Get Affordable Obamacare Florida Plans
Find the best Obamacare Florida plans with Cuspide. All at a low cost through the health insurance marketplace.
Why Cuspide stands out as your top choice
Partnered with the top insurance companies
Unlike other agencies, we can sell you every plan in the health insurance marketplace.
Plans at the lowest cost
We browse through all the carriers and find you the best coverage at the lowest cost.
Round-the-clock support
Unlike others we are 24/7 agents that assist you through phone, text, or email.
The metal tiers in Obamacare Florida health insurance
If you want to get affordable health insurance in Florida then, you MUST understand the different categories or “metal” tiers. The marketplace provides plans at different prices.
But what is it and how do they work? The Affordable Care Act (Obamacare) introduced 4 main categories of health plans. Bronze, Silver, Gold, and Platinum. Here is what you need to know:
Bronze
The Bronze tiers have lower monthly premiums higher but higher out-of-pocket costs. Made for individuals who don't expect frequent medical visits. Or who prefer lower upfront costs. Premiums may be more affordable, but you could have higher deductibles and copayments.
Silver
The Silver tier strikes a balance between premiums and out-of-pocket costs. They have moderate coverage and are good if you seek a reasonable level of medical coverage. Silver plans have both affordable monthly premiums and moderate costs. Making them a popular choice.
Gold
A gold tier has higher monthly premiums. And lower out-of-pocket costs compared to bronze and silver plans. Ideal for individuals who expect higher healthcare use or have ongoing medical needs. Gold plans provide more complete coverage. Lower deductibles and copayments, making them a good option for you.
Platinum
The Platinum tier has the highest monthly premiums but offer the fullest coverage. Made if you expect to have frequent medical care. Platinum plans have lower deductibles, copayments, and coinsurance. Leaving you with more coverage and reducing your out-of-pocket costs.
Here’s how health insurance covers you
Did you know that the average emergency room visit cost without insurance in FL is over $3,000? With the right plan, your healthcare provider will cover these medical costs. It is important for you to know the terms. Monthly premiums, low deductibles, and out-of-pocket. Here’s how healthcare works in the Sunshine state.
Premium
A premium is the monthly payment you make for your health coverage to the insurance company. Having a health plan from the marketplace could potentially help lower monthly costs. All through a premium tax credit.
Copays
This is a fixed fee you pay for covered services, like doctor visits or prescriptions. This amount will vary depending on your insurance plan’s copayment.
Deductible
Before your health insurance company starts to pay, a deductible is what you must pay out-of-pocket for the health services. For example: An MRI costs $1,000 and your plan's deductible is $500. You must pay $500 to get that MRI and the insurance will cover the other $500.
Out-Of-Pocket Maximum
OOP max is the limit amount you could pay in a year for covered services. After you reach this limit, your healthcare provider will cover all medical costs, doctor visits, prescriptions, etc.
Cuspide shares some Obamacare Florida statistics
$3,102
Avg emergency room visit cost without insurance in Florida
12%
of FL residents are uninsured
$29,159
Avg income in Florida
3,200,000
Number of Florida residents that signed up for health insurance through the ACA marketplace
$10
4 out of 5 people qualify for a $10 a month or less medical plan
Apply for Obamacare Florida plans!
Here at Cuspide we can help by browsing all the health insurance marketplace plans available in Florida. Free quotes! Contact us via phone, text, or email.
The 4 parts to affordable health insurance in Florida
In March of 2010, the Affordable Care Act (ACA) was put into place. It has it all, whether you want coverage for yourself, your family, or business. Understanding how this all works is crucial. We will provide you with information about the key coverage, benefits, and enrollment process. Below you will learn everything needed to get the best possible coverage.
Enrollment
When it comes to enrolling in ACA plans, the process is simple. You can sign up for coverage during the OEP (Open Enrollment) which usually runs from Nov 15 – Jan 15. It's important to know that FL residents can qualify for a “Special Enrollment Period” if they have had certain life events. Such as getting married or having a baby. By contacting us at Cuspide, we can help you enroll with what that best suits your needs.
Coverage
Obamacare coverage includes the essential health benefits. These benefits have many services. Like preventive care, prescription drugs, mental health treatment, and maternity care. They also offer coverage for pre-existing conditions. This makes sure that you access the care you need, without being denied or charged high premiums due to your health status.
