ACA Marketplace Health Insurance in Florida

Florida enrolls ACA plans through HealthCare.gov. How the marketplace works here, where Florida Medicaid fits in, what is different about Florida, and what drives what you pay.

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Matthew T. Giberti Matthew T. Giberti Published October 2026 5 min read
Family of four in a resort pool, palm trees and a tall white condo building behind them

At a glance

Florida uses the federal marketplace at HealthCare.gov, one application for plans, premium tax credits and a Medicaid referral.
Florida has not expanded Medicaid, so some low income adults fall into a coverage gap between Florida Medicaid and marketplace subsidies.
Financial help is income based, premium tax credits on any metal tier and cost sharing reductions on Silver plans. The temporary enhancements that applied through 2025 are gone, so expect different numbers than in 2025.
Florida has the largest ACA marketplace enrollment of any state, more people sign up through HealthCare.gov here than anywhere else, which also makes it one of the most competitive markets for insurers and agents.
The Florida Office of Insurance Regulation licenses the insurers; the ACA guarantees that each plan takes you regardless of health history and covers the essential health benefits.
Woman comparing marketplace plans on her laptop at her dining table

How the marketplace works in Florida

There is no separate state exchange in Florida. You apply at HealthCare.gov, which checks your income against the subsidy rules, screens for Florida Medicaid, and enrolls you in the plan you pick. The insurers behind those plans are licensed and examined by the Florida Office of Insurance Regulation.

Whichever insurer you choose, a marketplace plan in Florida must:

accept every applicant during an enrollment window, whatever their medical history;
cover the full set of essential health benefits with no annual or lifetime dollar caps on them;
set premiums without underwriting, your Florida rating area, age, tobacco use and household size are the only variables.

These rules are why a marketplace plan counts as minimum essential coverage, and why it costs more than an underwritten plan. Short term and fixed indemnity products sold in Florida do not have to follow them; see our short term, extended short term and fixed indemnity guides for Florida before treating one as a substitute.

Medicaid in Florida

Florida has not expanded Medicaid. Florida Medicaid covers children, pregnant women, seniors, people with disabilities and parents with very low incomes, not adults without dependents simply because their income is low.

That leaves a gap. Marketplace subsidies in Florida start at 100% of the federal poverty level, and Florida Medicaid stops well below it for most adults, so some people have no subsidized option at all. If your income is near the 100% line, estimate it carefully, crossing it changes everything. If someone offers you a cheap plan “because you fell in the gap,” read the fine print, it is almost certainly a supplemental product, not major medical.

Not sure which plan fits?

A licensed agent compares your real options for your ZIP in plain English. No cost. No pressure.

What is different about Florida

Four things about Florida that change the advice we give:

Florida has the largest ACA marketplace enrollment of any state, more people sign up through HealthCare.gov here than anywhere else, which also makes it one of the most competitive markets for insurers and agents.
Florida allows short term plans with terms of up to 36 months under state law, so you will see underwritten plans marketed alongside marketplace coverage; they are not a substitute for an ACA plan.
Our home office is in Miami, and Florida is the state where we enroll the most families.
Consumer help: The Florida Office of Insurance Regulation handles complaints about insurers and agents, and the Florida Department of Financial Services also assists consumers; the NAIC directory lists its contact details and license lookup.

Local guides for Florida: Boca Raton · Brevard County · Broward County · Cape Coral · Clearwater · Coral Springs · Davie · Duval County · Fort Lauderdale · Gainesville · Hialeah · Hillsborough County · Hollywood · Jacksonville · Lake County · Lakeland · Lee County · Manatee County · Miami · Miami Gardens · Miami-Dade County · Miramar · Orange County · Orlando · Osceola County · Palm Bay · Palm Beach County · Pasco County · Pembroke Pines · Pinellas County · Polk County · Pompano Beach · Port St. Lucie · Sarasota County · Seminole County · St. Petersburg · Sunrise · Tallahassee · Tampa · Volusia County · West Palm Beach

Plan options in Florida

Marketplace plans in Florida are sorted into metal tiers. The tiers describe how you and the insurer split costs, not the quality of care or the network:

Bronze, lowest premiums, highest deductibles; a fit if you mainly want protection from a large bill.
Silver, mid-range premiums, and the only tier where cost sharing reductions apply if your income qualifies; often the best value below about 250% of the poverty level.
Gold and Platinum, higher premiums, much lower costs when you use care; worth pricing if you have regular prescriptions or a planned procedure.
Catastrophic, for people under 30 or with a hardship exemption; low premium, very high deductible, and no premium tax credit can be applied.

Networks matter as much as tiers in Florida: many marketplace plans are HMOs or EPOs with no out of network coverage except emergencies, so check that your doctors and hospital participate before you choose. We are not tied to any carrier, so the comparison we give you is the plans side by side and a straight answer about which tier matches how you use care.

How and when to enroll in Florida

Apply at HealthCare.gov yourself or let a licensed agent do it with you; agents are paid by the insurer, so the price is identical. What matters is when:

November 1 to January 15 is the HealthCare.gov Open Enrollment window Florida follows; pick a plan by December 15 to start January 1, or by January 15 to start February 1. Confirm the dates when you shop, the window has moved before and may again.
Special Enrollment Periods run 60 days from a life event such as losing coverage, relocating to Florida, getting married or adding a child; outside those events the marketplace is closed until fall.
No window applies to Florida Medicaid: apply in any month, and coverage can start quickly after approval.

If you are outside every window, the honest options are an employer plan, Medicaid if eligible, or a temporary product with real limits. If that is where you are, compare what is available in your ZIP code and ask us which path makes sense.

What it costs in Florida

There is no single Florida premium; there is yours. It comes from:

Income first, for most Floridians the subsidy, not the sticker price, decides what you pay.
Then age, a 60-year-old pays up to three times a 21-year-old’s premium before subsidies.
Then geography, Florida’s rating areas price the same plan differently.
Then tier and network, and finally tobacco use.

Because Florida did not expand Medicaid, subsidies start at 100% of the poverty level; just above that line they are often large, and just below it there may be none.

Subsidies for 2026 and 2027 are calculated under the ACA’s original schedule now that the temporary 2021–2025 enhancements have ended. Run a current estimate, compare the benchmark Silver plan against Bronze and Gold in your Florida rating area, and let us check the math before you decide.

Matthew T. Giberti Matthew T. Giberti Licensed Insurance Producer · National Producer Number: 20698856 Licensed Insurance Producer · National Producer Number: 20698856 About Matthew →

ACA marketplace plans are comprehensive major medical coverage and are minimum essential coverage under the Affordable Care Act. Eligibility for premium tax credits and cost sharing reductions depends on your income, household size, and other factors and is determined when you apply through the marketplace; this page is general information, not an eligibility determination.

GetHealthPlans.com® is operated by MTG Insurance Agency, an independent, carrier neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect the marketplace and Medicaid status for Florida as of the last reviewed date and can change; confirm current details at HealthCare.gov before you enroll.