Best Health Insurance Plans in Florida

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Florida’s health care options are below average. It’s ranked the 34th best state for healthcare. This rating comes from a US News study, which considers health care access, health care quality, and good public health.

Health Care Choices in Florida

According to the Florida Office of Insurance Regulation, there are several ways for residents to get health insurance:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most Floridians get their health insurance coverage?

Florida Health Insurance Sources
Sources Percent
Employer-Provided 42%
Individual or family 10%
Medicaid 16%
Medicare 18%
Other Public Care 3%
Uninsured 12%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

12 percent of Floridians are uninsured. That’s one of the worst uninsured rate in the US, far above the nine percent national average. These numbers aren't good for policyholders in the state. The more people uninsured in a state, the higher the rates for those with insurance.

Florida Health Insurance Costs and Rate Factors

Floridians spend an average of $8,076 per year on health insurance expenditures, only a few dollars more than the national average. Health care costs are highly dependent on the individual. Here are some factors that will influence your costs:

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Body Mass Index

A high BMI can lead to a serious risk of health conditions and diseases. Health insurance providers look at your BMI because it affects your risk as a policyholder. People with a higher BMI will likely have higher premiums.

In 2016, Florida had a 27.4 percent obesity rate, ranking 36th in obesity in the US. Of the many Floridians who use QuoteWizard to shop for health insurance, 30 percent have a BMI in the obese range.

Tobacco use

Tobacco use often leads to several serious health conditions, which is why tobacco users face higher insurance rates. In 2017, 15.5 percent of the Florida population were smokers, the 16th lowest rate in the country.

Age

According to healthcare.gov, age is a factor in the cost of your insurance plan. The site states that older people often pay three times as much as younger people for coverage. FL residents who used QuoteWizard to compare health insurance plans are, on average, 42 years old.

Plan type

The more health insurance coverage you have, the more you'll pay in monthly premiums. Marketplace health insurance plans use metal tiers to categorize coverage. These metal tiers are bronze, silver, gold, and platinum.

What can you expect to pay for health coverage as a Florida resident? The 2018 table below outlines the average monthly premium for a 40-year-old Floridian.

Florida Martketplace Plan Rates
Bronze Silver Gold
$313 $450 $479
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

In Florida, a gold plan costs about 53 percent more than a bronze plan. This is a significant leap in monthly costs. However, investing a gold plan might be worth it. Gold plans cover 80 percent of medical costs, whereas bronze plans only cover 60 percent. Paying more money each month may save you money in case of a medical emergency.

Catastrophic coverage is the lowest level health plan. If you are under 30 or have a hardship or affordability exemption, you may be eligible for this type of coverage. This plan has the lowest monthly premiums, but it comes with a $7,150 deductible.

Location

Every state has different laws, regulations, and health care providers, and the Sunshine State is no exception.

Insurance rates are also usually community-regulated. This means that the number of claims your neighbors file could influence your monthly price tag. If your area files more claims than average, your premiums could rise.

That means that the healthier your state is, the lower your premiums could be. According to America's Health Rankings, Florida is the 32nd healthiest state in the US.

Florida Health Insurance Companies

Now that you know a little more about health insurance factors, it's time to find a provider. Florida is home to several insurance companies that offer both family and individual plans:

Florida Health Insurance Laws

In 2014, the Affordable Care Act (ACA) made it so that insurance companies cannot consider these factors when pricing your policies:

Marketplace plans have out-of-pocket maximum limits that are not included in your monthly premiums. For 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

According to the Centers for Medicare & Medicaid Services, insurance companies must provide Florida residents with some coverage for these services:

  • Mammograms
  • Use of drugs for cancer treatment
  • Dental anesthesia
  • Bone marrow transplants
  • Diabetes treatment
  • Child health supervision services
  • Mastectomy
  • Autism spectrum disorders

Find the full list of benefits and how they vary based on small group, large group, and individual coverage here.

Medicare and Medicaid in Florida

People from all different walks of life can get coverage with government-funded health care programs Medicare and Medicaid. These programs cater to two different categories of people. Medicare offers health coverage to senior citizens, and Medicaid helps low-income families and children.

Medicare

Medicare is a program available to people 65 years and older in Florida. There are multiple options within the program, including parts A, B, C, or D and supplemental coverage plans. There are also several ways to get support through a Medicare Savings Program. There are four types of savings programs in Florida:

Qualified Medicare Beneficiary (QMB)

  • Individual with a monthly income lower than $1,032
  • Married couple with a monthly income lower than $1,392

Specified Low-Income Medicare Beneficiary (SLMB)

  • Individual with a monthly income lower than $1,234
  • Married couple with a monthly income lower than $1,666

Qualifying Individual (QI)

  • Individual with a monthly income lower than $1,386
  • Married couple with a monthly income lower than $1,872

Qualified Disabled and Working Individuals (QDWI)

  • Individual with a monthly income lower than $4,312
  • Married couple with a monthly income lower than $5,572

Medicaid

Florida Medicaid is a state and federal program that offers coverage for certain categories of people who reside in the state. These are Florida's Medicaid financial requirements:

Florida Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $16,040
2 $21,599
3 $27,159
4 $32,718
5 $38,277
6 $43,837
7 $49,396
8 $54,956

Florida Office of Insurance Regulation

Website:
Homepage
Insurance Commissioner:
David Altmaier
Consumer Insurance Helpline:
1-877-MY-FL-CFO (1-877-693-5236)
Office Hours:
Monday - Friday
9:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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