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Florida Health Insurance

Are you shopping for a Florida health insurance plan?  Discover affordable health plans from top insurance companies in the federal marketplace. Consider essential coverage that fits your budget, balancing deductibles and copayments. Seek expert guidance to find the right plan for your needs in the State of Florida.

 

 

Florida Health Insurance CrosswalkChoosing the Right Florida Health Insurance Plan

Choosing the right health plan starts by selecting and understanding what metal tiers are, as they directly relate to your expected healthcare needs and financial preferences. If you have predictable healthcare, consider a higher metal plan like Gold or Platinum which offers more comprehensive coverage. If you are generally healthy and prefer lower monthly costs, a lower metal plan like Bronze may be suitable, but it may have higher out-of-pocket expenses when you need medical care. Consider your health status and anticipated medical expenses to find a metal-tier plan that balances coverage and affordability.

  • Bronze Tier: The Bronze tier plans typically have the lowest monthly premiums but higher out-of-pocket costs when you receive medical services. These plans generally cover around 60% of your healthcare expenses, while you would be responsible for the remaining 40%. Bronze plans are a good choice for individuals who want to keep their monthly premium costs low and are relatively healthy with minimal medical needs.
  • Silver Tier: Silver-tier plans to strike a balance between premiums and out-of-pocket costs. They cover approximately 70% of your medical expenses, leaving you responsible for the remaining 30%. Silver plans also offer cost-sharing reductions (CSR) for eligible individuals, which further lower out-of-pocket expenses for those with lower incomes. These plans are suitable for individuals who need more coverage than what a Bronze plan offers but want to avoid higher premiums of Gold or Platinum plans.
  • Gold Tier: Gold tier plans have higher monthly premiums compared to Bronze and Silver plans but provide more extensive coverage. They typically cover about 80% of your medical costs, leaving you with 20% to pay out of pocket. Gold plans are a good fit for individuals who expect to have higher medical expenses and want more predictable and comprehensive coverage.
  • Platinum Tier: Platinum tier plans have the highest monthly premiums but the most comprehensive coverage. They cover around 90% of your healthcare expenses, and you are responsible for the remaining 10%. Platinum plans are ideal for individuals who frequently use medical services and want the most extensive coverage with minimal out-of-pocket expenses.

 

 

Lowest-Costing Florida Health Insurance Plans by County

There are numerous budget-friendly FL health insurance plans available offering essential coverage without overwhelming financial resources and ensuring access to quality medical care. Below is a listing of the least expensive health insurance plans by county:

 

