10/22/2025
🚨 “Private PPO” ≠ Real Health Insurance — Here’s the Truth
Lately, I’ve seen more ads floating around for “Private PPO” health plans — especially targeting people under 65 who buy through the Marketplace.
Let me be clear:
If it’s not sold on Pennie (the official Marketplace) or through a licensed agent offering ACA-compliant coverage, it’s not real health insurance.
These “Private PPOs” are usually indemnity or cost-sharing plans dressed up with fancy buzzwords. They’ll promise:
💬 “Any doctor, any time!”
💬 “Low monthly cost!”
💬 “Private network PPO!”
…but here’s what they don’t tell you:
🚫 They don’t cover pre-existing conditions
🚫 They have no maximum out-of-pocket limit
🚫 They can deny claims for major procedures
🚫 They don’t count as creditable coverage under the ACA
🚫 And when you actually need care… you’re often left paying the bill yourself
These plans look official, but they’re not regulated like real ACA-compliant insurance.
If you get sick or need surgery — they’ll send you a small check, not full coverage.
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✅ Real PPO plans are available through legitimate carriers like Geisinger, Highmark, Ambetter, Capital Blue, and UnitedHealthcare — and every one of those can be verified directly through Pennie.com or with a licensed local agent.
So before you click an ad or give your info online — call someone local and licensed.
I’ll happily review your options and make sure you’re protected with real insurance, not just paperwork with a logo on it.
📞 (570) 401-6816
📍 1100 Hwy 315, Wilkes-Barre
💙 Local, no-cost help — because your health coverage shouldn’t be a gamble.
