Frequently asked questions about health insurance coverage options in Florida
Florida uses the federally run health marketplace (exchange), so individuals and families who need to buy their own health coverage use HealthCare.gov to enroll. The marketplace is used by individuals and families who don’t have an option of coverage from an employer or Medicare.
Individual/family health plans are purchased by people who are self-employed, people who have retired prior to age 65 and need to buy their own coverage until they become eligible for Medicare, and by people employed by small businesses that don’t provide health benefits. The marketplace is also the only place Florida residents can get income-based financial assistance with their individual major medical health coverage.
Read our overview of the Florida health insurance marketplace – including news updates and exchange history.
For individual/family health coverage in Florida, open enrollment runs from November 1 through January 15. Outside of the annual open enrollment period, Floridians will need a qualifying event to enroll.
Learn more about the enrollment process in our comprehensive guides:
In Florida, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). More than 90% of consumers who enrolled in 2022 coverage through HealthCare.gov received premium subsidies.
Floridians may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Florida.
Short-term health insurance is also a lower-cost coverage option in Florida, where five insurers offer short-term plans.
During the open enrollment period for 2022 coverage, 2,723,094 people enrolled in individual market plans through the Florida health insurance marketplace. This was a new record high, far surpassing the 2.1 million people who had enrolled the year before.
The higher enrollment was driven largely by the American Rescue Plan’s affordability enhancements that took effect in 2021. These provisions have been extended through 2025 by the Inflation Reduction Act, ensuring that coverage will continue to be more affordable in 2023 than it was before the ARP was enacted.
Fourteen insurers are offering coverage in Florida’s marketplace for 2023. That includes one new insurer (AmeriHealth Caritas) and one exit (Bright Health is no longer offering plans after 2022).
As is the case in most states, insurer participation varies from one area of the state to another, but most Florida counties have at least five insurers offering plans for 2023. The following insurers offer 2023 coverage through Florida’s exchange:
- AmeriHealth Caritas (new for 2023)
- Blue Cross Blue Shield of Florida (Florida Blue)
- Capital Health Plan
- Aetna CVS Health/Coventry Health Plan of Florida
- Florida Health Care Plan Inc
- Health First Health Plans
- Oscar Health (Enrollment in 2023 coverage from Oscar is no longer available after December 12, 2022, although people who enrolled by that deadline can keep their Oscar coverage for 2023. Oscar experienced very strong enrollment for 2023. In an effort to maintain a sustainable level of enrollment, Oscar paused new enrollments for 2023. In Minnesota, Medica took a similar approach in the fall of 2017.)
- Florida Blue HMO (Health Options)
- Sunshine State Health Plan (also affiliated with Ambetter)
For the state’s existing marketplace insurers, the average rate changes that were approved for 2023 by the Florida Office of Insurance Regulation (FLOIR), amounted to a weighted average rate increase of 7.2%.
But that was calculated before Bright Health announced its exit from the market, and Bright’s approved average rate increase was nearly 12%. So the overall weighted average rate increase is lower without Bright, but people with Bright Health plans in 2022 do need to switch to a different insurer for 2023.
Although the Sunshine State has not embraced the Affordable Care Act from a legislative standpoint, the healthcare reform law has had some positive impacts there.
Florida’s federally facilitated health insurance exchange has the nation’s highest enrollment numbers, all of whom have coverage for the ACA’s essential health benefits. And more than 2.6 million of them qualified for premium subsidies during the open enrollment period for 2022 coverage. These subsidies make monthly health insurance premiums much more affordable than they would otherwise be.
According to U.S. Census data, Florida’s uninsured rate was 20% in 2013, and had dropped to 12.5% by 2016 (it had risen slightly, to 13%, by 2018, and to 13.2% by 2019, mirroring a nationwide increase in the uninsured rate under the Trump administration).
The national average uninsured rate stood at 9.2% as of 2019, but Florida’s rejection of federal funding to expand Medicaid has locked a significant portion of the population out of coverage. If Florida were to expand Medicaid, the uninsured rate would drop substantially.
Although most states have opted to accept federal funding to expand Medicaid coverage as called for in the ACA, there are a dozen – including Florida – that have not.
Florida’s decision not to expand Medicaid leaves an estimated 415,000 people in the coverage gap, meaning they do not qualify for Medicaid nor are they eligible for tax subsidies to help them afford private health insurance. According to a Robert Wood Johnson Foundation analysis, more than 1.3 million people in Florida would gain Medicaid coverage if the state were to expand coverage, and the uninsured rate would drop by 30%.
Since 2013, monthly Florida CHIP/Medicaid enrollment has increased by just 27% — versus a nationwide average increase of 56%.
Read more about Medicaid expansion in Florida.
Because Florida does not have state regulations for short-term plans, federal regulations apply in the state. Insurers can offer short-term plans with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.
The Florida Health Insurance Advisory Board recommended that lawmakers add a provision to Florida statute to require stronger disclosure language for short-term plans, and a requirement that consumers sign a statement indicating that they have read the disclosure or had it read to them by a salesperson (the recommendation was approved during a December 2019 FHIAB board meeting, to be forwarded to leaders in the Florida House and Senate. But no action has been taken by lawmakers thus-far).
Read more about short-term health coverage in Florida.
As of mid-2022, there were nearly 4.9 million Florida residents enrolled in Medicare. Most are eligible because they’re at least 65 years of age. But a little more than 10% of Florida Medicare beneficiaries are under 65, and are eligible because of a disability that’s lasted at least two years, or ALS, or end-stage renal disease.
Learn more about Medicare enrollment in Florida, including the state’s rules for Medigap plans.
Learn more about the Medicare open enrollment period for Medicare Advantage and Medicare Part D prescription drug plans.
- Florida Consumer Action Network (FCAN)
- Florida Kid Care
- Federally-funded Navigator organizations in Florida
- University of Florida/Florida Covering Kids & Families
- Urban League of Broward County, Inc.
- Florida Office of Insurance Regulation — Licenses and regulates health insurance companies, brokers, and agents. Provides information and assistance to consumers who have questions or complaints.
- Medicare Rights Center — A nationwide service (call center and website) that can provide advice and information for Medicare beneficiaries.