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Private and individual health plans in Florida
How individual major medical coverage works in Florida for 2027, including metal levels, network types, and the issuers compiled from official sources. See also the <a href="carriers.html">carriers this agency is appointed with</a>.
Guaranteed-issue ACA coverage
For 2027 individual ACA plans in Florida, coverage is guaranteed issue regardless of health history, and there is no pre-existing condition waiting period on those ACA plans. You generally must enroll during Open Enrollment or a Special Enrollment Period. You also have to live in the plan’s approved geographic area — many networks are county- or ZIP-specific.
Source: Florida 2027 issuer source.
Metal levels, in plain language
Marketplace and other ACA individual plans are grouped by actuarial value — a standard-population estimate of the share of essential health benefit costs the plan is designed to pay, not a promise about your household:
- Bronze — about 60%
- Silver — about 70%. Cost-sharing reductions, if you qualify, are generally tied to selecting a Silver plan on the Marketplace.
- Gold — about 80%
- Platinum — about 90%
Catastrophic plans are a separate category with narrower eligibility (typically under age 30, or a hardship or affordability exception). Lower monthly premiums usually mean higher deductibles, and the reverse.
Sources: HealthCare.gov plan categories; ACA section 1302(d).
What ACA plans must cover
Non-grandfathered individual and small-group plans must cover essential health benefits in these ten categories: ambulatory (outpatient) services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. In-network preventive services required by the ACA are typically $0 when delivered as specified in the plan.
Sources: CMS, essential health benefits; HealthCare.gov glossary.
Network types you will see in Florida
- HMO — Generally covers only in-network providers except in an emergency. You often select a primary care physician, and specialists may require a referral. You usually must live or work in the service area.
- EPO — Services are generally covered only in-network except in an emergency. Referral rules vary by plan.
- PPO — A contracted network with a lower cost for in-network care, and some coverage (usually at a higher cost) for out-of-network care. Balance billing may still apply out of network.
- POS — Typically an HMO-style plan with an out-of-network option at higher cost-sharing if you go outside the network.
Companies offering individual ACA plans in Florida for 2027
Companies that notified the Florida Department of Financial Services / Office of Insurance Regulation that they are marketing individual ACA plans for policies effective on or after January 1, 2027. A company may sell on the Marketplace, off the Exchange, or both. You must live in the plan’s approved service area. This agency is appointed with these issuers and with the other Florida Marketplace/ACA issuers from plan years 2020–2027 listed on the Carriers page. An appointment does not mean every plan is available in every Florida county or ZIP code.
Insurers listed by the official source
- Blue Cross and Blue Shield of Florida dba Florida Blue
- Oscar Insurance Company of Florida
HMOs listed by the official source
- Ambetter Health of Florida, Inc.
- AmeriHealth Caritas Florida
- Av-Med, Inc.
- Capital Health Plan, Inc.
- Centene Venture Company Florida
- Community Care Network, Inc.
- Florida Health Care Plan, Inc.
- Health First Commercial Plans, Inc.
- Health Options, Inc. dba Florida Blue
- Oscar Health Maintenance Organization of Florida, Inc.
- Preferred Care Partners, Inc.
- Simply Healthcare Plans dba WellPoint Florida, Inc.
- UnitedHealthcare of Florida, Inc.
Filed as off-Exchange only in the official 2027 premium table
- Ambetter Health of Florida, Inc. (HMO, off-Exchange only)
- Oscar Insurance Company of Florida (EPO, off-Exchange only)
- Preferred Care Partners, Inc. (HMO, off-Exchange only; new to the individual market in this filing)
County-level detail is in the official availability table. Compare filed rates in CHOICES: Family and Individual Rate Comparison Tool, and confirm Marketplace plans at your ZIP code on HealthCare.gov.
We are appointed with these 2027 issuers and with the other Florida Marketplace and ACA individual issuers from plan years 2020–2027 listed on Carriers we’re appointed with, along with the private PPO and other appointments named there. Availability still depends on your county and ZIP code.
What a quote actually depends on
Individual ACA premiums in Florida may vary by age, tobacco use, plan, and rating area (tied to where you live). They cannot be based on your health status, medical history, or sex. The published figure of $898 per person per month for 2027 is a market snapshot, not your rate. These are statewide weighted averages per person from the Florida Office of Insurance Regulation. They do not include premium tax credits, and they are not a quote for any household.
Sources: HealthCare.gov, How insurance companies set health premiums; official premium publication.