Residents of the Sunshine State can enroll in a variety of health insurance plans if they purchase healthcare policies on their own. The most common is a comprehensive Affordable Care Act (ACA) health insurance plan from HealthCare.gov, website entities, private insurance companies.
Some carriers offer access to licensed insurance agents who can help enroll you over the phone, or you can buy directly online. If you need extra assistance, federal navigators may offer office appointments to get you enrolled in person.
Florida health insurance can be purchased during the Open Enrollment Period each year between Nov. 1-Jan. 15. Special Open Enrollment periods are available when you have a specific life situation that changes your health insurance status or if the federal government declares a special enrollment period.
More Read
What Are Your Options for Florida Health Insurance?
Affordable Care Act in Florida
Today, there are at least seven different insurance carriers offering Florida health insurance ACA plans. ACA plans (or Obamacare) come with ten essential benefits required by the law.
There are several different types of health insurance people can get in Florida.
Obamacare plans are tiered by “metal” level. Bronze plans are the most affordable, and Platinum plans are the most expensive. Bronze plans pay 60% of medical services, while the Platinum plans pay 90% of services after reaching your annual deductible.
A deductible is the amount of money you have to pay before your insurance company begins paying for the most coverage. ACA plans also offer you the opportunity to apply for a tax subsidy to lower the cost of health insurance. If you don’t qualify, you can look for additional policy options on the private marketplace.
Medicare in Florida
Medicare is for individuals 65 and older, although some people with disabilities can qualify before age 65. Medicare is a federal program that pays for approximately 80% of medical care and treatments.
You can add a Medicare supplement policy to help fill in the 20% coverage gap. You can also enroll in Medicare Advantage, which adjusts pricing based on income and includes extra coverage like dental, vision, and prescription drugs.
Medicaid and CHIP
Medicaid is health insurance coverage for eligible low-income adults, pregnant women, elderly adults, and people with disabilities. Medicaid is administered by Florida according to federal regulations and funded by both state and federal entities.
The Children’s Health Insurance Program (CHIP) in the state is Florida KidCare. CHIP is Medicaid that cares for medical needs from birth to the end of 18 years of age.
To be eligible for Medicaid, you must be a Florida resident, a U.S. national, citizen, permanent resident, or legal alien in need of health care/insurance assistance, whose financial situation would be characterized as low income. You must also be:
- Pregnant
- Be responsible for a child 18 years of age or younger
- Blind
- Have a disability or a family member in your household with a disability
You can also be 65 or older to qualify. To do so, your income cannot exceed $17,131 before taxes. This number increases based on household size.
Short-Term Health Insurance in Florida
Short-term health insurance is temporary medical coverage for when you’re in between more permanent health insurance. Prices are affordable but can have higher deductibles than ACA plans. They don’t cover preexisting conditions, and many don’t offer coverage for preventive care.
Health Insurance Costs in Florida
Affordable Care Act: The average price for an unsubsidized ACA health plan in Florida is $449 per month, which has dipped every year since 2018.
Medicare: The base rate for Medicare Part B is $148.50. However, costs vary based on your income and the plan selected.
Medicaid: Florida KidCare includes free, subsidized, and full-pay options based on total household income and family size. Costs range from $0 a month to up to $20 a month for all children in one household. Families who do not qualify for free or subsidized coverage can purchase an affordable full-pay plan.
Short-Term Health Insurance: For a 30-year-old woman in Florida, plans can run between $92 per month to nearly $600, depending on the level of coverage. Age, ZIP code and gender all play a factor in final rates.
Enrolling in Florida Health Insurance
Here are some specifics for enrolling in Florida health insurance:
Affordable Care Act
You can sign up for ACA plans online, over the phone, or in person. You can also apply for a financial subsidy online. Create an account at HealthCare.gov to see how much you can save with a tax subsidy.
If you don’t qualify for a subsidy, you can buy health plans online from a private marketplace or directly from a health insurance company. Contact a licensed agent from the website or from your area to learn what options are the best for your life situation.
If you want to speak with someone in person, consider scheduling time with an ACA plan Navigator or a licensed agent.
Medicare
If you qualify for Medicare, you can get started at Medicare.gov. If you desire Medicare Advantage or want to add a supplemental plan to your Original Medicare coverage, you can reach out to a private health insurance carrier or insurance agent to learn more.
Medicaid and CHIP
You can access the Agency for Health Care Administration for Medicaid (AHCA) to learn more about starting an online application or getting help with other community programs in person.
Short-Term Health Insurance
Short-term medical plans are purchased from private health insurance carriers online. You will want to do your research about what they cover, as sometimes health insurance won’t cover car accidents or similar causes of injury.
Next Steps
Applying for a health insurance plan can feel overwhelming. However, take the time to investigate. You can ultimately 1) qualify for a subsidy for an ACA plan, 2) qualify for Medicaid benefits due to a lower household income, 3) qualify for Medicare because you are turning 65 years old, or 4) benefit from a temporary short-term plan while deciding on a permanent policy.
If you take your time and do your research, you could find the best plan for your wallet and coverage needs.
Bio: Colleen McGuire is an independent consultant who has spent most of her career writing about healthcare and the health insurance industry. For fun she blogs, travels and takes a lot of pictures along the way.
