Florida Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
September 9, 2020

Are you buying your own insurance this year? Many people opt to buy their own healthcare coverage for various reasons. As a resident of Florida, you have many options for health care coverage, and we want to help. But first things first. You’ll want to enroll in a new health plan during open enrollment, unless you have a qualifying event that allows you to buy health insurance at any time.

When Is Open Enrollment in Florida?

November 1, 2020 - December 15, 2020. Coverage begins January 2021.

How to Get Health Insurance in Florida

Selecting the right healthcare coverage requires a little forethought. You’ll want to select a tier based on the previous year’s healthcare needs, unless it included services that you would not normally require. Looking at how often you needed care will help you estimate costs for the upcoming year. And you’ll be better able to select a plan based on the number of visits you anticipate and based on whether or not you want to keep your current doctors.

Regardless of which type of plan or how much coverage you plan to buy, it’s a good idea to compare health insurance companies and health insurance quotes before you buy. After you submit a form with SmartFinancial by clicking the second link above, you’ll get several competing health insurance rates to choose from. We’ll also connect you with the best matching agent in your area so you can buy the coverage or simply ask questions about the plan you’re considering.

What Types of Health Insurance Are Available in Florida?

HMOs, EPOs, PPOs and POS plans are the most commonly available in Florida. You can also find short-term insurance plans and catastrophic plans, which only provide coverage for emergencies but not regular care. Full health care plans are available in the following tiers: bronze (covers 60% of costs), silver (70%), gold (80%) and platinum (90%). So, if you see your doctor several times a month, a platinum plan, which costs more each month, may save you money overall by covering more of your copays and coinsurance. That’s why it’s important to look at your health care needs when selecting a plan.You’ll also want to choose a plan based on whether or not you wish to keep your current doctor(s).

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Florida

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • When you lose or quit a job or start your own business, you are free to buy health insurance outside the enrollment period.
  • When you turn 26, you have to get off your parents’ health insurance plan(s), so you can buy a new plan outside the open enrollment period.
  • When you move to another county or state, it may impact your coverage. If you need new health insurance due to a move, you can buy a plan outside the open enrollment period.
  • When a Cobra extension reaches its deadline, you can buy a new health plan outside the open enrollment period.
  • When you divorce a spouse with whom you shared a health insurance plan, you can buy a new one outside the open enrollment period.
  • When you get married, you can opt to buy a new health insurance plan together or separately, and you can do so outside the open enrollment period.
  • When you have a new child, you can buy a new health plan for that child outside the open enrollment period.
  • When a partner or spouse, with whom you share a health insurance policy, passes away, you can buy a new health plan outside the open enrollment period.
  • When a spouse or partner, with whom you share a health insurance plan, loses coverage due to a qualifying reason, you may buy a new health plan together or separately.

Is Health Insurance Required in Florida?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Florida?

Health insurance in Florida is not cheap. The average cost of health insurance in Florida for a 40 year old is about $554 a month. Health insurance only becomes more expensive as you age. Tobacco use also increases health insurance rates.

How to Save on Health Insurance in Florida

The best way to save on health insurance in Florida is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs

Medicare in Florida

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Florida?

Roughly 21% of the people in Florda are insured through Medicare.

How Much Is Medicare in Florida?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Florida

The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Florida?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Florida State Health System Ranking

  • Florida: Overall State Ranking: 44 of 51
  • Florida: Overall Performance: Worse than Average
  • Florida: Access & Affordability: 47
  • Florida: Prevention & Treatment: 44
  • Florida: Avoidable Hospital Use & Cost: 49
  • Florida: Healthy Lives: 31
  • Florida: Health Care Disparities: 32

Find Affordable Health Insurance in Florida

Florida Health Insurance Coverage

The people of Florida have different kinds of health insurance while some Florida residents are not insured at all. See the breakdown below:

  • Private coverage: 44%
  • Medicaid: 19%
  • Medicare: 21%
  • Uninsured: 16%

Florida Health Insurance Companies

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