Most Commonly Asked Health Insurance Questions in Florida

Finding the right health insurance can feel overwhelming—especially with so many rules, costs, and coverage options to navigate. To make things easier, we’ve compiled answers to the most common health insurance questions for Florida residents, based on real conversations with our licensed agents at RateQuote.

Whether you’re exploring Affordable Care Act (ACA) marketplace plans, Medicare, or private coverage, this guide explains what you need to know—clearly, fact-checked, and tailored for Floridians.

Understanding Enrollment in Florida

What actions are Enrollment Agents authorized to take on my behalf?

Enrollment Agents can:

• Search for marketplace applications
• Complete eligibility and enrollment applications
• Assist with government insurance affordability programs (like subsidies or Medicaid)
• Respond to marketplace inquiries on your behalf

Tip: Having a licensed agent in Florida can help avoid errors and ensure you don’t miss deadlines.

Eligibility for Coverage

How can the marketplace determine my eligibility for future years?

• The marketplace can use your income data (including tax returns) for up to five years to assess eligibility. You’ll receive notices to review or update your details, and you can opt out at any time.
• In 2023, over 3.2 million Floridians enrolled in marketplace plans—the highest of any state, largely due to strong subsidy availability (KFF).

Tax Credits and Subsidies

What are the requirements to ensure I receive the tax credit?

To qualify for premium tax credits in Florida, you must:

• File taxes for the year you’re claiming credits
• File jointly if married
• Not be claimed as a dependent on someone else’s return

Case Example:
A Miami family of four earning $55,000 in 2024 qualified for $6,200 in premium tax credits, cutting their monthly premium by 65%.

Account Updates

What should I do if my application information changes?

You must inform the marketplace within 30 days if your household, income, or address changes. Updates can be made online or by phone. Failing to update can affect eligibility and tax credits.

Finding a Doctor or Provider

Can the agent look up a specific doctor or medical facility to see if they are covered?

Yes—agents can check provider directories to confirm whether a Florida doctor, hospital, or clinic is in-network for your plan.

How do I find healthcare providers in my insurance network?

• Use your insurer’s website or mobile app
• Call customer service for assistance
• Ask your licensed agent to help with provider lookups

ID Cards and Member Information

How can I receive my insurance ID cards?

Cards may arrive by mail, email, or both—depending on your insurer.

How do I get my member ID number or request a replacement card?

Log in to your online account or call your insurer directly. Be ready with your name, date of birth, and last four digits of your SSN. Replacement cards usually arrive in 7–10 business days.

Agents of Record

For how long can I authorize an agent of record?

You can authorize an agent from one day up to 365 days, depending on your preference.

Coverage and Benefits

What services are typically included in a marketplace plan?

Florida marketplace health plans generally cover:

• Preventive care at no cost (checkups, screenings, vaccines)
• Hospitalization and emergency services
• Prescription drugs
• Mental health services
• Maternity and newborn care

Note: Dental and vision are usually separate add-on plans.

Payments, Billing, and Reinstatement

When are premium payments due and what happens if I miss one?

Premiums are usually due by the end of the preceding month.
Missing a payment may lead to suspension after the grace period.

How can I reinstate insurance after cancellation due to non-payment?

Contact your insurer directly. You may need to pay outstanding balances, and reinstatement depends on provider policies and income eligibility.