Plans
Plans come in different tiers. Bronze, Silver, Gold, and Platinum. Each tier offers varying levels of coverage and cost-sharing. Bronze plans have lower monthly premiums but high out-of-pocket costs. Platinum plans have high premiums but lower OOP costs. Silver plans may be eligible for cost-sharing reductions based on your income. At Cuspide, we can help you with all the available options in the Sunshine state.
Requirements
ACA eligibility is simple and so is the qualification. You must meet certain requirements. One of the primary criteria is being a FL resident. You need to provide proof of income and household size to see if you qualify for subsidies. This will help lower premiums. Now that you know how to get Obamacare insurance, we can provide you with help and support at Cuspide.
Here at Cuspide we partner with all the companies. Each insurance carrier has its own unique plans, networks, and costs. This allows you to find the most affordable health insurance in Florida. Whether you need coverage for self-employed, unemployed, or your small business. The marketplace has you covered. Let’s look at the top healthcare providers in the Sunshine State.
Ambetter from sunshine health has been around in the insurance marketplace since 2013. Their network has access to doctors, prescriptions, and top medical care services. This is all possible through their provider search. Dental plans are also possible with them as well as vision plans. Affordable plans.
Oscar Health is one of the newer ones in the field but already dominant. Like other companies they have benefits like urgent care and health services with their plans. If you are looking for EPO plans, then browse the large EPO network they have. This is all possible through their provider portal. If you are looking for low-cost coverage, then they might be a good fit for you. Offers great customer service.
Aetna better health of Florida or known as CVS health is a frontrunner in the industry. With their provider search you can find a doctor, specialist, urgent care, and more services. One of the leading HMO providers because of their large network. Made for individuals or families. Their low-cost options are a great choice in the Sunshine state.
Cigna Healthcare is one of Florida’s top-tier medical carriers. One of the older ones out of all of them here. Their many benefits offer low-cost coverage and a wide range of healthcare services. Their ACA plans have budget friendly options through their HMO networks. Superb reviews and great customer service.
AvMed offers lots of good coverage options in the industry. Dental plans for individuals and families are also available. You can also shop for vision plans as well. Use the provider portal to find a specialist doctor or any medical services. They only have HMO networks and do not include any EPOs.
Blue Cross and Blue Shield of Florida is one of the more recognizable names in the business. Giving residents affordable coverage since 1945, they are one of the leading companies. EPOs and HMOs are available through them. Quality treatment and a large network that give you access to best care.
Molina Healthcare is a well-established organization. From being Medicaid providers to offering low-cost medical coverage. A veteran in the industry. They are a good choice if you qualify for free or cheap coverage, then they can help. Make payments, find care, and more all through their member portal.
The largest insurance company in the US. Use all the available ACA benefits with all their different products. Dental and vision is available in FL. Great for people from all income levels.
Many ask questions like “Which company is the best?” When you compare the carriers under Obamacare, it’s important to know that it’s based on many factors. Like coverage options, network size, reviews, and affordability. All comes down to you. As there is no superior provider. These will all be able to provide cheap health insurance in Florida!
Who is eligible for Obamacare Florida Plans?
Obamacare (Affordable Care Act) gives a place for you to get low-cost health coverage. To be eligible for Marketplace coverage, you must be a U.S. citizen, national, or present immigrant residing in the USA (also have green, card, social security number, etc).
Additionally, you cannot be currently incarcerated. If you have employer-sponsored coverage that meets minimum standards, you may not qualify for coverage. But, if your employer’s plan does not provide enough coverage, you may still be eligible to enroll in a marketplace plan. You also need to meet the income limits to qualify. Those are the requirements for health insurance in FL.
Looking for affordable health insurance in Florida?
Cuspide will search the entire marketplace to find you the best health coverage in the Sunshine State. Reach out to us and get quotes at no cost to you! Phone, text, or email.
Difference between HMO and EPO insurance
The 2 main Obamacare Florida plans in the marketplace are Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO). Questions like “Which is better?” are always asked. If you are looking for medical insurance, both HMO and EPO plans offer great options. However, they have differences that can affect coverage. Let’s explore the key differences between HMO and EPO plans. We will do it with graphs because they are fun, and paragraphs are not:
| HMO | EPO |
|---|---|
Requires selecting a PCP within the network and obtaining referrals for specialist visits. | You do not need to set up a PCP if you do not want. Can get direct care as you like. |
Limited to a specific network of healthcare providers and facilities. | Like an HMO plan, the network coverage is also limited. Usually has a larger network. |
No coverage for out-of-network care, except in emergencies. | Generally, no coverage for out-of-network care, except in emergencies. |
Lower monthly premiums and lower out-of-pocket costs for in-network services. | Moderate monthly premiums and cost-sharing for in-network services |
Less flexibility in choosing healthcare providers outside the network. | This remains the same as the HMO counterpart. |
Requires referrals from the PCP for specialist visits and certain services. | Referrals are not needed. Direct access to specialists. |
Obamacare Open Enrollment and Special Enrollment Period Explained
To enroll in Obamacare Florida plans, you need to know when to apply. There are 2 periods (OEP and SEP) in which you can sign up for.
