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Health Insurance in Florida

Compare ACA health insurance, Medicare, life, dental, vision, supplemental, short-term, travel medical, and group coverage with licensed broker Mercy Makarevich.

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Florida family comparing health insurance coverage

HealthCare.govWhere Floridians apply
Medicaid not expandedFlorida Medicaid status
67 countiesPlans are set county by county

Florida residents face a diverse range of insurance options, from corporate group coverage to individual plans. Mercy Makarevich helps Floridians navigate the 2027 ACA Marketplace, compare Medigap Supplement policies, and choose plans that keep major local networks in-network.

Whether you reside in Miami, Tampa, Jacksonville, or Orlando, Mercy provides bilingual support and personalized comparisons of available plans from the carriers she represents.

Florida coverage review

National Producer Number: 8193581

Bilingual English/Spanish support for South Florida families
Subsidy calculations for self-employed and contract workers in Florida
Network validation for Cleveland Clinic Florida, Baptist Health, and Jackson Health

The Florida Marketplace

Where you apply for coverage in Florida

Florida uses the federally facilitated Marketplace at HealthCare.gov for individual and family ACA plans. There is no separate state exchange to sign up for, and no Florida-only website that replaces the federal application. Anything presented as an official Florida marketplace outside HealthCare.gov deserves scrutiny.

Florida consistently has one of the largest Marketplace enrollment populations in the country, and that scale shows up as choice: many Florida counties have a comparatively deep field of participating insurers, while smaller rural counties in the Panhandle and north-central Florida can have far fewer. The county you live in — not the city — determines which plans appear in your results.

Plan availability, pricing, and provider networks are all set at the county level, so two households thirty minutes apart can see materially different options. Check the current issuer count for your own county before assuming a plan you read about is offered where you live.

Preview plans and prices on HealthCare.gov

Medicaid and CHIP in Florida

Florida has not adopted the ACA Medicaid expansion. Florida Medicaid covers specific categories — children, pregnant women, some parents with very low incomes, people with disabilities, and older adults meeting program rules — rather than covering all adults under a single income threshold.

Because the state did not expand Medicaid, there is a well-documented coverage gap: adults whose household income falls below 100% of the federal poverty level are generally too poor to qualify for Marketplace premium tax credits, yet do not meet the state's narrow Medicaid categories. Premium tax credits begin at 100% FPL, so reporting income accurately on the application matters enormously — an estimate that lands just above or just below that line changes the entire result.

Florida KidCare is the state's children's coverage program and operates on separate income rules from adult coverage, so it is common for children in a household to qualify for KidCare while the parents shop on the Marketplace. Eligibility for every one of these programs is determined by the state agency or the Marketplace, never by an agent.

What drives your premium in Florida

Your Florida premium is built from a small set of inputs: the rating area tied to your county, the ages of everyone enrolling, household size, tobacco use, and the metal tier you select. Health history and gender do not affect ACA premiums — pre-existing conditions cannot raise your rate or disqualify you.

Financial help is calculated against a benchmark, specifically the second-lowest-cost Silver plan available in your county. Premium tax credits are pegged to that benchmark, which is why choosing a Bronze plan usually lowers your net premium while choosing Gold usually raises it. The applicable percentage schedule that converts income into an expected contribution is set per plan year, so confirm the current figures through the Marketplace application rather than an article.

One Florida-specific planning point: cost-sharing reductions, which lower your deductible, copays, coinsurance, and out-of-pocket maximum, are only attached to Silver plans and only for households under 250% of the federal poverty level. A Silver plan with CSR can be dramatically better value than a Gold plan for a qualifying household, and this is the single most commonly missed detail in Florida enrollment.

Enrollment

When you can enroll

Individual ACA coverage is bought during an annual Open Enrollment Period, which for states on HealthCare.gov has opened on November 1 in recent plan years. Exact opening and closing dates are set per plan year, so confirm the current window on the official Marketplace site rather than relying on last year's dates.

Outside that window you need a Special Enrollment Period, which is opened by a qualifying life event. Most Special Enrollment Periods last 60 days from the event, and the Marketplace typically asks for documentation proving it.

Events that commonly open a Special Enrollment Period

Losing other qualifying coverage — job loss, aging off a parent's plan at 26, or exhausting COBRA
Moving permanently to a new coverage area
Getting married, or having a baby, adopting, or placing a child in foster care
Divorce or legal separation that causes a loss of coverage
Losing Medicaid or CHIP eligibility
Gaining lawful presence, becoming a citizen, or being released from incarceration

Florida seniors reviewing Medicare enrollment timing

How Medicare timing works

Medicare runs on its own calendar, separate from the ACA Marketplace. Your Initial Enrollment Period is seven months long — the three months before the month you turn 65, your birthday month, and the three months after. Missing it can trigger Part B and Part D late enrollment penalties that last for as long as you hold the coverage.

