How the Marketplace works
The Affordable Care Act set up a Marketplace where you buy health insurance on your own. Florida doesn't run its own, so Floridians use the federal Marketplace, the one behind HealthCare.gov. Private insurance companies sell the plans. The government sets the rules and, if your income qualifies, pays part of your premium through a tax credit.
Every Marketplace plan follows the same basic rules:
- Pre-existing conditions are covered, and the application has no health questions
- Essential health benefits are included: doctor visits, hospital care, emergency care, maternity, mental health, prescriptions and pediatric care
- Preventive care, like a yearly checkup and many screenings, costs you nothing in the plan's network
- There's a yearly out-of-pocket maximum. Once you reach it, the plan pays 100% of covered in-network care for the rest of the year
That last rule is why most people should start here. A bad diagnosis or a long hospital stay has a ceiling on what it can cost you.
The words on every plan
Four terms decide what you pay when you actually use care.
| Term | What it means |
|---|---|
| Premium | What you pay each month to keep the plan, after any tax credit |
| Deductible | What you pay for covered care before the plan starts sharing the cost. Many plans cover some visits before you meet it |
| Copay or coinsurance | Your share after the deductible, either a flat amount per visit or a percentage of the bill |
| Out-of-pocket maximum | The most you pay in a year for covered in-network care. Premiums don't count toward it |
Metal levels: Bronze, Silver, Gold and Platinum
Metal levels tell you how a plan splits costs with you. They say nothing about the quality of the doctors.
| Level | Plan pays on average | Often a fit for |
|---|---|---|
| Bronze | About 60% | Healthy people who want a low premium and can handle a high deductible |
| Silver | About 70% | Incomes from 100% to 250% of the poverty level, because of extra savings on Silver |
| Gold | About 80% | People who see doctors often and prefer lower costs per visit |
| Platinum | About 90% | People with large, steady medical costs. Few companies sell it |
Catastrophic plans also exist for people under 30 or with a hardship exemption. They have a very high deductible, and you can't use a tax credit on them.
If your income is between 100% and 250% of the poverty level, look hard at Silver. Those plans come with cost-sharing reductions that lower the deductible and copays, and you only get them on Silver.
HMO, EPO, PPO and POS plans
The plan type tells you how strict the network is.
- HMO: you use the plan's doctors and hospitals, and you usually need a referral from your primary care doctor to see a specialist. Out-of-network care isn't covered except emergencies.
- EPO: network only, like an HMO, but usually without referrals.
- PPO: you can see doctors outside the network, and you pay more when you do.
- POS: a mix. You pick a primary care doctor and use referrals, with some out-of-network coverage.
In Florida most Marketplace plans are HMOs. In the 12 large counties we track, Florida Blue was the only company selling PPO plans in 2026, and most other companies sold only HMOs. Emergencies work the same on every type: an out-of-network ER visit is charged at your in-network cost share.
Networks: check before you pick
A low-premium HMO only helps if your doctors are in it. Before you choose, look up your doctors and the hospital you'd use in the plan's own directory, then find your prescriptions on its drug list. Two plans from the same company can have different networks, so check the exact plan and not just the company name.
Our county pages name the big local hospital systems so you know what to search for. People in Miami-Dade often ask about Jackson Health System, and people in Tampa about Tampa General.
Insurance companies in Florida
In 2026, 13 insurance companies sold Marketplace plans somewhere in Florida. Florida Blue sold in all 67 counties and Ambetter Health in 63. The rest cover fewer counties. The 2027 lists can change, and your quote always shows what's sold at your ZIP code.
| Company | Counties served |
|---|---|
| Florida Blue | 67 of 67 |
| Ambetter Health | 63 of 67 |
| Oscar Health | 32 of 67 |
| UnitedHealthcare | 32 of 67 |
| Wellpoint | 24 of 67 |
| AvMed | 22 of 67 |
| Molina Healthcare | 20 of 67 |
| Cigna Healthcare | 11 of 67 |
| Capital Health Plan | 9 of 67 |
| AmeriHealth Caritas Next | 7 of 67 |
| Florida Health Care Plans | 5 of 67 |
| Health First | 5 of 67 |
| 22 Health | 1 of 67 |
Source: CMS Marketplace public use files, plan year 2026. Lists for 2027 can change; your quote shows the current plans.
Who qualifies
You can buy a Marketplace plan if you live in Florida, are a U.S. citizen or lawfully present, and aren't incarcerated. If you have Medicare, the Marketplace isn't for you.
Being able to buy a plan and getting a tax credit are two separate questions. The credit depends on your income, your household size and whether you have an offer of affordable job coverage. Florida did not expand Medicaid, so adults under 100% of the poverty level often land in a coverage gap with no credit and no Medicaid.
Timing matters too. You can enroll during Open Enrollment, November 1, 2026 to January 15, 2027 for 2027 coverage, or later with a Special Enrollment Period after a life event like losing coverage or having a baby.
How enrollment works through us
- Fill in the short form: ZIP, date of birth, sex, tobacco, household size and income. No account and no phone number.
- Compare Marketplace plans with your estimated tax credit already taken off. Fixed indemnity plans show up next to them, but read what they don't cover before you lean on one.
- Pick a plan and finish the Marketplace application on HealthSherpa, a private enrollment site connected to the federal Marketplace. The Marketplace makes the final decision on your eligibility and your tax credit.
- Pay your first premium to the insurance company. Coverage doesn't start until you do.
Licensed agents help for free if you get stuck, and the chat answers in English or Spanish. We're not HealthCare.gov and we're not a government website. For a wider look at your options, including who buys individual coverage, see our Florida health insurance guide.
Common questions
Does Florida have its own health insurance marketplace?
No. Florida uses the federal Marketplace. You can apply on HealthCare.gov or through a connected private site like HealthSherpa, which is what we use.
Which metal level should I choose?
It depends on your income and how much care you use. Bronze keeps premiums low, Gold lowers what you pay per visit, and Silver is usually the pick under 250% of the poverty level because of the extra savings.
Can I keep my doctor on an Obamacare plan?
Only if your doctor is in that plan's network. Check the exact plan in its directory before you enroll, since two plans from one company can have different networks.
Do Marketplace plans include dental?
Dental care for children is an essential benefit, though it may come as a separate dental plan. Adult dental and vision usually aren't part of a Marketplace health plan.
Does it cost anything to enroll through you?
No. Seeing prices is free and licensed agents help for free. The plans and tax credits come from the same federal Marketplace.