Think of this as a grand shopping spree that happens once a year. This period opens the doors for you to explore a wide range of coverage. It’s your chance to apply, compare options, change income, and make any changes that you may need to make. So, mark your calendars and get ready to shop for the ultimate protection for you and your family.
Dates: Begins November 15 and runs through January 15 of the next calendar year.
Life is full of surprises, and the marketplace has your back with Special Enrollment. This allows you to enroll in health insurance outside the regular Open Enrollment period. Let’s dive deeper into the various qualifying events that make you eligible:
- Getting Married or Divorced: Tying the knot or going separate ways. This gives you the chance to make some changes to your policy.
- Having a Baby or Adopting a Child: Welcoming a new addition to your family brings joy and responsibility. This period allows you to secure coverage for your growing family’s needs.
- Losing Existing Coverage: Whether due to job loss, aging out of a parent’s plan, or the expiration of a previous policy. Losing coverage triggers an opportunity to apply.
- Moving: Relocating to a new state or even within the same state can often result in changes to your healthcare options, making you eligible.
- Gaining Citizenship or Lawful Presence: If you recently became a U.S. citizen or obtained lawful presence status. Like your green card or residency, you have the chance to enroll outside of the standard dates.
- Experiencing a Significant Income Change: If you’ve recently experienced a large change in your income. You may qualify to adjust your coverage.
- Becoming Eligible for Medicaid or the Children’s Health Insurance Program (CHIP): Qualifying for Medicaid or CHIP. This allows you to enroll in coverage without waiting for the Open Enrollment period. (Can also qualify if you are denied Medicaid.)
Income limits for ACA/Obamacare Florida plans
To see if you qualify for affordable health insurance in Florida, you must meet the income requirements. Here are the Obamacare/ACA income levels for the 2024 year. On the left is the household amount and on the right is the Federal Poverty Level from 100% to 400%. Want to test your eligibility? Let’s find out.
To put it simply, the closer you are to 100% the less you will pay for your plan. The closer you are to 400% the more you will pay for your plan. It’s important to note that if you make less than the minimum then you can’t qualify but if you make more than the maximum amount you can still qualify you will just pay the plan for the full price (no discount.) This “discount” is what is called the “Premium Tax Credit”. But how does this work? It’s easy.
Example: A marketplace plan can be $500 a month but the person who applies gets a Premium Tax Credit of $475 a month. That tax credit is applied leaving the applicant paying only $25/mo.
If you want to find out how much credit you will receive you have to contact an agency like us here at Cuspide. It’s important to figure out how many people in your household will apply and the correct income so you do no not end up overpaying.
| Household # | 100% | 400% |
|---|---|---|
1 person | $14,580 | $58,320 |
2 people | $19,720 | $78,880 |
3 people | $24,860 | $99,440 |
4 people | $30,000 | $120,000 |
5 people | $35,140 | $140,560 |
6 people | $40,280 | $161,120 |
7 people | $45,420 | $181,580 |
8 people | $50,560 | $202,240 |
3 reasons why your health insurance is expensive
Residents usually want to find Obamacare Florida health insurance for cheap, not something expensive. So, when you are shopping for coverage, you may run into a cost problem. Residents may have high premiums or wonder why the deductible is so high. We at Cuspide, are here to help. Use our Obamacare cost per month calculator to get an estimate on what you will pay! Below are 3 key factors into why you are overpaying.
1. Your Agent/Broker
When getting help from an agent, you may face a limit because of their contracts. Many agencies can only sell policies from a select few companies. This prevents them from offering you the best plan available in the market. This may be the reason why it is not cheap for you. Here at Cuspide, you won’t run into this problem because we have partnerships with all the top carriers in the United States.
