Affordable health coverage for individuals, families, and self-employed
Individuals: Single adults needing comprehensive coverage
Families: Parents and children requiring family plans
Self-Employed: Business owners and freelancers
Early Retirees: Coverage before Medicare eligibility (under 65)
Between Jobs: COBRA alternatives and gap coverage
How individual and family coverage works, when you can enroll, and how to choose a plan
If you do not get coverage through an employer, you can buy an individual or family plan. Most people in that position shop the Health Insurance Marketplace created by the Affordable Care Act; in Florida, that is the federal Marketplace at HealthCare.gov. Marketplace plans must cover pre-existing conditions and a core set of essential health benefits, including doctor visits, hospital care, prescriptions, maternity care and preventive care.
Depending on your household income, you may qualify for a premium tax credit that lowers your monthly premium, and some lower-income households also qualify for lower deductibles and copays on Silver plans. The amount depends on income, household size and the cost of plans where you live.
You can buy a Marketplace plan during Open Enrollment, which opens each fall. Outside that window you need a qualifying life event, such as losing other coverage, moving, getting married or having a baby, which opens a Special Enrollment Period for a limited time. If you are leaving a job, compare a Marketplace plan with COBRA before you decide.
Total cost, not just the premium: Plans come in Bronze, Silver, Gold and Platinum tiers. Bronze has the lowest premiums and the highest out-of-pocket costs; Gold and Platinum cost more each month and less when you need care. Add the premium to what you expect to spend on care in a year.
The network: Check that your doctors, specialists and the hospital you would use are in the plan's network, and know whether it is an HMO, EPO or PPO.
Your prescriptions: Check each plan's drug list and the tier your medicines fall on. The same drug can cost very different amounts from plan to plan.
Seasonal residents: Many individual plans have local networks with limited coverage away from home except for emergencies. If you split the year between Florida and somewhere else, factor that in.
Short-term health insurance can fill a brief gap, but it does not have to follow ACA rules. It can exclude pre-existing conditions, cap benefits and leave out services such as maternity or mental health care, and it is limited in how long it can last. For anything beyond a brief gap, compare it carefully against a Marketplace plan.
Early retirees usually need an individual plan until Medicare begins. As you approach 65, see our Medicare insurance page.
No. Marketplace plan premiums are the same whether you enroll on your own or with an agent's help.
Not for a Marketplace plan. Those plans cannot turn you down or charge you more because of your health. Short-term plans can.
Most self-employed people without employees buy an individual or family Marketplace plan and may qualify for a premium tax credit based on expected income. Estimate your income carefully, because the credit is reconciled on your tax return.
Protecting your family in other ways? See life insurance.
Tell us who needs coverage, your doctors and prescriptions, and your expected household income, and we will walk through your options. Call (239) 439-2500 any time and Sarah, our AI assistant, will take your quote application, or use the form above.