If you’re searching for health insurance in Florida, there are many resources available. A good place to start is the federal Marketplace, where you can determine your eligibility and compare your options. You can shop online or receive individual assistance in person or over the phone.
There are also private websites that can help you find the right plan at the right price. Here are a few key takeaways to start off with:
- The Open Enrollment Period for signing up for health insurance through the Affordable Care Act, also known as Obamacare, was extended through August 15, 2021 due to the COVID-19 pandemic.
- Subsidies were also increased and expanded, so there’s a good chance you will qualify for help with your monthly premiums.
- Outside of Obamacare, Medicaid, Medicare and short-term health insurance are other options to get covered.
- Affordable Care Act (ACA): The ACA created health insurance Marketplaces where people can purchase coverage and get subsidies if eligible. Over 2 million Floridians bought ACA plans in 2020.
- Private Health Insurance: You can purchase directly from an insurance carrier instead of through an exchange.
- Medicare: Medicare is publicly-funded health insurance for anyone 65 or older or has a disability. Florida has the second highest number of Medicare enrollees in the US (4.6 million).
- Medicaid and CHIP: Florida offers free or low-cost coverage to low-income residents through Medicaid and the Children’s Health Insurance Program (CHIP).
- Short-Term health Insurance: Used to fill coverage gaps, short-term plans may be an option if you’re between jobs or waiting on new coverage to start.
The Affordable Care Act was created to offer public access to individual health insurance plans.
Marketplace plans are split into four metal tiers: bronze, silver, gold and platinum. The tiers vary by how much you pay for covered medical services versus the insurance company. For example, with a bronze plan, you pay a lower monthly premium but more out of pocket when you see the doctor. With a platinum plan, you pay a higher premium but less out of pocket.
ACA plans must cover certain core services (essential health benefits) like preventive care, mental health and maternity care. ACA also provides subsidies to help offset monthly premium costs. Anyone can sign up for a Marketplace plan but your eligibility depends on your income. Most who enroll in a Marketplace plan qualify for help.
In a typical year, you can enroll in a plan during the Open Enrollment Period (November 1 to December 15). You can buy coverage outside this period if you have a life-changing event such as marriage.
The federal government opened a Special Enrollment Period through August 15, 2021 due to COVID-19. So, you don’t need to wait for open enrollment to get covered. Subsidies also were increased and expanded, making ACA plans more affordable than ever.
You can also go directly to insurance companies to buy an individual or family health plan. If it’s major medical insurance, it’ll likely have the same coverage and benefits of similar ACA plans.
But if you buy outside of a government exchange, you won’t qualify for any subsidies or help to pay your monthly premium.
Medicare is a health insurance program run by the federal government for people age 65 and up or who have a disability. Options include Original Medicare and Medicare Advantage.
Original Medicare includes Part A (hospital care) and Part B (doctor’s visits and other outpatient services). You can also purchase separate prescription drug coverage (Part D). Plans under Medicare Advantage (also called Medicare Part C) are offered by private insurance companies. They combine features of Part A, Part B and usually, Part D. Some plans offer extra benefits such as vision, dental and hearing care.
Medicaid provides health coverage for low-income individuals and families. The following groups are eligible for Medicaid in Florida:
- Parents and caretaker relatives of children
- Former foster care youths up to age 26
- Pregnant women
- Non-citizens with medical emergencies
- Elderly (65 and older) and disabled adults who don’t currently receive Social Security Income
Florida’s Child Health Insurance Program (CHIP), called Florida KidCare, is also available for children up to age 19 who live in households who earn too much to qualify for Medicaid.
Short-term health insurance plans in Florida can bridge gaps in your coverage while you wait for other insurance to start. Florida allows short-term plans to cover you up to 364 days with renewals up to 36 months.
These types of plans generally cost less than ACA plans. But they generally don’t cover preexisting conditions and aren’t required to offer the ACA essential health benefits. You may not be able to find affordable life insurance without a medical exam under short-term health insurance options.
- Affordable Care Act: The average monthly premium for a silver plan in Florida is $447. When comparing costs of ACA plans, make sure to consider deductibles, copayments and coinsurance.
- Medicare: For Original Medicare, there’s usually no premium for Part A, depending on how much Medicare taxes you paid. But you’ll pay an annual deductible and copays. For Part B, costs include the monthly premium ($148.50 or higher depending on your income) plus an additional $203 deductible and 20% coinsurance. Part D premiums vary by plan.
- Medicare Advantage: In Florida, Medicare Advantage customers pay an average monthly premium of $8.28.5 This is in addition to the Part B premium you pay to enroll in a Medicare Advantage plan.
- Medicaid: Medicaid offers free to low-cost coverage based on your income. The annual income limit to qualify is $17,131 for an individual and $35,245 for a family of four. For CHIP, you’ll pay a monthly premium of $15 to $20, depending on your income.
- Short-Term Health Insurance: Short-term health insurance plans generally cost less than ACA plans; however, your out-of-pocket expenses may be higher.
You can check your eligibility and shop for ACA plans at HealthCare.gov. You can also get help in person or speak to someone over the phone. You can also search plans and enroll on private, commercial websites.
For Medicare, visit Medicare.gov to check your eligibility and compare plans, including Original Medicare and Medicare Advantage plans.
For Medicaid or CHIP, you can sign up at myFLFamilies.com.
For short-term health insurance, you’ll need to check directly with health insurance companies who offer this kind of plan.
Finding the right health insurance plan that matches your needs and budget will take some research. But it’s time well-spent to protect your family’s health and financial future.
About the Author: James is a writer and editor for HealthCare.com and its web properties. He is a former newspaper journalist. James has an MA in journalism from Syracuse University and a BA in history from the University of Pennsylvania.