With an average cost of $325 per month, Florida health marketplace provides a mix of options, including both the ACA and Short Term health coverage. You can purchase additional coverage, such as hospital indemnity, dental, or vision insurance - as stand-alone or supplementary plans. All health insurance sales in Florida are regulated by the Office of Insurance Regulation.
Here are the most common health insurance companies in Florida:
|Most Commonly Purchased Health Insurance Providers in Florida
(in alphabetical order)
|Also Offers Short Term Health Insurance|
|AIG Life Limited||NO|
|AXA Insurance Company||NO|
|Florida Blue (Blue Cross Blue Shield)||NO|
|New Era Life Insurance Company||NO|
|The Doctors Company||NO|
|Common Dental Insurance Providers in Florida|
|Florida Blue Dental|
|MCNA (Medicaid provider)|
|Metlife (State of Florida Employees)|
|MultiflexSM Dental insurance (Nationwide)|
|Common Vision Insurance Providers in Florida|
|VSP (Vision Service Plan)|
While there is no individual mandate that requires Florida’s residents to get private health insurance, businesses with 50 or more full-time employees are required by the federal law to offer health insurance benefits to all employees. The individual mandate penalty, which was assessed from uninsured individuals since the start of the Affordable Care Act in 2010 was eliminated in 2017, as part of the Tax Cuts and Jobs Act.
While Florida does not have its own state-based health insurance marketplace, residents can buy health insurance on the federally-run healthcare exchange.
On average private health insurance in Florida costs around $300-$500 for basic health coverage per person, while seniors on average spend $200-$300 per month. Persons applying with their families (spouses and/or children) may be able to get discounted rates. Florida is considered one of the states with the most expensive health insurance in the United States. Health insurance costs are determined by an individual’s lifestyle, age, gender, health status, underlying medical conditions, occupation, and smoking habits. In addition, the policy’s premiums, deductibles, copayments, and tax credits directly contribute to health insurance costs. The following is a breakdown of common health insurance packages in Florida:
Below are the key points about the types of health insurance available to the residents of Florida: ACA, Short-term health, Medicare, Social Welfare Programs, and Supplemental health care options.
Affordable Care Act health insurance incorporates all types of health insurance policies which meet the minimum coverage requirements outlined in the federal law. To be ACA-compliant, a health insurance plan must accept anyone who applies (without discrimination) and offer the 10 Basic Essential Health Benefits, which include preventive, pregnancy, emergency, and drug coverage. ACA insurance can be purchased only during certain times of the year, based on qualifications:
By default, all of the following health insurance in Florida is ACA-compliant and cannot discriminate against the insured:
Individual marketplace health plans (FL uses the Federal Healthcare marketplace)
Employer-offered (employer-sponsored) health insurance
Group health insurance
Government-sponsored plans (Medicare, Medicaid, Veterans Affairs healthcare, etc.)
FACT: Health insurance policies that are not ACA-compliant require more scrutiny of the terms by the consumer and the assisting agent.
Short-term health insurance is a temporary (non ACA-compliant) coverage, which can discriminate against the insured based on their health and pre-existing conditions. While some of the ACA’s essential health benefits, such as Preventive care, can be added to select short-term plans, most short term health insurance is primarily meant for emergencies only and typically has a high deductible. To help with covering the deductible in case of an emergency, a hospital indemnity plan is typically purchased as a supplement.
Short term health insurance is not sold on the health marketplace and typically requires you to speak to an agent. Unlike ACA coverage, which can be purchased only during certain times of the year or when offered, short term health insurance can be purchased year-round.
Short term health insurance can be right for Florida residents who are:
Florida Short-term Limited Duration Health Insurance can be purchased for a maximum consecutive term of 36 months (3 years). Note that there is no guaranteed renewal for Short-term plans. Therefore, individuals whose health worsens during the policy may be unable to renew their insurance, or their health condition may be excluded from their policy when they renew it. Always check your Short-term Limited Duration Health Insurance plan details to learn more about exclusions or coverage of pre-existing conditions.
NOTE: If your short-term insurance provider drops the coverage due to pre-existing or newly developed conditions, ACA insurance is the only one that can cover you.
Short-term plans benefit individuals who do not need regular medical care, like frequent doctor visits or expensive prescriptions. Note that this plan may make you ineligible for any guaranteed issue individual health plans in Florida.