After that, Medicare Open Enrollment runs October 15 through December 7 each year, when you can change between Original Medicare and Medicare Advantage or switch Part D plans. A separate Medicare Advantage Open Enrollment Period runs January 1 through March 31 for people already enrolled in an Advantage plan.

One window is easy to miss and hard to recover: your Medigap open enrollment is the six-month period beginning when you are 65 or older and enrolled in Part B. During those six months a Medicare Supplement insurer generally cannot use medical underwriting to deny you or raise your price. Outside it, in most states, they can.

Doctors & hospitals

Provider networks in Florida

Florida's individual market leans heavily on HMO and narrow-network EPO designs. That structure keeps premiums competitive but makes network verification non-optional: an out-of-network specialist on an HMO plan can mean no coverage at all rather than a higher percentage of the bill.

South Florida households frequently need to confirm participation across Baptist Health, Jackson Health System, Cleveland Clinic Florida, and Memorial Healthcare System. Central Florida enrollees look at AdventHealth and Orlando Health; Tampa Bay at BayCare and Tampa General; Northeast Florida at Baptist Health Jacksonville and UF Health. Participation varies by individual plan and by year, not just by carrier.

Verify each doctor and hospital in the specific plan's directory, then call the provider's billing office to confirm they are contracted for that exact plan. Directories can lag real contract changes, and a plan-level check is the only reliable answer.

Systems worth verifying

Baptist Health South Florida
Jackson Health System
Cleveland Clinic Florida
Memorial Healthcare System
AdventHealth
Orlando Health
BayCare Health System
UF Health

System participation is not guaranteed and changes by plan and year. Confirm each provider in the specific plan's directory and directly with the provider before receiving care.

Before you choose

Before you enroll, verify these five things

01
Every doctor and hospital you intend to use, checked in that specific plan's directory — not the carrier's general directory
02
Every prescription, by exact name and dosage, checked against the plan's formulary and tier structure
03
Your realistic estimated household income for the coverage year, since this drives subsidy eligibility
04
The full cost picture: annual premium, deductible, copays, coinsurance, and out-of-pocket maximum together
05
Whether anyone in the household has an offer of employer coverage, which can affect Marketplace subsidy eligibility

Coverage options

Compare coverage in Florida

ACA Marketplace plan comparison

Medicare Advantage, Supplement, and Part D

Life, dental, vision, and supplemental insurance

Short-term, travel medical, and group health options

Compare Florida plans by more than monthly premium.

Use the Florida comparison guide to evaluate networks, prescriptions, deductibles, subsidies, and total yearly risk.

Read the Florida Comparison Guide

Choose your next step

What do you need to do with Florida health coverage?

Start with the task in front of you. These guides and private planning tools help you gather facts, compare documents, and prepare questions without making an eligibility or coverage decision.

Official Marketplace notices determine eligibility and deadlines. Current plan documents and the insurer determine benefits, network participation, and prescription coverage.

Local help

Key Florida service areas

Florida city guides

Carriers, networks, and pricing are set county by county. These pages cover local markets in more detail.

18 local guides

Miami-Dade County

Broward County

Palm Beach County

Free tools

Free tools to compare your coverage

Calculators and checklists for estimating subsidies, real annual cost, and enrollment windows.

Official sources for availability and credential checks

Availability changes by ZIP code, plan year, and application details. Use these sources to confirm current information; this site does not replace a Marketplace result or regulator record.

Preview plans and prices by ZIP code — HealthCare.gov 2026 individual-market carriers — Florida DFS Verify an insurance license — Florida DFS How we research and correct content

FAQ

Florida Health Insurance FAQ

Ask Mercy a question

Can Mercy help me compare health insurance anywhere in Florida?

Yes. Mercy is licensed statewide in Florida and helps residents compare ACA Marketplace plans, Medicare Supplement/Advantage policies, and life insurance.

How do I check if my doctor is in-network in Florida?

Mercy can help check your preferred doctors and clinics against current carrier directories. Because networks can change, confirm participation with both the carrier and provider before receiving care.

Does Florida have its own health insurance exchange?

No. Florida uses the federal Marketplace at HealthCare.gov. There is no separate Florida state exchange, and applications for premium tax credits go through the federal system.

Why do plan options differ between Florida counties?

Insurers file products and networks county by county, so availability and price are set by your county's rating area. A plan sold in Broward County may not be offered in Leon or Walton County, and premiums for the same metal tier can differ significantly across the state.

What happens if my Florida income is below the poverty level?

Because Florida did not expand Medicaid, premium tax credits generally start at 100% of the federal poverty level and Medicaid covers only specific categories. Households below that line can fall into the coverage gap. Report your realistic expected annual income on the application — the Marketplace makes the eligibility determination.

Can I get covered in Florida outside of Open Enrollment?

Only with a qualifying life event that opens a Special Enrollment Period, such as losing other coverage, moving to a new coverage area, marriage, or the birth or adoption of a child. Most of these windows last 60 days, and documentation is typically required.

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Contact Our Insurance Team

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