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Florida Health Insurance Guide
From its sun-drenched beaches and vibrant theme parks to the unique ecosystems of the Everglades, Florida remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances.
If you’re currently without coverage, here’s what you need to know about getting insured in Florida.
Health Insurance Options in Florida
Florida offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:
Employer-Sponsored Insurance
Many Floridians receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.
ACA Marketplace Plans (HealthCare.gov)
Individuals and families without employer coverage can shop for insurance through Florida’s official ACA marketplace at HealthCare.gov.
Subsidies may be available to reduce premium costs based on your income and household size, even if you are unemployed. You can check your eligibility using our ACA Subsidy Calculator.
Marketplace Plans:
- Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
- Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
- Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
- Platinum (if available): Highest premiums, lowest out-of-pocket costs.
Metal Tier Breakdown:
| Metal Tier | Insurance Company Pays | Consumer Pays |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Catastrophic plans are also available through the Marketplace for individuals under the age of 30, or those over 30 who qualify for a hardship exemption (e.g., eviction, high medical debt, bankruptcy). These plans cover essential health benefits but generally have lower premiums and higher deductibles.
Medicaid Florida’s Statewide Medicaid Managed Care (SMMC) program provides free or low-cost coverage for eligible low-income residents and families. Benefits typically include preventive care, hospital visits, mental health, prescriptions, and more. To see if you qualify, visit the Florida Medicaid website.
Student Health Insurance
College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans—making Florida student health insurance accessible and flexible for a wide range of needs.
Children’s Health Insurance Program (CHIP)
Known as Florida KidCare, this program helps children and pregnant women in families that earn too much for Medicaid but need affordable insurance. Florida KidCare is a brand name for four programs: Medicaid, MediKids, Florida Healthy Kids, and the Children’s Medical Services (CMS) Health Plan, providing seamless coverage from birth until the 19th birthday.
Medicare
Medicare plans are available for residents age 65 and older and younger individuals with qualifying disabilities. Options include:
- Medicare Advantage (Part C)
- Medicare Advantage is an alternative to Original Medicare offered by private insurers to those enrolled in Parts A and B. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
- Prescription Drug Plans (Part D)
- Medicare Part D provides prescription drug coverage for anyone with Medicare, helping pay for medications and many vaccines. Offered by private insurers, these plans vary in cost and coverage and can be joined during specific enrollment periods.
- Medicare Supplement (Medigap)
- Medicare Supplement plans, or Medigap policies, help cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare (Parts A and B) lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.
COBRA Coverage If you’ve recently lost job-based insurance, COBRA allows you to continue your employer coverage temporarily, typically at full cost.
Short-Term Plans Short-term medical plans are available in Florida with initial terms of up to 3 months and a total duration, including renewals, of up to 4 months as of September 1, 2024, aligning with federal regulations. These plans are not regulated by the ACA, do not provide comprehensive coverage, and can deny coverage based on pre-existing conditions. They are generally suited for temporary gaps in coverage.
Enrollment Periods in Florida
Open Enrollment for 2025 Coverage: November 1, 2025 – December 15, 2025
During this window, all eligible residents can apply for, renew, or change their marketplace health plans.
Special Enrollment Period: Available year-round for those experiencing qualifying life events such as:
- Job loss
- Marriage or divorce
- Birth/adoption of a child
- Relocation
- Change in income
You typically have 60 days from the event to enroll.
Health Insurance Providers in Florida
As of 2025, insurers typically offering individual and family plans through HealthCare.gov in Florida include:
- Florida Blue
- Aetna CVS Health
- Ambetter from Sunshine Health
- Oscar Health
- Molina Healthcare
- UnitedHealthcare
- Cigna
- Humana
Plan availability may vary by county or zip code.
Understanding Health Insurance Costs
When selecting a plan, be sure to understand these common cost terms:
- Premium: Monthly payment to maintain your plan.
- Deductible: What you pay before insurance covers services.
- Copayment (Copay): Fixed amount per visit/service.
- Coinsurance: Shared costs with your insurer after the deductible.
- Out-of-Pocket Maximum: Your yearly cost cap for covered services.
- In-Network vs. Out-of-Network: Staying in-network helps you avoid higher charges.
Bottom Line
Health insurance in Florida comes with many choices—whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure affordable, reliable coverage that supports your well-being and budget.
Need help choosing a plan? Use our ACA Subsidy Calculator or speak with a licensed insurance agent.
