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Compare plan types, understand networks, and find the right private health insurance plan for your situation — with a licensed Florida agent who works for you.
Private health insurance — also called individual or commercial health insurance — is coverage you purchase directly from an insurance carrier or through the ACA Marketplace, rather than getting through an employer or a government program like Medicaid or Medicare.
In Florida, any resident under age 65 can buy private health insurance. Thanks to the Affordable Care Act, carriers cannot deny coverage or charge higher premiums due to pre-existing conditions. All plans must cover the 10 essential health benefits including preventive care, prescription drugs, and mental health services.
Florida is one of the most competitive private insurance markets in the country, with carriers like Florida Blue, UnitedHealthcare, Cigna, Ambetter, and Oscar Health all competing for your business — which means more choices and more room to find the right fit.
The most common plan types available to Florida residents and how they compare.
Preferred Provider Organization
Best for: Anyone who wants maximum flexibility in choosing doctors
See any doctor in or out of network
No referral needed for specialists
Direct access to specialists
Higher monthly premiums
Higher out-of-pocket costs for out-of-network care
Health Maintenance Organization
Best for: Cost-conscious individuals with predictable healthcare needs
Lower monthly premiums
Lower copays and deductibles
All care coordinated through PCP
Must stay in-network (except emergencies)
Referral required for most specialists
Exclusive Provider Organization
Best for: People who want lower premiums but flexibility to self-refer
No referral needed
Lower premiums than PPO
Straightforward plan structure
No out-of-network coverage except emergencies
Smaller networks than PPOs
As an independent agent, we work with all major carriers — our job is to recommend what fits your situation, not what pays the highest commission.
Florida Blue
Largest network in Florida, lowest complaint rates, PPO & EPO
UnitedHealthcare
Extensive statewide network, strong digital tools
Cigna Healthcare
Competitive PPO rates, strong specialist access
Ambetter from Sunshine Health
Affordable HMO options, good for cost-conscious buyers
Oscar Health
Digital-first HMO, great app experience, telemedicine included
Monthly Premium
What you pay every month to keep your coverage active — whether you use healthcare services or not.
Deductible
The amount you pay out-of-pocket before your insurance starts covering most services. Plans with higher deductibles typically have lower premiums.
Copay
A fixed dollar amount you pay for a specific service (e.g., $30 for a primary care visit). Copays often don't count toward your deductible.
Coinsurance
After meeting your deductible, you pay a percentage of costs. For example, 20% coinsurance means you pay 20%, insurance pays 80%.
Out-of-Pocket Maximum
The most you'll pay in a year. After reaching this limit, insurance covers 100% of covered services. Federal law caps this annually.
Network
The group of doctors, hospitals, and providers that have contracted with your insurer. In-network care always costs less than out-of-network.
This is the only time most people can enroll in or switch private health insurance plans. Outside this window, you need a qualifying life event (losing job-based coverage, getting married, having a baby, or moving) to enroll through a Special Enrollment Period.
Missing Open Enrollment means waiting up to a year for coverage. If you've recently experienced a life event, you may be eligible to enroll now — book a free call to find out.
Use our free Coverage Navigator to get a personalized recommendation in 3 minutes, or book a call with a licensed Florida agent.
A PPO (Preferred Provider Organization) lets you see any licensed doctor without a referral, including out-of-network providers at a higher cost. An HMO (Health Maintenance Organization) requires you to choose a primary care physician (PCP) who coordinates all your care, and you must get referrals for specialists. HMOs typically have lower monthly premiums; PPOs offer more flexibility.
With a PPO plan, you can typically see any doctor, but you'll pay less if they're in-network. Before enrolling, ask your doctor which carrier networks they participate in. Florida Blue, UnitedHealthcare, and Cigna have some of the largest provider networks in Florida.
Any Florida resident under 65 who is not covered by an employer group plan, Medicaid, or Medicare can purchase private individual health insurance. Coverage is guaranteed issue — carriers cannot deny you due to pre-existing conditions.
Premiums vary by age, coverage level, and carrier. A 35-year-old non-smoker in Tampa might pay $350–$600/month for a PPO plan. If your income qualifies, ACA subsidies can significantly reduce this cost even on private plans purchased through the marketplace.
Open Enrollment runs November 1 – January 15 each year. Outside of Open Enrollment, you need a qualifying life event (job loss, marriage, new baby, moving) to trigger a Special Enrollment Period.
An EPO (Exclusive Provider Organization) is a hybrid — like an HMO, you must stay in-network for coverage (except emergencies), but like a PPO, you don't need referrals to see specialists. EPOs often have lower premiums than PPOs with similar flexibility.