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Florida Health Insurance

Updated on December 7th, 2021

Fact checked by: Joseph Amodio

The Sunshine State is one of the best places to get financial assistance on Obamacare health insurance sold through the Marketplace.

We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.

What You Need to Know

Florida’s 2022 Open Enrollment Period begins on November 1, 2021 and ends on January 15, 2022.

You may qualify for subsidies and federal help paying for monthly premiums. It depends on how much you make.

Other public and private options exist outside of Obamacare. Low-income families can apply for Medicaid while those between jobs or waiting on Medicare eligibility can consider short-term health insurance.

The Sunshine State is one of the best places to get financial assistance on Obamacare health insurance sold through the Marketplace.

Florida Health Insurance Overview

If you’re looking for individual or family health insurance in Florida under the Affordable Care Act also known as Obamacare, you’ll probably have a good chance of getting government subsidies to lower your costs. You can also get low-cost or free Florida health insurance through public programs like Medicaid and the Children’s Health Insurance Program (CHIP).

Health insurance through Medicare is also a big deal in Florida. So if you’re at least 65 years old (or disabled), Medicare may be a cheaper option for you.

You can review the sections below to learn different aspects of buying health insurance in Florida, such as how to enroll, average health insurance costs, and income requirements to qualify for subsidies.  

Florida Health Insurance Facts

  • 2.1 million people enrolled in an ACA plan in 2021.
  • 4.6 million Floridians enrolled in Medicare in 2020.
  • Fourteen companies sell individual and family health insurance.
  • Floridians who got an ACA plan paid an average of $104 per month after federal subsisides.
  • Premiums will rise 6.6% for the 2022 plan year.

ACA (Obacamacare)

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Although there are attempts to repeal the ACA, or at least some parts of it, you can still sign up for Florida health insurance, apply for subsidies to lower your monthly costs, or get coverage through Medicaid if eligible.

Florida Health Insurance Enrollment in the Marketplace

Florida uses the federal exchange at Healthcare.gov for Obamacare open enrollment that takes place from November 1 to January 15 each year.

Despite opposition to the federal healthcare law by state legislators, Florida has had the highest number of sign-ups for individual Obamacare plans since 2015.

Florida saw enrollments climb from about 1.7 million in 2018 to just over 2.1 million in 2021.3

The vast majority of Floridians who enroll in Marketplace coverage are under age 65, which shouldn’t be a surprise given that the 65-and- older age group are better suited for Florida Medicare plans. As of 2021, total ACA enrollment for the under-65 market in Florida is nearly 2.1 million compared to nearly 45,000 for those 65 and older.4

Health Insurance Companies in Florida

You have access to 2022 individual and family health insurance from 14 companies that sell plans both on and off the exchange. You can also buy these plans if you’re a self-employed entrepreneur with no employees.

For the 2022 plan year, four new insurers are entering Florida:9

Capital Health Plan

Coventry Health Plan of Florida

Sunshine State Health Plan

UnitedHealthcare of Florida

Below are Florida health insurance companies offering 2022 ACA plans in the individual market:

AvMed

Blue Cross and Blue Shield of Florida

Bright Health Insurance Company of Florida

Celtic Insurance Company

Capital Health Plan

Cigna Health And Life Insurance Company

Coventry Health Plan of Florida

Florida Health Care Plan 

Health First Commercial Plans

Health Options 

Molina Healthcare of Florida

Oscar Insurance Company of Florida

Sunshine State Health Plan

UnitedHealthcare of Florida

Medicare

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Most people know Medicare as government health insurance for people 65 and older. But people under 65 with a disability or chronic illness can also get Medicare.5

With the Sunshine State being a top retirement destination, it may be no surprise to know that Florida has the second highest number of Medicare enrollees of any state. As of 2020, more than 4.6 million Floridians are enrolled in Medicare.

Among Florida’s Medicare enrollees, more than 2.4 million get benefits directly through the federal government’s Original Medicare program. Another 2.2 million get coverage through private Medicare Advantage plans, which offer benefits not included with Original Medicare such as prescription drug coverage.6 Since 2018, a separate 1.5 million Florida residents (approximately) are enrolled in standalone Medicare Prescription Drug Plans.7

As of 2021, Aetna, Anthem, Florida Blue, Humana, and UnitedHealthcare are the largest Medicare Advantage providers in Florida by number of enrollees.8

Word of Advice

Review all your options. See what makes sense for your needs and your budget.

For 2022, the state approved a 6.6% increase on the average unsubsidized premium, or a rise of $40 per month.10

Meanwhile, Florida residents who enrolled in 2021 Marketplace coverage paid an average premium of $599 per month before premium tax credits (called subsidies) and $104 per month after tax credits. Those already receiving subsidies saved $527 on average, which brought their monthly premium down to an average rate of $73. We talk more about subsidies and how to qualify in the section below.

Check a 2022 subsidy chart and calculator to see which subsidies you might qualify for.

Subsidies

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For 2021 and 2022 the federal government changed the subsidy income limits, doing away with that 400% cap, or “subsidy cliff.” Instead, families now are expected to pay no more than 8.5% of their annual income toward health insurance costs.

