Florida Health Insurance Consumer Guide

To qualify for Marketplace coverage in Florida, you must:¹

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

The open enrollment period to sign up for ACA-compliant individual and family health plans is from November 1 to January 15.⁴ 

• 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.

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.

There are other instances when a qualifying life event is not required to enroll.⁵ For example:

• Native Americans can enroll year-round.⁶
• People earning less than 150% of the poverty level can enroll anytime until at least 2025.

People who lose Medicaid or CHIP between March 2023 and July 2024 may qualify for a temporary extended SEP.⁷

If you qualify for an ACA Marketplace plan in Florida, you have four 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.⁸
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 plans in Florida through HealthCare.gov, the ACA exchange.

During 2023 open enrollment,, more than 90% of enrollees through Florida’s exchange qualified for subsidies.⁹ These subsidies, called Advance Premium Tax Credits (APTC), lower your monthly premiums.

With subsidies, Floridians who enrolled through the Marketplace during the 2023 open enrollment saved about $564 per month on premiums. Those receiving subsidies paid approximately $59 per month in premiums.⁹

If your household income is under 250% of the federal poverty level, you may also receive cost-sharing reductions (CSR).¹⁰

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

Medicaid is another affordable health insurance option in Florida if you qualify. Alternatively, short-term plans also offer low-cost health coverage.

Source: CMS.gov ¹¹

Fourteen insurers are offering plans on Florida’s Marketplace for 2023.¹² They include one new insurer: AmeriHealth Caritas. Bright Health is no longer offering health coverage in Florida. 

Insurer availability can vary by region. The following insurers provide coverage through Florida’s exchange:

• Aetna CVS Health / Coventry Health Plan of Florida
• AmeriHealth Caritas (new for 2023)
• AvMed
• Blue Cross Blue Shield of Florida, Inc. (Florida Blue)
• Capital Health Plan
• Celtic Insurance Company (Ambetter)
• Cigna
• Florida Health Care Plan, Inc.
• Health First Health Plans
• Health Options (Florida Blue HMO)
• Molina Healthcare of Florida, Inc. 
• Oscar Insurance Company of Florida*
• Sunshine State Health Plan (also affiliated with Ambetter)
• UnitedHealthcare

*Oscar paused new enrollments in Florida for 2023. This means if you enrolled in one of their plans before December 12, 2022, you can keep your coverage for 2023. But after December 12, 2022, you cannot sign up for a new Oscar plan in Florida.

All 14 of the insurance companies offering Marketplace plans in Florida’s individual market have proposed raising average rates for the year 2024:¹³ 

Remember that these rate changes are calculated before subsidies are applied. Most Florida exchange enrollees receive subsidies, so they may find coverage more affordable than expected.¹⁴

During the 2023 open enrollment, a new record high of 3,225,435 people enrolled in health plans through Florida’s Marketplace.¹⁵ This is a significant increase compared to the 2.1 million enrollments from the previous year.

This surge in enrollment was 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 in 2023 than before the ARP became law.¹⁶

Source: 2014,¹⁷ 2015, ¹⁸ 2016,¹⁹ 2017,²⁰ 2018,²¹ 2019,²² 2020,²³ 2021,²⁴ 2022,²⁵ 2023,²⁶ 2024²⁷

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.

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