A licensed Florida broker's plain-English map of every realistic way to get covered here, and how to tell which one fits your income and health.
There are five realistic ways to get health coverage in Florida: an ACA Marketplace plan through Healthcare.gov, the federal exchange, an off-exchange plan bought directly from a carrier, a medically underwritten private plan, short-term medical as a bridge, and group coverage if you own a business.
Which one fits comes down to two questions: does your household income qualify for a premium tax credit, and if not, can you pass medical underwriting? Subsidy-eligible households usually belong on the Marketplace. Healthy households above the subsidy range often pay meaningfully less on an underwritten plan than at full Marketplace price.
Florida enrolls more people through the federal Marketplace than any other state, and with that volume comes a flood of ads, call centers, and "private plan" pitches that all claim to be the answer. Most of them are selling one product and calling it a recommendation.
We live and work here. Between the contractors, realtors, restaurant operators, and 1099 professionals that make up so much of Florida's economy, the most common situation we see is a healthy household earning too much for a subsidy and paying full Marketplace price for no reason.
Three structural facts shape every Florida decision before any quote is run: where Marketplace plans are sold, what happens at the low-income end, and who regulates the carriers.
Florida does not run its own exchange. ACA Marketplace plans here are sold through Healthcare.gov, the federal platform, during Open Enrollment or a Special Enrollment Period. Florida consistently has among the largest Marketplace enrollments in the country, so carriers compete hard in most counties.
Florida has not expanded Medicaid. Practically, that means some adults with income under the federal poverty level fall into a coverage gap: over the limit for Florida Medicaid, under the floor for Marketplace subsidies. If you're in that band, talk to us before assuming you have no options.
Health insurance in Florida is regulated by the Florida Office of Insurance Regulation, and carriers file their rates by rating area, which is why the same plan prices differently across Miami, Tampa, Orlando, and Jacksonville. Broker compensation is built into those filed rates, so working with us costs you nothing extra in any lane.
Every lane below is real coverage sold in Florida today. What differs is who each one prices well for, and what it quietly leaves out. For the deep national version of this comparison, see our full coverage guide.
Sold through Healthcare.gov during Open Enrollment or a Special Enrollment Period. The only lane where premium tax credits apply, and it cannot decline you for health history. If your household qualifies for a subsidy, this lane is almost always your answer in Florida.
The same class of ACA-compliant major medical, bought directly from a carrier instead of through Healthcare.gov. No subsidy applies, so it's for households above the credit range who want guaranteed-issue coverage, sometimes with networks or plan designs the exchange doesn't list.
You answer health questions, and the carrier can decline or exclude conditions. The trade: healthy applicants often pay meaningfully less than unsubsidized Marketplace pricing. For healthy Florida households above the subsidy line, this is the lane most worth pricing and the one most buyers have never been shown.
A bridge, not a destination: between jobs, waiting on an enrollment window, aging off a parent's plan. Lower premiums, but pre-existing conditions and maternity are typically excluded, and terms are capped by federal and state rules. Fine for a healthy person covering a gap measured in months.
If you own a business with even a few employees, a small-group plan, a level-funded plan, or an ICHRA can beat what everyone would pay individually, with contributions that are deductible to the business. We built a separate guide for that: group health insurance in Florida.
The most expensive default in this market is a healthy self-employed household above the subsidy range buying an unsubsidized Marketplace plan because it was the only quote they ever saw. If you can pass medical underwriting, an underwritten private plan will often cover the same real-world risks for meaningfully less per month.
Florida's mix of construction, real estate, hospitality, and independent professionals makes this the single most common conversation we have with Florida buyers. And the check is honest in both directions: if you have real pre-existing conditions, underwriting is the wrong lane, and we'll tell you so and point you back to guaranteed-issue ACA coverage.
Run a business with employees in Florida? The individual lanes above stop being the whole story. Traditional small-group plans, level-funded plans, and ICHRAs each handle a different size and budget, and contributions are deductible to the business. Start with our dedicated Florida group health insurance guide, then bring us your census and we'll price the realistic options.
It depends on age, county, plan tier, and whether a subsidy applies; Florida premiums are set by rating area, so Miami, Tampa, Orlando, and Jacksonville can each price differently for the same plan.
Three patterns hold: subsidized Marketplace plans are cheapest for those who qualify, unsubsidized Marketplace plans usually cost the most, and medically underwritten plans for healthy applicants typically land in between. A real quote is the only accurate number, which is why we don't publish ranges that would mislead.
No. Florida uses the federal platform, Healthcare.gov, for ACA Marketplace enrollment; there is no separate state exchange.
Keep in mind Healthcare.gov only lists on-exchange Marketplace plans. Off-exchange, medically underwritten, and group options are sold outside it, so it shows one lane of the market, not all five.
Coverage follows your primary residence, so if Florida is your legal home state, you buy in Florida even if you spend months elsewhere. The catch is networks: many Marketplace plans here are HMOs whose networks stop at the county line, let alone the state line.
Part-year residents should weight plan choice toward broader networks and check how emergency versus routine care is treated away from home. It's one of the most common Florida-specific questions we untangle, and the answer depends on the exact plan.
Yes. Premium tax credits are based on modified adjusted gross income (MAGI) and household size, not employment type, so 1099 and self-employed households qualify on the same terms as anyone else.
Self-employed income also has legitimate deductions (including the self-employed health insurance deduction) that change MAGI, so plenty of owners qualify who assume they don't. Run the numbers before writing the subsidy off.
Then you're choosing between full-price lanes, and health becomes the deciding question. If you can pass medical underwriting, an underwritten private plan often costs meaningfully less than an unsubsidized Marketplace plan for comparable real-world coverage.
If you can't, an off-exchange or on-exchange ACA plan at full price is the right protection: guaranteed issue, pre-existing conditions covered. Expensive beats excluded when you'll actually use the coverage.
Florida has not expanded Medicaid. Practically, that means some adults with income under the federal poverty level fall into a coverage gap: over the limit for Florida Medicaid, under the floor for Marketplace subsidies. If you're in that band, talk to us before assuming you have no options.
Income counting has real nuances (household size, what counts toward MAGI), so borderline situations deserve an actual eligibility check rather than an assumption.
Start with headcount and budget: those two facts decide whether traditional small group, a level-funded plan, or an ICHRA fits. All three are live options in Florida, and contributions are deductible to the business.
We keep a dedicated walkthrough at our Florida group health insurance page, and a census (ages and ZIP codes, no health details needed up front) is enough for us to price the realistic lanes.
You've seen the menu for Florida. If you want the lanes priced against your actual age, county, income, and health, that's the part we do every day: real numbers across whichever lanes fit, in about one short call.
If our honest recommendation is that you'd be better off going through Healthcare.gov on your own, we'll tell you. Quotes are non-binding and based on the information you provide.