Previously, if your income was between 100 and 400% of the federal poverty level (FPL), you qualified for Obamacare subsidies to get low-cost coverage through Florida’s Health Insurance Marketplace. This means that for 2021, you would have had to earn between $12,880 and $51,520 for a single-member household and $26,500 and $106,000 for a family of four.

Florida is one of the best states to get financial assistance for individual and family health plans under the Affordable Care Act or Obamacare. As of 2021, 94% of Florida Marketplace enrollees receive subsidies that lower their monthly premiums. Another 63% receive cost-sharing reductions that help reduce out-of-pocket expenses, such as copays and prescription drug costs.11

Keep in mind that subsidies are only available on metal-tiered plans sold through the Marketplace, which are bronze, silver, gold, and platinum. And only silver plans qualify for cost-sharing reductions.

Short-Term

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If you need coverage for a limited time, Florida short-term health insurance may be right for you. This can happen if you’re changing jobs, waiting for coverage to begin at a new job, or you missed the annual open enrollment and don’t qualify for a Special Enrollment Period to buy an Obamacare plan.

Below are some highlights of short-term health insurance:

Offers initial coverage limits up to 364 days with renewals for up to 36 months

Can enroll year-round and get coverage as soon as the next day

Offers limited coverage for services, such as emergency care, doctor’s visits, and specialist care

An alternative to Obamacare — plans don’t have to follow federal rules for things like covering pre-existing conditions and including essential health benefits

Can be denied coverage based on health status 

Usually cheaper than Obamacare — can get a plan for less than $100

Plans are not eligible for federal subsidies 

Medicaid

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Nearly 4.3 million people in Florida are enrolled in Medicaid, which offers free or low-cost health insurance for those who qualify. This is despite the fact that Florida has not expanded its Medicaid program that would have allowed low-income individuals who earn up to 138% of the federal poverty level to qualify.12

If Florida had expanded Medicaid, 833,000 more residents who are uninsured would have access to affordable health insurance, according to a report by the Kaiser Family Foundation. The lack of Medicaid expansion in Florida typically affects able-bodied adults under 65 who are not pregnant and don’t have children.

You may qualify for Medicaid in Florida if you make no more than $17,131 as an individual or $35,245 if you’re a family of four13 and you’re among the following eligible people:

– Parents and caretaker relatives of children
– Children
– Former foster care youths up to age 26 (regardless of income)
– Pregnant women
– Non-citizens with medical emergencies
– Elderly (65 and older) and disabled adults who don’t currently receive Social Security Income (SSI)

Florida CHIP

Florida has nearly 160,000 residents who enrolled in the Children’s Health Insurance Program (CHIP).12 Florida CHIP is available to children ages 1 to 19 who live in households that make no more than 210% of the FPL and pregnant women who earn up to 191% of the FPL as of July 2021.14

Generally, you and each eligible child in your household qualify for CHIP if you earn too much to get Medicaid. Each household member who’s applying usually must be a U.S. citizen or legal Florida resident. You can enroll in CHIP year-round by completing an application online with Florida KidCare.

Below are the income limits to qualify for CHIP in Florida:

– 1 person: $25,760

– 2 people: $34,840

– 3 people: $43,920

– 4 people: $53,000

– 5 people: $62,080

– 6 people: $71,160

– 7 people: $80,240

– 8 people: $89,320

For households with more than 8 people, add $9,080

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Average Rate Changes

Resources

Insurance and Department of Health Information

Florida Office of Insurance Regulation
200 East Gaines Street
Tallahassee, Florida 32399-0305
Phone: (850) 413-3140
http://www.floir.com/

Florida Department of Health
4052 Bald Cypress Way
Tallahassee, FL 32399
Phone: (850) 245-4444
http://www.floridahealth.gov/

Next Steps

Whether you’re applying for coverage for yourself or a family of four, make sure to review all your options. Examine what makes sense for your needs and budget.



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  1. Marketplace Enrollment, 2014-2021. kff.org Accessed October 28, 2021.

  2. Marketplace Plan Selection by Age. kff.org. Accessed October 28, 2021.

  3. Who Is Eligible for Medicare? hhs.gov. Accessed October 28, 2021.

  4. Total Number of Medicare Beneficiaries.” kff.org. Accessed October 28, 2021.

  5. Medicare Prescription Drug Plans: Stand Alone PDP Enrollment, 2018. kff.org. Accessed October 28, 2021.

  6. Health Coverage: State-to-State 2021. ahip.org. Accessed October 28, 2021.

  7. Individual PPACA Market Monthly Premiums for Plan Year 2022. floir.com. Accessed October 28, 2021.

  8. Florida: Approved Avg. 2022 #ACA Rate Changes: +6.6% Individual Market, +7.9% Sm. Group; 4 New Carriers Enter Market.” acasignups.net. Accessed October 28, 2021.

  9. Marketplace Plan Selections with Financial Assistance. kff.org. Accessed October 28, 2021.

  10. May 2021 Medicaid & CHIP Enrollment Data Highlights. medicaid.gov. Accessed October 28, 2021.

  11. Florida Medicaid. florida.gov. Accessed October 28, 2021.

  12. Medicaid, Children’s Health Insurance Program, & Basic Health Program Eligibility Levels. medicaid.gov. Accessed October 28, 2021; May 2021 Medicaid & CHIP Enrollment Data Highlights.