Medicare in Florida is a government-sponsored program that provides low cost health insurance to residents aged 65 or older, who have worked and paid Medicare taxes for at least 10 years. Once qualified, Floridians can sign up for Medicare 3 months before their 65th birthday. However, a resident may be eligible to get it before age 65 if they have a disability, ALS (Lou Gehrig’s disease), or End-Stage Renal Disease (ESRD).
Low income Florida residents and their children can qualify for low-cost and even free health insurance through programs such as Florida State Medicaid and Florida KidCare (see Public Health section below).
Additional or stand-alone health insurance options are also called supplemental health insurance. They help cover healthcare costs like copayments, coinsurance, deductibles, and services typically not covered by basic health insurance plans. The common types of supplemental health insurance in Florida are:
Critical Illness health insurance plans are also available for specific conditions like cancer, stroke, or kidney failure. Some additional or stand-alone health insurance policies may cover food, medicine, transportation, and other expenses related to an illness or injury.
Yes, Florida offers public health insurance to the qualifying residents: Medicare, Medicaid, and Children’s health insurance program (read more).
A person looking to get a health policy may ask what health insurance should I get? Before choosing a health insurance plan in Florida, you should consider which plans meet your needs, budget, duration, and eligibility.
Read more about: Choosing between health insurance plans in Florida
You can get health insurance in Florida from the federal health insurance marketplace, through a broker/agent, an online brokerage, directly from the health insurance company, and through your or your spouse's employer. The health marketplace sells only ACA insurance and dental plans. Short term and supplemental plans are purchased through agents.
NOTE: Make sure to always read and understand the terms of the policy before binding the coverage. Seek the help of a Florida-licensed professional insurance agent for advice and to help you get better terms (a knowledgeable agent is able to negotiate some aspects of the coverage directly with the insurer).
Florida health insurance can be purchased:
Read about the “Steps of Applying for Health Insurance”
A health insurance deductible is the amount an insured in Florida must pay out of pocket to cover medical expenses before their insurance plan starts providing coverage. Florida deductibles differ based on the type and plan of health insurance:
For ACA health insurance, deductible is a part of the expenses that count towards the federally set Maximum Out of Pocket (MOOP) amount. In 2023, MOOP is $9,100 for an individual and $18,200 for a family (an increase from $8,700/$17,400 in 2022), which means that no ACA health plan in Florida can have a deductible higher than $9,100.
Short term health insurance in Florida does not have to follow ACA rules, and the deductible is typically between $5,000 to $15,000 per year.
Medicare plans can have deductibles as low as $0 per year, but the plans that offer higher deductibles have restrictions on how high they can get:
Copay, also known as a copayment, is the flat fee you pay to your medical service provider for a covered medical service every time you receive the service. For most plans, you pay a copay each time you visit your doctor or fill a prescription. For ACA insurance, copay is part of the overall annual Maximum out-of-Pocket limit. For short term health insurance here is no limit, and copay is defined by the policy.
Coinsurance is a percentage of your medical expenses shared between you and your insurance provider after you have paid your deductible. For instance, suppose your medical bill is $3,500, your coinsurance is 20%, and your deductible is $500; after you pay your deductible, what is left will be $3,000. You will then pay your 20% coinsurance of the $3,000, which is $600, while your insurer covers the remaining 80%, which is $2,400. Note that if your coinsurance percentage is high, your share of the medical bills will also be high. The main difference between coinsurance and copay is that copay is a fixed fee you pay every time you visit your doctor or fill a prescription, while coinsurance is a percentage of the total cost of covered services.
An open enrollment period is a specific yearly period during which you can sign up for ACA health insurance and cancel or change your current health plan. A person looking to get ACA health insurance in Florida may ask when is open enrollment for health insurance 2023 in Florida? The open enrollment period in Florida typically runs from November 1 through December 15, the same as the federal open enrollment. After this period, you may have to wait until the next open enrollment period to register or make any changes to your plan, except if you qualify for a special enrollment period triggered by a qualifying event. You qualify for SEP if you had to deal with certain life events, like losing health coverage, relocation, marriage, childbirth/adoption, or adopting a child, or your household income is a specified percentage below the FPL.
If you are left without health insurance coverage in between eligible enrollment periods, as a Florida resident you are able to purchase short-term health insurance as a temporary solution. Speak with your health insurance agent for more details about affordable health insurance options.