CountyCostInsurance company & Plan NameMetal Level
Alachua$372.82Ambetter Clear BronzeBronze
Baker$388.04Ambetter Clear BronzeBronze
Bay$357.59FloridaBlueHMO myBlue Bronze 2311SBronze
Bradford$412.25Ambetter Clear BronzeBronze
Brevard$332.60Ambetter Clear BronzeBronze
Broward$327.04AmeriHealth Caritas Next BronzeBronze
Calhoun$362.07Ambetter Clear BronzeBronze
Charlotte$326.81Ambetter Clear BronzeBronze
Citrus$349.68Florida Blue BlueSelect Bronze 2341SBronze
Clay$339.25Molina Core Care Bronze 8Bronze
Collier$373.25FloridaBlueHMO myBlue Bronze 2321SBronze
Columbia$399.37Ambetter Clear BronzeBronze
Desoto$384.66Ambetter Clear BronzeBronze
Dixie$418.69Ambetter Clear BronzeBronze
Duval$324.97Ambetter Clear BronzeBronze
Escambia$377.81Florida Blue BlueSelect Bronze 2341SBronze
Flagler$372.93FloridaHCP Bronze HMO OA Standard 2440Bronze
Franklin$381.56Ambetter Clear BronzeBronze
Gadsden$364.64Capital Health Plan HMO Bronze 1000Bronze
Gilchrist$445.64Ambetter Clear BronzeBronze
Glades$492.05Ambetter Clear BronzeBronze
Gulf$344.19Ambetter Clear BronzeBronze
Hamilton$542.85Ambetter Clear BronzeBronze
Hardee$521.30Ambetter Clear BronzeBronze
Hendry$425.73FloridaBlueHMO BlueCare Bronze 2361SBronze
Hernando$360.75Florida Blue BlueSelect Bronze 2341SBronze
Highlands$353.22Ambetter Clear BronzeBronze
Hillsborough$332.28Ambetter Clear BronzeBronze
Holmes$394.11FloridaBlueHMO myBlue Bronze 2311SBronze
Indian River$347.93FloridaBlueHMO myBlue Bronze 2321SBronze
Jackson$375.92Ambetter Clear BronzeBronze
Jefferson$346.31Ambetter Clear BronzeBronze
Lafayette$448.93Florida Blue BlueOptions Bronze 2301SBronze
Lake$343.61Ambetter Clear BronzeBronze
Lee$393.12UHC Bronze Standard Bronze
Leon$329.66Capital Health Plan HMO Bronze 1000Bronze
Levy$409.7FloridaBlueHMO myBlue Bronze 2311SBronze
Liberty$373.47Ambetter Clear BronzeBronze
Madison$394.91Capital Health Plan HMO Bronze 1000Bronze
Manatee$333.82Ambetter Clear BronzeBronze
Marion$312.49Ambetter Clear BronzeBronze
Martin$376.91Cigna Simple Choice 9100Bronze
Miami-dade$321.57AmeriHealth Caritas Next BronzeBronze
Monroe$553.57Florida Blue BlueSelect Bronze 2341SBronze
Nassau$395.52Ambetter Clear BronzeBronze
Okaloosa$387.82Ambetter Clear BronzeBronze
Okeechobee$397.68FloridaBlueHMO myBlue Bronze 2311SBronze
Orange$359.69Ambetter Clear BronzeBronze
Osceola$352.21Ambetter Clear BronzeBronze
Palm Beach$360.55Aetna CVS Bronze SBronze
Pasco$350.84Ambetter Clear BronzeBronze
Pinellas$332.92Ambetter Clear BronzeBronze
Polk$348.61Ambetter Clear BronzeBronze
Putnam$380.27Ambetter Clear BronzeBronze
Saint Johns$308.46Ambetter Clear BronzeBronze
Saint Lucie$362.07Aetna CVS Bronze SBronze
Santa Rosa$371.40FloridaBlueHMO myBlue Bronze 2311SBronze
Sarasota$329.15Ambetter Clear BronzeBronze
Seminole$366.23Health First Bronze Savings 1820Bronze
Sumter$311.99Ambetter Clear BronzeBronze
Suwannee$400.06Ambetter Clear BronzeBronze
Taylor$432.43Florida Blue BlueOptions Bronze 2301SBronze
Union$494.17Ambetter Clear BronzeBronze
Volusia$335.05Ambetter Clear BronzeBronze
Wakulla$341.74Ambetter Clear BronzeBronze
Walton$361.74Ambetter Clear BronzeBronze
Washington$436.71Florida Blue BlueOptions Bronze 2301SBronze

 

Lowest-Costing Florida Health Insurance Plans by Metal Level

The table below is a listing of the least expensive Florida health insurance plans sorted by metal level.

 

Metal LevelCostPlan Name
Bronze$321.57AmeriHealth Caritas Next Bronze
Silver$441.83FloridaBlue myBlue Connected Care Silver 2332
Gold$436.75Ambetter CMS Standard Gold VALUE
Platinum$853.76FloridaBlue BlueSelect Platinum 1451
*based on a healthy 35-year-old individual in Miami, Florida.

 

 

Lowest-Costing Florida Health Insurance Plans by Insurance Company 

There are currently eight health insurance companies operating in Florida that sell health plans to individuals and families. Below is a listing of the least expensive plan options that are sorted by Health Insurance companies.

 

Insurance companyCostPlan NameDescription
Aetna CVS Health$366.09Bronze SDeductible: $7,500
PCP:$50
Specialist: $100
Ambetter$367.67Standard Expanded Bronze VALUEDeductible: $7,500
PCP:$50
Specialist: $100
AmeriHealth Caritas Next$321.57Next BronzeDeductible:$9,100
PCP:$0 after deductible
Specialist: $0 after deductible
AvMed$451.37Entrust Bronze 650 (2023)Deductible: $8,200
PCP: $75
Specialist: $0 after deductible
Cigna Healthcare$386.99Simple Choice 9100Deductible:$9,100
PCP:$0 after deductible
Specialist: $0 after deductible
Florida Blue$482.07BlueSelect Bronze 2341SDeductible:$9,100
PCP:$0 after deductible
Specialist: $0 after deductible
Florida Blue HMO$359.82myBlue Bronze 2311SDeductible:$9,100
PCP:$0 after deductible
Specialist: :$0 after deductible
Molina Healthcare$371.09Core Care Bronze 8Deductible: $7,500
PCP:$50
Specialist: $100
UnitedHealthcare$368.28Bronze Standard $9,100Deductible:$9,100
PCP:$0 after deductible
Specialist: $0 after deductible
*based on a healthy 35-year-old individual in Miami, Florida.

