Guide To Health Plans In Florida

Florida is a beautiful sunny state in the United States. It is a famous tourist destination. Retired people love to settle in this place. The residents of Florida under the federal affordable care act are required to have health insurance coverage. This state has the highest number of ACA compliant plans. For health coverage in Florida, residents can get private providers’ plans or the federal exchange during open enrollment.

Different Types of Health Coverage in Florida

There are many types of health insurance plans. The plan chosen by you will determine the cost structure of the range you take if you need a referral to meet a specialist and the health care providers you may see. The three most common types of health insurance plans are

  • Health maintenance organization plans- Under this plan, you can seed doctors, specialists, and care providers from within the network. Any medical expert outside the panel is not covered under the scheme. A referral is required to visit a specialist. These plans are the most affordable ones but with the least freedom to choose the health care provider.
  • Preferred provider organization plan-This plan has a network of doctors and specialists but does not require that you see them. An additional amount is charged for visiting a medical expert outside of your coverage. You do not need a referral to visit a specialist with this plan. These schemes are more costly than health maintenance organization plans.
  • Point-of-service plans- This plan is a blend of the Health maintenance plans and the preferred provider organization plans. You can visit doctors and specialists out of your coverage in this plan. A doctor’s referral is required to call a specialist. Under this plan, you can see care providers with lower rates than preferred provider organization plans.

What does health insurance cover?

The Affordable care act states that every permanent health insurance plan must include the following benefits-

  • Ambulatory patient services- These services mean the outpatient care that you receive outside the hospital.
  • Emergency services – The insurance provider must cover emergency care at any hospital. There is no need to contact the insurance provider before taking the emergency treatment. You should contact the closest hospital near the vicinity at the time of emergency.
  • Hospitalization: Here, the expenses incurred on overnight stays at the hospital, the doctor’s prescription drugs are included.
  • Pregnancy, maternity, and newborn care cover the expenses incurred for care before birth and after birth. It also includes the cost incurred for pregnancy complications.
  • Mental health and substance use treatments cover the expenses incurred on inpatient mental health services, behavioral therapy, and treatment of substance use.
  • Prescription drugs: Although the drugs prescribed cannot be excluded; the insurance provider can ask you to try less expensive medications.
  • Laboratory services- This includes both the outpatient as well as inside the hospital.
  • Preventive services-This includes vaccinations and booster shots.
  • Breastfeeding support for women-It This includes counseling and equipment for nursing mothers.


Health insurance coverage in Florida has changed the planning for the health plans thoroughly since the introduction of ACA. You don’t need to compare much in the programs as minimum essential benefits are included in it.