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FL Health Insurance Plans & Direct Enrollment

Health Insurance Coverage

The Affordable Care Act (aka Obamacare) created what’s called Minimum Essential Coverage. These plans can be found both on the Federal Marketplace.

The plans all fall into certain metal tiers: Bronze, Silver, Gold and Platinum. Each offers a varying amount of coverage with differing out of pocket exposure. Bronze plans will be the least expensive and have larger out of pocket costs for the insured.

Federal law prohibits discounting, so you will not find less expensive rates anywhere else on the Internet. That is to say, rates will be the same no matter your source. With our independent agency you are enrolling direct with the carrier of your choice.

Insurance companies offering Marketplace plans in FL in 2020-21 are:  Ambetter from Sunshine Health, Cigna Healthcare, Florida Blue (Blue Cross & Blue Shield FL), Florida Health Care Plans, Health First, Humana, Molina, Bright Health, and Oscar.

Many of these On-Exchange plans are expanding into new counties for 2021. Considering most plans are HMOs, it’s wise to make sure your most important doctors and hospitals are in network before enrolling.

What About Plans Sold Off The Exchange?

Except for short term plans, there are not many policies sold off the Federal Exchange any longer. The primary reason is you can only qualify for tax credits on the Marketplace. People were making the mistake of buying plans off the Marketplace and losing those discounts. Most companies moved their plans to the Marketplace, but not all.

Cigna will offer plans both on and off the exchange in FL for 2021. They look to be very competitive in the southern part of the state. Florida Blue will be a big competitor as well.

However, if you qualify for a tax-credit due to your income threshold, the Federal Exchange (Marketplace) is where you shop and compare ACA options. And if it’s close, buying on the Marketplace is smart just in case your income changes during the middle of the year.

Short Term Plans As A Longer Term Option

Considering the cost and network limitations of some Marketplace plans, some consumers are purchasing short term health insurance for longer periods of time. These plans are much less expensive in some cases and help cover catastrophic or major incidents. Insurance companies offer plans now that can cover years at a time.

These policies are not right for everyone, however. They are medically underwritten, don’t cover many preexisting conditions, and don’t offer maternity coverage. Typically our younger and healthier clients on few or no prescriptions purchase this coverage.

We work with several carriers who offer short term plans. Florida Blue, National General (uses the Aetna and Cigna networks) and United Healthcare are most popular. And since short term plans still offer PPO networks, you have more places you can receive care.

More and more, short term plans look like policies did before the advent of the Affordable Care Act. They are not right for everyone, but do provide catastrophic coverage at much lower rates than what you might see on the Marketplace.

Maternity Health Insurance Coverage In Florida

By law, all ACA compliant health insurance plans offered today will cover maternity expenses. Out of pocket expenses will differ based on the coverage of the plan you select. A Bronze Plan will offer less coverage than a Gold Plan for instance. Deductibles and coinsurance amounts will determine your out of pocket costs.

There are certain open enrollment windows to be aware of so it is wise to speak with an agent to make sure your coverage is effective when you need it most. If you miss your open enrollment window, you will have to wait until November to enroll in coverage that will begin January 1st of the next year.

If you are experiencing a Qualifying Life Event, you can purchase a Marketplace plan outside of Open Enrollment that covers maternity. You might qualify if you’re involuntarily losing group or individual coverage because of a job change or because you moved from a different state.

Networks: Understanding HMO And PPO Plans

Our carriers have agreements with many of the top doctors and health care facilities in Florida. This way you will have several choices when it comes to your health care needs. If you have a particular doctor you would like to keep, we can help you find a plan with that provider in-network.

Staying in network will provide you with the best negotiated prices for medical services. When travelling outside of the state, some carriers will offer better coverage than others. A PPO is always stronger than an HMO when travelling. Al plans must cover emergencies, however.

Some of our customers prefer HMO plans while others desire PPO coverage. We will work with you to find the plans that best suit your needs and budget. We understand that networks are an important part of health coverage.

High Deductible Health Savings Account Qualified Plans

Our clients also like Health Savings Accounts coupled with high deductible health plans. They’re popular as they are some of the most affordable options available. Funds deposited into HSAs are tax deductible, grow tax-deferred, and when withdrawn for qualified medical expenses are tax free. The accumulated funds always belong to the you, not the insurance company – even if the policy is later cancelled.

HSA funds can be used to meet your deductible and coinsurance obligations, pay for prescriptions or doctor’s visit, and even some dental and vision procedures. Once the deductible has been reached with an HSA qualified plan, typically the policy will cover all services as outlined in the policy at 100%.

It is important to understand that all health savings account qualified plans will (by law) cover preventive care without copay before the deductible has been reached. However, you will be responsible for most other out-of-pocket expenses (at the negotiated network rate) before any other medical expenses will be covered.

HSA type plans can only be purchased on the Federal Marketplace. No short term coverage qualifies for HSAs with the I.R.S.

Contact Us For Assistance

Our independent brokerage provides health insurance in Florida to individuals and families. We offer plans direct from carriers such as Ambetter, Aetna, Bright Health, Florida Blue, Humana, Molina, Oscar, United Healthcare and others.

We serve all of FL and can help you stay compliant with the Affordable Care Act. We have placed online quoting and enrollment links for short term plans below. Use the link on the right quote all Marketplace plans or to request free assistance.

United Healthcare Insurance Plans

United Health One

View UHC Quotes →

  • Affordable Monthly Rates
  • Short Term Health PPO Insurance
  • Stand Alone Dental Plans
  • Optional Vision Coverage
  • Large Nationwide Network

Humana Health Insurance Coverage

Humana

View Humana Quotes →

  • Very Competitively Priced
  • Marketplace Coverage
  • Individual & Family Plans
  • Stand Alone Dental Coverage
  • Stand Alone Vision Insurance

Cigna Off Exchange Plans

Cigna

View Cigna Quotes →

  • Competitively Priced South Florida
  • Coverage On & Off Exchange
  • Individual & Family Plans
  • Stand Alone Dental Coverage
  • No Waiting Periods