Florida: Health Insurance Resources And Plan Alternatives

Updated November 5, 2019

Pivot Health is proud to offer quality health insurance coverage plans to Floridians. These plans, described below, offer individuals and families living in Florida the ability to choose the benefit structure that best meets their insurance coverage needs and budget.

  • Short Term Health Insurance – Also known as temporary health insurance, or short term medical coverage, this plan provides comprehensive benefits coverage for physician visits, in-hospital care, urgent care facility visits and much more. This plan has no network restrictions, enabling insureds with this plan to seek treatment from any doctor or hospital to access benefits. Pivot Health’s user-friendly online application process ensures that you know within minutes of applying if you’ve been approved for coverage. Qualified applicants can then choose a date to begin coverage – which can be as soon as 24 hours from the time you apply.
  • Supplemental Insurance Coverage – Are you struggling with high deductibles or costly coinsurance rates? The cash benefits provided by a supplemental coverage plan help you afford out-of-pocket medical expenses, such as insurance deductibles, copayments or coinsurance. You may even choose to use the cash benefits toward any other expenses you incur due to a serious illness or accident. This type of plan is designed to work with – or supplement – your primary major medical coverage, whether you have an individual plan or receive health care coverage sponsored by your employer.

In addition to insurance benefits, Pivot Health short term health plans provide you with many extra non-insurance benefits, including:

Unlimited access to discounted telemedicine doctor consultations.
Your time is precious. Skip the waiting room and connect directly with a doctor at whatever time of day it works for you – telehealth is available 24/7.
Significant savings on eye care and eyewear.
With discounts of 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses, maintaining good ocular health has never been so affordable.
Valuable discounts on prescription drugs.
With the cost of prescription medications continuing to rise, you’ll appreciate savings of up to 75 percent on prescription drugs at thousands of pharmacies across the nation.

Health Coverage Challenges for Many Florida Residents

With nearly 20% of its residents age 65 or older, Florida ranks number one in the country with the highest percentage of senior citizens among its population. The good health insurance news for those seniors is that they receive health care coverage from Medicare.

But what about the millions of Floridians not yet eligible to receive insurance through Medicare? Despite an increase in the number of Florida residents who have enrolled in health care coverage over the past few years, nearly 3 million Floridians – more than 13% of the state’s population – still have no medical insurance. Compared to the national uninsured rate of 9.1%, this rate means that Florida has one of the country’s highest rates of uninsured residents.

For many Floridians, the average 19.5% premium increase in 2017 for individual major medical insurance will be covered by federal subsidies that will increase to match the rising premium cost. But for Florida residents who purchase plans on the exchange but don’t qualify for subsidies, the premium hike is a costly price to pay for coverage.

And just as concerning to Floridians is the disappearance of the Preferred Provider Network (PPO) system from many insurance plans offered on the exchange. Under the traditional PPO system, insureds could choose to receive health care services from either in-network or out-of-network providers, recognizing that services from in-network providers were covered at a higher benefit percentage than out-of-network providers.

However, starting in 2016, to help curb staggering annual premium increases, plans offered on the exchange replaced PPOs with Exclusive Provider Organization (EPO) arrangements. The EPO system significantly narrows provider networks, which may result in insureds having fewer choices in health care providers and even prescription drugs. And under an EPO, insureds who receive treatment from out-of-network providers may end up receiving no insurance benefits for that treatment – which means they are responsible for paying the entire bill. This can be a true hardship for insureds who are sicker or require treatment from specialists not covered under the new EPO.

Another concerning issue for Florida residents who purchase individual major medical insurance is the fact that several large insurers have withdrawn from participating in the exchange. With the exception of residents living in the Miami, Orlando and Tampa metropolitan areas, Floridians have only one or two exchange insurance carriers from which they may purchase coverage.

Floridians seem to be feeling the economic pressures that these health insurance challenges present. A recent Gallup-Healthways State of American Well-Being report examined how well-being varies by state. Residents in Florida reported difficulties in managing their economic life effectively to reduce stress and increase security, resulting in a rank of 34th in the nation for financial well-being.

