How to Find an Affordable Florida Healthcare Insurance Plan

Finding an affordable health insurance plan can be a challenge. If you’re someone who needs to purchase insurance through the health insurance marketplace, you may need some assistance in finding and choosing the right Florida health insurance.

At Addition Financial, it’s our goal to help our valued members achieve their financial goals and that includes providing them with the tools they need to choose the right health insurance. With that in mind, here are the facts you need about how to find an affordable Florida health care plan.

How Do You Get Health Insurance in Florida?

Health insurance is available to every resident of Florida. People who are employed may get health insurance through their employers. Employer-sponsored plans may be funded fully by the employer, or through a combination of employer contributions and withdrawals from employee paychecks.

People who qualify, including those who are unemployed or below the poverty line, can get health insurance through Medicaid, while those who are retired and over the age of 65 are covered by Medicare, which they may choose to supplement with additional coverage.

The final option is the health insurance marketplace, which was created after the passage of the Affordable Care Act (ACA) in 2009.

What Type of Health Insurance Marketplace Does Florida Use?

Florida is one of 33 states that use the federal health insurance marketplace to allow its residents to purchase health insurance. The marketplace has allowed millions of Floridians to obtain health insurance. In fact, during the 2021 open enrollment period, the Centers for Medicaid and Medicare Services reported that 2,120,350 people in Florida chose insurance plans via the marketplace.

The federal healthcare marketplace can be found on Healthcare.gov, the website created specifically for the purpose of helping people find health insurance. We will review the process to find health insurance later in this post.

Who is Eligible for Florida Medicaid?

Florida Medicaid is available for people who meet the income requirements plus one of the other requirements that Florida has put in place. The income limitations are based on household size, as follows:

1 person, $17,131
2 people, $23,169
3 people, $29,207
4 people, $35,245
5 people, $41,284
6 people, $47,322
7 people, $53,360
8 people, $59,398

You must also meet one of these qualifications:

Pregnant
Responsible for a child 18 years or younger
Blind
Have a disability or someone in your household with a disability
Be 65 years of age or older and not yet eligible for Medicare

If you qualify based on income and meet one of the other qualifications, you can get Medicaid in Florida.

How to Get Florida Healthcare Insurance on the Health Insurance Marketplace

If you do not qualify for Medicaid and you don’t have employer-sponsored health insurance, you can purchase health insurance through the federal health insurance marketplace. Here are the steps to follow to find insurance.

Familiarize yourself with the marketplace. Even before you apply for health insurance in the federal marketplace, you should get familiar with the available plans and prices as well as the requirements to qualify for discounted rates. You can do that by visiting Healthcare.gov and using their Quick Guide to get started.
Create an account. Creating an account is easy and can be done in just a few minutes. You can do it by clicking the “Create an Account” button in the Quick Guide. You will be prompted to enter some basic information, including your name, address and email, create a login ID and password and verify your identity by providing some information that will be checked against your credit report. This is so nobody else can create an account in your name.
Gather necessary information. To apply for a health insurance plan on the federal marketplace, you will need some information about yourself and other members of your household. Specifically, you will need the income of each household member, tax filing status and information about any employer-sponsored health insurance or Health Reimbursement Accounts (HRAs) to complete your application. You can find a complete list of what you need in this health insurance marketplace guide.
Submit your application. Once you have estimated your income and gathered all necessary information, you will submit your application.
Choose an insurance plan. The final step is to choose an insurance plan from the options you receive after you submit your application.

The open enrollment period for the health insurance marketplace starts on November 1 each year and ends on January 15 of the following year. However, if you have a qualifying life event, then you can find insurance at any time. Examples of qualifying events include the following:

You got married or divorced
You gave birth to a child or adopted a child
You moved to another state
You lost your insurance

If you have experienced one of these events, then you can qualify for a special enrollment period to choose a new health insurance plan.

Which Insurance Plan Should You Choose in the Marketplace?

If you’ve never purchased health insurance in the federal marketplace before, then you might need some basic information about the various types of plans and what they mean. Here’s a quick rundown.

Health Maintenance Organization (HMO) plans provide coverage for treatment with HMO-employed and approved providers. You must choose a primary care physician who will refer you to other providers as needed.
Preferred Provider Organization (PPO) plans offer both in and out of network coverage but members are incentivized to stay in network with lower deductibles, copays and out of pocket maximums. You can see a specialist without a referral.
Exclusive Provider Organization (EPO) plans offer in-network coverage only, although you can see an out of network specialist with a referral.

We should note that with all of these plans, you will be able to decide on a deductible that suits your needs. It’s important to balance the expense of your monthly premium against the deductible, keeping in mind that you will need to pay the deductible out of pocket.

Should You Get a High Deductible Plan?

For people who have never purchased health insurance on the federal marketplace, there can be a bit of sticker shock. Many employers pay for at least part of the monthly premium for the plans they sponsor, which means you may have paid a relatively low amount for insurance in the past.

We noted in the previous section that you can choose your deductible. One way to save money on your health insurance premiums is by opting for a high deductible health plan, or HDHP. You should know that for 2022, the federal government defines any health plan with a deductible of $1,400 or more for an individual, or $2,800 or more for a family, as a high deductible plan.

If you opt for a high deductible plan, you may want to open a Health Savings Account. With an HSA, you can make contributions to your savings plan up to $3,600 per year as an individual or up to $7,200 per year if you have a family plan. Withdrawals are tax free if you use them to pay for qualified medical expenses and if you contribute post-tax dollars, you will be eligible for a tax deduction.

You should know that the funds in your HSA may be used to pay your deductible, copays and other out of pocket expenses. They may not be used to pay your health insurance premiums.

How Much Does Florida Health Insurance Cost?

There are several factors that can impact the cost of your health insurance plan. These include your age, whether or not you smoke, whether you have a serious pre-existing condition and where you live.

The age effect is something you should know about before you shop for a plan. The baseline age is 21 and premiums are increased for people in their 30s, 40s and 50s. Older people tend to have more health issues than younger people and they also are more likely to use their health insurance, which is why insurance companies charge more to insure them.

People who meet the income qualifications may qualify for a subsidy to reduce the cost of health insurance. For example, the average cost of marketplace insurance in the United States in 2019 was $612 per month without any subsidies and $143 with subsidies.

For Florida residents, the average without subsidies is a bit lower than the national average. As of 2020, the monthly average without subsidies was $468, and in 2021, the monthly average without subsidies was $457.

You will need to go to the Healthcare.gov site and enter your location and some other information to find out if you qualify for a subsidy. If you do, you can get insurance for a substantially lower premium than the national or state average.

Buying health insurance is always a smart option if you don’t get coverage through your employer. Even if you are young and reasonably healthy, there’s always a chance that you could get sick or sustain an injury that would have a significant impact on your finances.

One way to mitigate the cost of a high deductible health plan is to open an HSA. Addition Financial offers an HSA to members. You can read about it and open an account here!