tell me the hospital or doctor that matters. I will check it against every plan filed in your county.