icon

Creating a life you love

Share
Share on facebook
Share on twitter
Share on linkedin
Share on pinterest

Florida Health Insurance: Everything You Need to Know About Private Insurance

medical stethoscope on top of a stack of papers

The most common way people in Florida receive health insurance is through their employer. The second most common way people receive health insurance is through Medicare and Medicaid, both of which are public insurance programs.

If you do not receive health insurance from an employer or a public insurance program, then you probably have or are currently in the market for a private health insurance plan.

If you’ve never purchased private health insurance before, it may seem overwhelming maneuvering through the process of picking a plan. To help simplify that process, here’s everything you need to know about purchasing private health insurance in America’s sunny state.

When You May Need to Purchase a Private Health Insurance Plan

Private health insurance may be required if you are:

  • Self-employed
  • A part-time employee
  • Unemployed or in between jobs
  • Retired
  • You have been dropped by your existing carrier

Types of Private Insurance Plans

Assuming you have a choice, you’ll need to decide whether you want a health maintenance organization (HMO), an exclusive provider organization plan (EPO), high-deductible health plan (HDHP), preferred provider organization (PPO), point of service (POS) plan, or a consumer-driven health plan (CHDP).

If you need to fill temporary gaps in coverage, a short-term plan may be a good option for you. If you’re looking to cover emergency medical costs and essential health benefits such as preventive screenings and vaccinations, a catastrophic health plan may also be a good option.

Where to Buy Private Health Insurance in Florida

For those in the market for private health insurance in Florida, there are three ways you can purchase it. The first is through the state’s health insurance marketplace, the second is from a licensed insurance agent, and the third is through an insurance company.

If you’re interested in purchasing a private health care plan through the state’s health insurance marketplace, here’s what you need to know:

  • Every fall, there is an open enrollment period, which lasts around 90 days. You must wait until the first day of the open enrollment period to purchase a health care plan through the exchange. Before that time, you can view and compare health care plans online.
  • Health plans are divided into four tiersplatinum, gold, silver, and bronze. The different plans in the four tiers vary based on their actuarial value. Healthcare.gov explains actuarial value as the percentage of the total average costs for covered benefits that a health care plan will cover. For example, if your health care plan has an actuarial value of 80% on average, you would be responsible for paying 20% of the costs of all covered benefits out-of-pocket.
  • Premium tax credits are available for low to middle-income individuals and families who are looking for coverage in the marketplace. These subsidies help to reduce monthly premiums and out-of-pocket expenses such as copays and deductibles.

If you’re interested in purchasing a private health care plan outside of the exchange from either a licensed health insurance agent or an insurance carrier directly, here’s how an off-exchange plan differs from a plan purchased on the exchange:

  • Off-exchange plans do not offer premium tax credits, unlike plans on the marketplace.
  • All plans must meet the basic requirements outlined by the ACA. However, unlike plans on the marketplace, off-exchange plans do not need to be considered qualified health plans (QHP).
  • The same plans offered on the exchange and off the exchange are sold at the same price.
  • Some insurance companies only sell plans off the exchange and some only plans through the marketplace.
  • Although plenty of first-rate plans can be found in the marketplace, many insurance companies offer their most high-quality, benefit-rich plans off the exchange.

Summary

Choosing a health insurance plan comes down to figuring out what you can afford, the type of coverage you need, and how much freedom you want picking the doctors and hospitals you receive care from.

Taking time to review your budget and considering what is most important to you will help you to choose a plan that best fits your needs. 

THE LATEST

Hi, I’m Thea.

I started this brand as a personal online publication after graduating from Boston University with a degree in Marketing and Design. Originally from San Francisco, I was thousands of miles from family and friends, and needed an outlet for exploring my passions and connecting with others. My goal has always been to show others the beauty in enjoying life’s simple pleasures and to encourage others to look inward for self fulfillment.

Thousands of readers later, The Contextual Life has become a resource for anyone wanting a sense of community and a source of inspiration throughout their journey of life. It’s a place where readers can find suggestions on where to travel, what to eat, what to wear, and what to shop for, from experts who are almost like personal friends.

The Contextual Life brings our mission to life through news, products, experiences, and design. We are dedicated to providing the latest information to help you live a lifestyle that you love. Thank you for being here. Stay awhile.

thea-signature
Im-thea