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Early Retiree Health Insurance in Florida

Retiring in Florida before 65 means buying your own coverage until Medicare starts, and premiums are highest in exactly those years: insurers can charge a 64-year-old up to three times what they charge a 21-year-old. Florida individual premiums are also set to rise 10.4% on average for 2027. How you draw retirement income can matter as much as which plan you pick.

Private health insurance in Florida

Most people I help in Florida end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.

Why people leave the Marketplace

Premiums keep climbing. Florida Marketplace premiums are rising 10.4% on average for 2027.
The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
Surprise tax bills. Underestimate your income and you repay the tax credit in April.
Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.

What a private plan does differently

Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Florida too. Networks vary by plan.
Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
Approval is based on health. You answer health questions, and acceptance is not guaranteed.

With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.

Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.

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Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

Retiring early in Florida

Census Bureau estimates put about 3.1 million Floridians between 55 and 64 in 2024, about 13 percent of residents, and the group has grown since 2020. Retirement counties run older still. Charlotte County's median age is about 60, and Sumter County, home of The Villages, has a median age of 68 with 57 percent of residents 65 or older. Many early retirees come from public safety careers. The Florida Retirement System's Special Risk Class, which covers police, firefighters and corrections officers, allows normal retirement at 55 or after 25 years of service.

Florida rules for the bridge to Medicare

Florida adds a few protections for the years before Medicare. Under section 627.6692, a spouse and children can keep small-employer group coverage for up to 18 months when the worker becomes entitled to Medicare, which helps when one partner turns 65 first. At 65, section 627.6741 guarantees a six-month Medigap open enrollment, plus a second two-month window after group coverage ends. Floridians under 65 with Medicare through disability or kidney failure get the same enrollment rights. Florida has no birthday rule, so changing Medigap plans later usually means answering health questions.

The Florida market for 55-to-64-year-olds in 2027

Florida buyers shop the largest individual market in the country through HealthCare.gov, with no state exchange and no state subsidy above the federal 400 percent income line. Leaving an employer with fewer than 20 workers triggers Florida's own continuation law, which keeps the group plan for up to 18 months at up to 115 percent of the premium if you notify the insurer within 63 days. Florida law also allows short-term plans with an initial term under 12 months and up to 36 months in total, one of the more permissive rules in the country. For 2027, average individual premiums rise about 10 percent, and plan choice and networks vary enormously by county, so the same coverage decision can come out differently in Hillsborough, Miami-Dade and the Panhandle.

Other Florida rules to know

Leaving a small employer: If you leave an employer with fewer than 20 employees, Florida's Health Insurance Coverage Continuation Act lets you keep the group plan for up to 18 months, at up to 115 percent of the premium, if you notify the insurer in writing within 63 days.
Short-term plans: Florida law allows short-term plans with an initial term under 12 months and up to 36 months in total, and federal agencies are not prioritizing enforcement of the federal four-month limit, so multi-month plans are sold in Florida.
Where to enroll: Florida uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Private, medically underwritten plans can start the first of any month if approved.
2027 rates: individual plans 10.4% on average, small-group plans about 11.4%. See the Florida 2027 rate page.

Your income is partly your choice

The Marketplace credit is based on modified adjusted gross income. Early retirees often control it: Roth withdrawals and cash savings generally do not count, while traditional IRA withdrawals, Roth conversions and capital gains do. For 2027 the credit stops at 400 percent of the poverty level, $63,840 for one person and $86,560 for a couple. Plan withdrawals with that line in mind. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Private plans for healthy retirees

A retiree above the line pays full price on the Marketplace. A healthy 55-to-64-year-old can may pay less with a private, medically underwritten plan, which is priced on health and can start the first of any month if approved. With a health condition, the Marketplace remains the guaranteed choice.

Planning the switch at 65

Your Medicare initial enrollment period runs seven months around your 65th birthday. Line up the end of your individual plan with the start of Medicare so you never pay for both or go without.

For 2027 the Marketplace credit stops at 400 percent of the poverty level: $63,840 for one person, $86,560 for two and $132,000 for a family of four. The out-of-pocket maximum for 2027 Marketplace plans is $12,000 for one person and $24,000 for a family. The full guide covers the rest.

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Florida questions

Where do Florida residents enroll in 2027 coverage?

Florida uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027.

What continuation rights does Florida give after leaving a small employer?

If you leave an employer with fewer than 20 employees, Florida's Health Insurance Coverage Continuation Act lets you keep the group plan for up to 18 months, at up to 115 percent of the premium, if you notify the insurer in writing within 63 days.

How much are Florida premiums rising for 2027?

Individual-market premiums are set to rise 10.4% on average, and small-group plans about 11.4%.

What health insurance do people use if they retire before 65?

COBRA or state continuation for a while, a Marketplace plan, a private underwritten plan, or a spouse's employer plan. Many use COBRA briefly and then switch.

Do Roth IRA withdrawals count toward Marketplace income?

Qualified Roth withdrawals generally do not count toward the modified adjusted gross income used for the credit, while traditional IRA withdrawals do. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Sources: www2.census.gov, www2.census.gov, frs.fl.gov, www.leg.state.fl.us. Facts checked October 2026. See all Florida health insurance rules.

Written by Frank Caballero, licensed health insurance agent in Florida and 30 other states, NPN 21032307.