 

Florida Provider LogoHealth Insurance Carriers

Florida doesn’t operate its own health insurance marketplace, but rather it’s part of the federal government marketplace known as Healthcare.gov. Below is a listing of all the health insurance companies that Florida residents can find offering  both individual and group health insurance  options:

 

Aetna CVS Health

Ambetter from Sunshine Health

AmeriHealth Caritas Next

AvMed

Cigna Healthcare

Florida Blue

Molina Healthcare

UnitedHealthcare

 

These reputable carriers collectively contribute to the comprehensive array of health insurance plans available, ensuring that Floridians have access to various choices tailored to their specific needs and preferences.

 

 

Florida Health Insurance HeartFlorida Health Insurance Statistics and Figures

The information below provides a comprehensive insight into Florida’s health insurance landscape. The insured population of 17,716,700 showcases significant progress in coverage, but 2,588,100 individuals are still uninsured this year. This 2023, the average health insurance premium is $471, 3.20% more expensive than the previous year. While Florida has made substantial strides in expanding coverage, addressing the remaining uninsured individuals and managing premium costs remain crucial challenges for the future.

 

Insured (2021)17,716,700
Uninsured (2021)2,588,100
Ave. cost of Health Insurance (2023)$471
Change from Prev. Year's Ave. Premium (2022-2023)3.20%
*based on the kff.org dataset

 

Florida Health Insurance BookHealth Insurance Terms to Learn When Getting a Plan

Understanding the most basic health insurance terms is vital to making informed decisions about your coverage, comparing different plans, and effectively managing your healthcare expenses.

Premium: The premium is the amount you pay to the health insurance company regularly, usually monthly, to maintain your coverage. It is a fixed cost, regardless of whether you use healthcare services or not.

Deductible: The deductible is the amount you must pay out of pocket for covered medical services before your insurance starts to pay. For example, if you have a $1,000 deductible, you are responsible for paying the first $1,000 of covered medical expenses before your insurance coverage kicks in.

Co-payment (Co-pay): A co-payment is a fixed amount you pay for certain medical services, such as doctor visits or prescription drugs, at the time of service. Co-payments are typically a specific dollar amount (e.g., $20 per doctor visit) and can vary depending on the service.

Coinsurance: Coinsurance is the percentage of the cost of a covered healthcare service that you are responsible for paying after you’ve met your deductible. For instance, if your insurance plan has a 20% coinsurance for hospitalization, you would pay 20% of the covered costs, and the insurance company would cover the remaining 80%.

Out-of-Pocket Maximum (OOP Max): The out-of-pocket maximum is the highest amount you have to pay for covered medical services in a given year. Once you reach this limit, your insurance company covers 100% of the remaining covered medical expenses for the rest of the year.

Network: A network refers to a group of doctors, hospitals, and other healthcare providers that have contracted with a specific insurance company to provide services at discounted rates. Staying in-network usually results in lower out-of-pocket costs for the insured individual.

Out-of-Network: Out-of-network providers are healthcare professionals or facilities that do not have agreements with your insurance company. If you use an out-of-network provider, you may have higher costs, and some services may not be covered.

Enrollment Periods: For plans offered through the Health Insurance Marketplace, 

Open Enrollment Period (OEP) occurs once a year, typically from November 1 to December 15, allowing individuals to enroll in or change health insurance plans for the upcoming coverage year through the Health Insurance Marketplace or their employer. Special Enrollment Period (SEP) Allows individuals to enroll in or change health insurance plans outside of the regular Open Enrollment period due to qualifying life events such as marriage, birth of a child, losing other health coverage, moving, or changes in household income. Medicare Initial Enrollment Period (IEP) is available for those eligible for Medicare, lasting seven months, beginning three months before the 65th birthday and ending three months after, allowing enrollment in Medicare Part A, Part B, Part D, and Medicare Advantage plans.

 

 

Florida Health Insurance ShieldFree Health Insurance Options in Florida

In Florida, there are several free or low-cost health insurance options available to eligible individuals and families who meet specific criteria. These programs aim to provide essential healthcare services and coverage to those with limited financial resources. Here are some of the main options:

Medicaid: Medicaid is a state and federally-funded program that offers free or low-cost health coverage to low-income individuals and families, including pregnant women, children, parents, and adults with disabilities. Eligibility is based on income and other factors.

Florida KidCare: Florida KidCare is Florida’s version of the Children’s Health Insurance Program (CHIP), providing free or low-cost health insurance to children in families with incomes that exceed Medicaid limits but still need affordable coverage.

Marketplace Health Insurance with Subsidies: The Health Insurance Federal Marketplace in Florida, also known as Healthcare.gov, offers private health insurance plans with subsidies (premium tax credits and cost-sharing reductions) for individuals and families with low to moderate incomes. These subsidies help lower the monthly premiums and out-of-pocket costs.

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