Demystifying Florida State Insurance

There are multiple types of insurance types available to residents in Florida. However, for the purpose of this article, we’re going to focus on health insurance, specifically the State of Florida’s insurance regulations and the Affordable Care Act (ACA).

Florida offers a variety of health insurance plans for residents, ranging from individual private coverage to work-related group policies, and state and federally funded programs such as Medicaid and Medicare. These various options enable Florida residents to choose the best solutions based on their unique needs.

Yet, with the advent of the ACA, also known commonly as ‘Obamacare’, there arose a new category of health insurance plans, namely ACA Compliant Insurance Plans. These plans have changed the face of the health insurance industry in Florida and have added yet another alternative for Floridians seeking coverage for themselves and/or their families.

What are ACA Compliant Insurance Plans?

Under the ACA, health insurance policies are required to cover a set of 10 essential health benefits without any lifetime or annual dollar limits. These mandatory benefits include maternity care, mental health services, prescription medications, emergency services, and preventative & wellness services among others.

ACA Compliant Plans must also adhere to other policy stipulations such as guaranteeing coverage despite pre-existing conditions and providing coverage options for children up to the age of 26 on their parents’ plans.

The Florida Scene

In Florida, state insurance provisions and mandates co-exist with federal regulations stipulated by the ACA. Though Florida declined to create its own health insurance marketplace, it participates in the Federally Facilitated Marketplace, where residents can shop for and enroll in ACA-compliant plans.

Several insurance companies offer ACA Compliant plans in Florida, including Florida Blue, Ambetter, Cigna, Avmed, and Molina amongst others. Pricing and available services may vary from one insurer to another, and so residents are encouraged to shop around to find a plan that fits their needs and budget.

Medicaid in Florida

Another aspect of Florida State Insurance is Medicaid. However, it’s essential to note that Florida is one of the states that have not expanded Medicaid under the ACA. Therefore, non-disabled adults without dependent children are usually ineligible for Medicaid, regardless of how low their income might be.

Florida’s decision not to expand Medicaid has resulted in what is referred to as the ‘coverage gap’. Many low-income Floridians earn too much to qualify for Medicaid but earn too little to qualify for premium tax credits through the ACA marketplace.

Despite this, Florida still has multiple insurance options, including state-funded programs such as Florida Kidcare Program for children and ACA-compliant private plans.

For residents seeking insurance in Florida, understanding the interplay of state and federal provisions can yield the best possible coverage for their unique circumstances. While there are obstacles such as the Medicaid expansion issue, Floridians can still find comprehensive, affordable coverage to meet their healthcare needs.