Private Health Insurance in Florida
Private health insurance in Florida is coverage you buy directly, outside the ACA Marketplace, priced on your age, zip code and health instead of your income. With Florida Marketplace premiums rising 10.4% on average for 2027, more people who earn too much for a tax credit are pricing a private plan first. It is not the right fit for everyone, and the sections below explain how it works in Florida and when the Marketplace is the better call.
Who buys their own coverage in Florida
No state has more Marketplace enrollees than Florida. CMS counted 4,538,772 plan selections in the 2026 open enrollment, about 4 percent fewer than the 4,735,415 of a year earlier, the first season after the enhanced federal tax credits expired. About 94.6 percent of 2026 enrollees received an advance premium tax credit, leaving roughly 5.4 percent, or about 243,000 people, paying full price, nearly double the 2025 share. Census data for 2024 show about 38.5 percent of Florida households earn $100,000 or more, and many of them sit above the subsidy line.
How Florida regulates private plans
Florida sorts limited coverage into categories such as hospital confinement indemnity, limited benefit and supplemental insurance under section 627.643, and section 627.642 requires an outline of coverage that names the category and lists the main exclusions. Section 624.1265 exempts religious sharing ministries from the Insurance Code only if they report monthly sharing totals, get an annual audit and never sell through licensed agents. Since July 2025, section 624.4032 lets a qualifying agricultural organization founded before 1945 offer member plans that are not insurance. Self-funded employer association plans must hold a state certificate and print a no-guaranty-fund warning under section 624.438.
Protecting yourself when you buy in Florida
Florida Administrative Code rule 69O-154.003 asks insurers to print a notice on individual health policies letting the buyer return the policy within 10 days of delivery for a full refund, for any reason. Before signing, the Department of Financial Services suggests checking the agent and the company through its Licensee Search and Verify Before You Buy pages, or calling 1-877-693-5236. Complaints go through its online insurance concern form. The department's unlicensed health plan page warns about plans sold as memberships, union plans offered to the self-employed and company names that only resemble a licensed insurer.
The Florida Marketplace you would be comparing against
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.
Why people leave the Marketplace for a private plan
Marketplace premiums are rising again for 2027, and above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) there is no tax credit at all. Underestimate your income and you repay the credit in April. Many Marketplace plans are local HMOs or EPOs, out-of-pocket maximums reach $12,000 per person in 2027, and you can only enroll once a year without a qualifying event.
What a private plan does differently
A private, medically underwritten plan is priced on health, not income, so a strong year never raises the premium and there is nothing to pay back at tax time. If approved, it can start the first of any month, and many plans use national PPO networks that work when you travel.
The honest trade-offs
You apply and answer health questions, and approval is not guaranteed. Underwritten plans can decline an application or exclude a pre-existing condition, and benefits and limits differ from plan to plan. Private plans are not ACA Marketplace plans. If you have a significant health condition, the Marketplace is the guaranteed option, and I will tell you so.
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 is private health insurance?
Coverage you buy directly from an insurer outside the ACA Marketplace. Medically underwritten private plans are priced on age, zip code and health rather than income, and they can start the first of any month if you are approved.
Is private health insurance cheaper than the Marketplace?
Often for healthy people above the subsidy line, who pay full price on the Marketplace. Below the line, a Marketplace plan with a tax credit may be cheaper. The only way to know is to price both.
Can a private plan turn me down?
Yes. Underwritten plans can decline an application or exclude a pre-existing condition. The Marketplace has to accept everyone during open enrollment or a special enrollment period.
Sources: www.cms.gov, www.leg.state.fl.us, www.leg.state.fl.us, www.flrules.org, www.myfloridacfo.com. Facts checked October 2026. See all Florida health insurance rules.
Private plans in other states
Written by Frank Caballero, licensed health insurance agent in Florida and 30 other states, NPN 21032307.