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FLORIDA MARKETPLACE EXCHANGE

Helping Floridians make educated Healthcare choices.
 
 

HOW TO GET READY                                                                                             Contact Us


  • Make a list of questions you have before it's time to choose your health plan.
  • Make sure you understand how coverage works, including things like premiums, deductibles, out-of-pocket maximums, co-payments, and coinsurance. You'll want to consider these details while you're looking for health insurance.

  • Gather basic information about your household income. Most people using the Marketplace will qualify for lower costs on monthly premiums or out-of-pocket costs. To find out how much savings you're eligible for, you'll need income information, like the kind you get on your W-2, current pay stubs, or your tax return. Use this checklist to get started.

  • Set your budget. There will be different types of health plans to meet a variety of needs and budgets. You'll need to figure out how much you want to spend on premiums each month.
  • Ask your employer if it plans to offer health insurance.  If not, you may need to get insurance through the Marketplace or from other source. If you don’t get coverage, you may have to pay a fee.
  • Explore current options. You may be able to get help with getting coverage now through existing programs. Learn more about health insurance for adults up to age 26, and programs for people and children in families with limited incomes including Medicaid and the Children’s Health Insurance Program (CHIP). Medicare covers people who are 65 and older or who have certain disabilities.

Plans sold through the Federal Marketplace will be categorized in four "METAL" groups that represent the percentages of expenses covered by the different plans.

1.  Bronze level plan will cover 60% of deductibles, co-insurance and co-pays

2.  Silver level plan will cover 70% of deductibles, co-insurance and co-pays

3.  Gold level plan will cover 80% of deductibles, co-insurance and co-pays

4.  Platinum level plan will cover 90% of deductibles, co-insurance and co-pays 

Additionally: 

ALL PLANS MUST INCLUDE: 

The essential health benefits include at least the following items and services:

    • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
    • Emergency services
    • Hospitalization (such as surgery)
    • Maternity and newborn care (care before and after your baby is born)
    • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
    • Prescription drugs
    • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
    • Laboratory services
    • Preventive and wellness services and chronic disease management
  • Pediatric services

 

Essential health benefits are minimum requirements for all plans in the Federal Marketplace.