Florida health insurance Marketplace guide

To qualify for Florida Health Insurance Marketplace coverage, you must:³

• Live in Florida
• Be a U.S. citizen, national, or lawfully present in the U.S.
• Not be incarcerated
• Not be enrolled in Medicare

But those rules just allow a person to enroll in coverage through the exchange. Eligibility for financial assistance (premium subsidies and/or cost-sharing reductions) through the Health Insurance Marketplace depends on how your household income compares with the cost of the second-lowest-cost Silver plan in your area.

In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not be eligible for Medicaid or CHIP (Florida KidCare), or premium-free Medicare Part A.⁷
• Not have access to affordable employer-sponsored health coverage. If your employer (or your spouse’s employer) offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to learn whether you might be eligible for premium subsidies in the Florida Marketplace.
• If married, file a tax return jointly with your spouse.⁸
• Not be able to be claimed by someone else as a tax dependent.⁸

The open enrollment period to sign up for ACA-compliant individual and family health insurance in Florida runs from November 1 to January 15.⁹ 

• Enroll by December 15 for coverage to start January 1.
• If you enroll between December 16 and January 15, coverage will begin on February 1.

Open enrollment will be shorter, however, starting in the fall of 2026. Due to a rule change that was finalized in 2025, the open enrollment period will still start on November 1, but it will end on December 15. All plans selected during open enrollment will take effect January 1.

If you miss open enrollment, you can still enroll or switch plans if you meet the special enrollment period (SEP) requirements. Most SEPs require a qualifying life event like losing coverage, getting married, or permanently moving, but Native Americans can enroll year-round.¹⁰

To sign up for a Florida Health Insurance Marketplace plan, you have several enrollment options:

1. Online through HealthCare.gov.
2. By calling the Marketplace Call Center at (800) 318-2596.
3. With the help of licensed agents, navigators, or certified application counselors or an approved enhanced direct enrollment entity.¹¹
4. Mailing in a paper application

Go to localhelp.HealthCare.gov to find a navigator, certified application counselor, or agent in your area.

You can find affordable individual and family health insurance in Florida through HealthCare.gov, which is Florida’s ACA exchange/Marketplace.

During open enrollment for 2025 coverage, more than 97% of Florida’s Health Insurance Marketplace enrollees qualified for premium subsidies.¹² These subsidies, called Advance Premium Tax Credits (APTC), lower your monthly premiums.

The subsidies averaged $591/month, and the average subsidy-eligible enrollee was paying about $49/month for their coverage after the subsidies were applied.¹²

If your household income is between 100% and 250% of the federal poverty level and you select a Silver plan through the Florida Health Insurance Marketplace, you will also receive cost-sharing reductions (CSR). As of early 2025, two-thirds of Florida’s Marketplace enrollees were receiving CSR benefits.¹³

While APTCs help reduce health insurance costs, CSRs reduce out-of-pocket costs like deductibles, copayments, or coinsurance.

Source: CMS.gov ¹²

Medicaid and Florida KidCare (CHIP) are options for affordable health insurance in Florida if you qualify for either program.

Alternatively, short-term plans offer low-cost health coverage, for people who aren’t eligible for Medicaid or a Marketplace subsidy. These plans can also be used for temporary coverage by people who missed the annual enrollment period for ACA-compliant coverage. But short-term health insurance is much less robust than ACA-compliant coverage, generally does not cover pre-existing conditions or all of the essential health benefits, and should not be considered an adequate substitute for ACA-compliant major medical coverage.

Sixteen insurers are offering coverage through the Florida Health Insurance Marketplace for 2026, including two separate Cigna entities)² (coverage areas vary by carrier).⁵

There were 15 participating carriers for 2025, but there are some changes for 2026:

• Aetna is exiting at the end of 2025 (as is the case in all states where they offer individual market coverage), so Aetna enrollees will need to select new coverage during the open enrollment period that begins November 1, 2025.
• Community Care Network Inc. is new for 2026² (plans only available in Broward County).⁵
• Cigna already offers Marketplace plans in 2025 (Cigna Health and Life Insurance Company), but is adding new HMO plans in 2026 that are sold under a separate entity (Cigna Healthcare of Florida, Inc.)

The following average rate changes have been approved for 2026 for individual/family plans sold through Florida’s Health Insurance Marketplace, amounting to an overall weighted average rate increase of 31.5% (before any subsidies are applied).²

Source: FLOIR (Florida Office of Insurance Regulation)²

Average rate changes are calculated before subsidies are applied. Most Florida exchange enrollees receive subsidies that cover the majority of the premium cost.¹⁴ But unless Congress takes action to extend the federal subsidy enhancements that have been in place since 2021, the enhancements will expire at the end of 2025. That will result in smaller subsidies in 2026, and some people losing their subsidy altogether. If that happens, coverage will be significantly less affordable, and fewer people will enroll in Marketplace plans for 2026.

For perspective, here’s a summary of how full price premiums in Florida’s ACA-compliant market have changed over the years:

• 2015: Average increase of 7%¹⁵
• 2016: Average increase of 9.5%¹⁶
• 2017: Average increase of 19.1%¹⁷
• 2018: Average increase of 44.7%¹⁸ (federal funding for cost-sharing reductions was eliminated)
• 2019: Average increase of 5.2%¹⁹
• 2020: Average increase of 0%²⁰
• 2021: Average increase of 3.1%²¹
• 2022: Average increase of 6.6%²²
• 2023: Average increase of 7.2%²³
• 2024: Average increase of 5.3%²⁴
• 2025: Average increase of 7.5%²⁵

During the open enrollment period for 2025 coverage, a significant new record high of 4,735,415 people enrolled in health insurance through Florida’s Marketplace.²⁶

Enrollment has been increasing for several years in a row (see chart below). The enrollment growth in recent years is due in part to the American Rescue Plan, which improved affordability starting in 2021. The Inflation Reduction Act then extended these improvements until 2025, ensuring coverage remains more affordable than it was before the ARP became law.²⁷

The enrollment spike in 2024 and 2025 is also due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in 2023 after a three-year pause, and some people who previously had Medicaid transitioned to Marketplace coverage instead.

Source: 2014,²⁸ 2015,²⁹ 2016,³⁰ 2017,³¹ 2018,³² 2019,³³ 2020,³⁴ 2021,³⁵ 2022,³⁶ 2023,³⁷ 2024,³⁸ 2025²⁶

Healthcare.gov
This is the ACA Marketplace, where you can enroll in a health insurance plan online. You may also get help by calling (800) 318-2596. 

Florida Consumer Action Network (FCAN)
Nonprofit consumer advocacy group that helps Floridians understand their health insurance options.

Florida KidCare
Florida’s health insurance program for children.

FloridaHealthFinder.gov
State-run site to compare and enroll in health plans.

Federally funded Navigator organizations:

• University of Florida/Florida Covering Kids & Families – Helps people enroll in and understand health coverage.
• Urban League of Broward County – Helps underserved and vulnerable populations.
  

Florida Office of Insurance Regulation
Licenses and oversees health insurers, brokers, and agents. Helps consumers with complaints. Reviews annual health insurance rate changes. 

Medicare Rights Center
National service with a call center providing advice and information for people with Medicare.