Rising health insurance premium rates, narrowing provider networks, fewer carrier options and speculation surrounding health care system changes coming out of Washington all underscore the importance of providing Floridians with a broader range of health insurance options.

Pivot Health offers Florida residents choices that may help meet their needs and their budgets.

  • Pivot Health’s short term health insurance enables Florida residents to purchase comprehensive coverage at a fraction of the cost of major medical insurance coverage – with no provider network restrictions.
  • Pivot Health’s supplemental health insurance provides Floridians the opportunity to select insurance designed to provide financial protection against the coverage gaps of high deductible major medical insurance plans. This supplemental insurance – also called “gap” coverage – helps insureds pay for high deductibles, out-of-pocket costs, coinsurance, copayments, and other costs that they typically incur before their high deductible major medical plans begin to pay out benefits.

The State of Health and Health Insurance in Florida

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Florida an overall ranking of 39 out of 51 (the 50 states plus the District of Columbia).  This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.  The Commonwealth Fund’s Scorecard rated Florida in several areas, including:

  • Uninsured adults, including millennials, aged 19 to 64: 49th ranking (20 percent in Florida, compared to the U.S. average of 13 percent)
  • Uninsured children ages 0 to 18:  36th ranking (7 percent, compared to the U.S. average of 5 percent)
  • Adults who went without medical care because of cost in the previous year: 48th ranking (17 percent in Florida, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income:  27th ranking (15 percent, compared to the U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years:  19th ranking (12 percent in Florida, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year:  37th ranking (17 percent, compared to U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings:  28th ranking (67 percent in Florida, compared to the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects:  45th ranking (64 percent, compared to the U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 19th ranking (19.7 in Florida, compared to U.S. average of 20.6)
  • Colorectal cancer deaths per 100,000 people: 14th ranking (13.3 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000:  24th ranking (13.9 percent in Florida, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations: 27th ranking (26 percent, the same as the U.S. average of 26 percent)
  • Adults who smoke:  15th ranking (16 percent in Florida, compared to the U.S. average of 17 percent)
  • Adults who are obese: 15th ranking (27 percent, compared to the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 13th ranking (28 percent in Florida, compared to the U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease:  34th ranking (11 percent, compared to the U.S. average of 10 percent)

Florida made the Top Ten list for positive rankings in these categories:

  • Home health patients who improved at walking or moving around
  • Home health patients whose wounds improved or healed after an operation

2017 Health Insurance Plans in Florida

The Florida Office of Insurance Regulation reported that the following health insurance companies were offering individual major medical insurance in the state of Florida for 2017:

  • Aetna Health Inc.
  • Aetna Life Insurance Company
  • AVMed, Inc.
  • Blue Cross Blue Shield of Florida
  • Celtic Insurance Company
  • Cigna Health and Life Insurance Company
  • Coventry Health Care of Florida, Inc.
  • Florida Health Care Plan, Inc.
  • Freedom Life Insurance Company of America
  • Health First Commercial Plans, Inc.
  • Health Options, Inc.
  • Humana Medical Plan
  • Molina Healthcare of Florida, Inc.
  • Sunshine State Health Plan

Pivot Health offers in Florida

Medicaid Enrollment in Florida

There are more than 3.6 million Florida residents who are covered by Medicaid andthe Children’s Health Insurance Program (CHIP). An estimated 1.8 million more Floridians would become covered under these programs if Florida expanded Medicaid under the Affordable Care Act. However, Florida is one of 19 states that has chosen not to expand Medicaid at this time.

Your Health Care Coverage Choices

With a higher rate of uninsured residents than many other states, Florida has a significant number of uninsured and underinsured people in the state.

If you do not have health insurance: Pivot Health’s short term health insurance provides you comprehensive medical coverage that may meet your benefit and budget needs.

If you have a high deductible health insurance plan: Pivot Health’s Supplemental Insurance can help you cover costly out-of-pocket expenses, such as deductibles, coinsurance, copayments and more, before your high deductible plan starts paying benefits.

Pivot Health: offering you choices and flexibility to meet your needs as they change over time.

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