2. Incorrect Income Reporting
One critical aspect that affects your premium (what you pay monthly) is your reported income. An error in this calculation can lead to overpaying. Whether you receive income as a W-2 employee or a 1099 contractor, it’s important to report your earnings correctly. By fixing any mistakes, you can find options that fit your budget and don’t break your wallet.
3. Household Errors
Having errors in your marketplace application can be costly on your monthly payments. Failing to include all members of your household or not listing a dependent can result in not getting low premiums. If you look at the Obamacare income limits, then you will see why. Have your agent review your application to make sure that all information is correct.
Medicaid vs Obamacare Florida insurance: Which one is for you?
Medicaid and Obamacare are two different healthcare programs in the US. Both are designed to help individuals and families get affordable coverage. While Medicaid primarily caters to low-income individuals, offering good services at minimal or no cost, it has strict income and eligibility requirements.
On the other hand, Obamacare (Affordable Care Act) is designed to offer more options. It provides a marketplace where individuals, regardless of their income level, can shop for insurance that fits their specific needs and budget. This means that even if someone doesn’t meet the income criteria for Medicaid, they can still access low-cost coverage through the ACA marketplace. Obamacare’s flexibility and accessibility make it a great choice for many who may not qualify for Medicaid.
NOTE: If you were denied Medicaid, you can still qualify for Obamacare!
Let’s explore the internet’s top doubts regarding medical insurance in Florida.
The open enrollment period for health insurance is once a year and usually during the same dates. Since Obamacare’s opening in 2010, it has run from November 15th to January 15th. So, for 2023-2024 you can expect future dates to be the same (Nov 15, 2023 – Jan 15, 2024). If you missed it, you may still have options through a special enrollment period. This period is triggered by qualifying life events. Like getting married, having a baby, or losing your healthcare coverage. During this time, you can enroll in or make changes to your plan outside of the regular time.
Choosing the best plan in the sunshine state depends on your needs and many factors. While there are many companies to consider. Such as Ambetter, UnitedHealthcare, AvMed, Oscar, Molina, Cigna, Florida Blue, and Aetna. The “best” option varies for each person. Factors to consider include the cost of premiums, coverage options, network of healthcare providers, customer reviews, and specific benefits. Also depending on how much your total household income is, your dependents, and location. This will all factor into which to choose. If your goal is low-cost options, then Cuspide can help!
Everyone wants free health insurance in Florida. However, the monthly cost can vary depending on various factors. Such as location, age, income, and amount of coverage needed. It’s hard to provide an exact estimate without that information. It’s worth noting that many individuals may qualify for a subsidy through the marketplace. In fact, approximately 4 out of 5 individuals who enroll may be eligible for a plan that costs $10 a month or less. All based on their income and household size. It’s recommended to explore the available options and subsidies in your area. If you want to get affordable health insurance in Florida, then be sure to contact Cuspide. Our clients on average only pay $20/mo!
In some cases, yes, premiums are tax-deductible. The rules surrounding this deduction vary depending on different circumstances. Self-employed individuals and some small business owners may be able to deduct health insurance premiums as a business expense. Additionally, some countries provide tax deductions or credits for individuals who buy plans. The deductibility of premiums from your tax return is dependent on when and how you made the premium payment. Like for example if you contribute to your insurance expenses pre-tax. It may not be possible to deduct those premiums from your taxes.
Yes, it will help cover car accident-related medical costs. Car accidents are usually covered by auto insurance. Liability coverage and personal injury protection (PIP). A healthcare plan covers medical expenses related to illness or injury like, for example, if you sustain injuries in a car accident and need treatment. Your provider will cover any medical services that are not covered by your auto insurance policy. Like ongoing rehabilitation or specialized treatments. It’s important to look over both policies with your agent. Understand the specific coverage and benefits they provide.
To see which plan you have, contact Cuspide Insurance at (305) 970-8583. We will look up your policy information and assist you in finding your provider. We also offer support in looking up your plan through the Marketplace. Cuspide can help in making any necessary changes to your coverage. Our team is ready to help and ensure that you have a clear understanding of your medical coverage.
To apply for health insurance in Florida, you must do it through the marketplace with an insurance agent. You can get covered today with Cuspide, in under 5 minutes. Most who apply can qualify for a $10 a month or less plan. All we do is ask a couple pre-qualifying questions and we start looking at the best the marketplace offers. We are a group of brokers that focus on finding you great low-cost options. Contact us today to get started and ensure you have the best health plan in the Sunshine State.
