There is no shortage of reasons why people want to move to Florida, the most obvious being the temperate climes, which offer year-round sunshine and temperatures that average out to a practically perfect 78 degrees Fahrenheit. There are also miles and miles of beautiful beaches featuring white sand and warm waters. Residents of The Sunshine State will also enjoy abundant outdoor activities and recreational opportunities, not to mention the chance to visit theme parks and attend sporting events. The benefits don’t end there, though.
Florida also has a wealth of affordable housing options, with new construction underway now that the U.S. has emerged from the Great Recession. Perhaps more notable, however, is the lack of sales tax. Florida is one of just a handful of states that does not charge residents and visitors a sales tax on purchases.
While there’s a lot to love about living in Florida, residents will still have to follow a variety of federal laws, including the mandate under the Affordable Care Act (ACA), or Obamacare, to maintain individual health insurance that meets minimum standards. As a Florida resident, however, you have many options to explore when it comes to complying with ACA requirements.
If you’re planning a move to Florida or you’re already a resident and you’re interested in what options may be available to you when it comes to health insurance, here are a few things you should know.
Healthcare is Improving
Unfortunately, Florida is among the states that has thus far elected not to participate in adopting Medicaid Expansion. This doesn’t mean that Medicaid is unavailable in Florida, just that the state has elected not to accept federal funding for the program expansion and that they have yet to contribute additional state funds to the Medicaid program.
According to America’s Health Rankings, Florida ranks 32nd among states where public health is concerned, although they have moved up a spot since 2013, when they ranked 33rd. This is probably due to the many challenges the state faces, including a high percentage of uninsured residents.
On the upside, however, studies show that Florida features low levels of air pollution as compared to other states, and they rank low in instances of smoking and cancer deaths. In addition, the rates of uninsured Florida residents dropped significantly following the passage of the Affordable Care Act.
Gallup surveys indicated that rates of uninsured residents dropped from 22.1% in 2013 to 18.3% in 2014, and further dropped to 15.2% in 2015. In 2014, Florida residents turned out en masse to take advantage of enrollment in health insurance plans via HealthCare.gov, showing the highest enrollment rates of any state using the marketplace.
Florida continues to improve healthcare options for residents, most recently setting standards to reduce rates for policies offered through the healthcare marketplace. Prior to the open enrollment period for 2015-2016, Florida’s insurance commissioner, Kevin McCarty, successfully challenged proposed insurance rates so that 10 of 16 carriers selling plans privately and through the marketplace reduced their rates.
Still, Florida residents need to shop around to make sure they understand all of their options for health insurance coverage. Getting the best coverage at the most affordable rates requires residents to exercise due diligence. What are your options?
Employer-Sponsored Health Coverage
If you are able to gain insurance benefits through your place of employment, this is likely to be the most affordable option to meet your individual responsibility for maintaining mandatory minimum coverage under the ACA. However, not all employers are required to provide health insurance benefits. How do you know if you’re eligible for such benefits?
Just as U.S. citizens are responsible for maintaining coverage, the ACA also require businesses of a certain size to provide health insurance for employees. These benefits must meet the employer mandate standards, including providing minimum essential coverage at affordable rates.
Companies that employ 50 or more full-time employees (FTEs), or full-time equivalent employees, are required by the ACA employer mandate to share responsibility with employees by providing health insurance benefits as part of the employment package for all FTEs.
Although smaller businesses (with fewer than 50 FTEs) are not necessarily required to provide health benefits to employees, they may still be willing to offer benefits if they are able to take advantage of incentives. The Small Business Health Options Program (SHOP) is designed to offer affordable health insurance options to companies that have fewer than 25 FTEs (earning less than $50,000 in average annual wages).
Small businesses that fit this profile can take advantage of tax breaks or credits when they elect to provide suitable health insurance policies to their employees.
If you are unable to obtain health insurance coverage through employment, your next option is to sign up for coverage through the healthcare marketplace. Florida residents can enroll for health coverage via HealthCare.gov. You’ll have to sign up during the open enrollment period unless you qualify for a special enrollment due to life changes like job loss, marriage, birth of a child, and so on.
Florida also offers Florida Health Choice at MyFloridaChoices.org, which is listed as the Health Insurance Marketplace. It’s important to understand that although this organization offers ACA approved health insurance plans, it is not part of the official ACA health exchange, and residents who shop for health coverage through Florida Health Choice cannot obtain government subsidies. These may only be obtained by Florida residents that enroll at HealthCare.gov.
Levels of Coverage
Those who enroll in Obamacare will have many options for coverage. Several health insurance providers offer plans through the healthcare marketplace in Florida. Enrollees can not only compare plans from different providers, but also compare policy levels that range from Bronze plans on the more affordable end up to Platinum plans on the high end (with Silver and Gold levels in between).
The more precious the metal, the greater the level of coverage and the higher the cost. Florida residents should explore all options to find the provider and policy that best suits their needs.
Low-income, elderly, disabled, minor, and other needy residents may qualify for cost assistance programs like Medicare, Medicaid, CHIP, and so on. In order to find out if you or your dependent family members qualify for such assistance you will have to enroll in Obamacare.
Florida residents also have the option to apply for coverage independently through private insurance providers (off-exchange). You simply have to make sure that the policy you choose meets standards for mandatory coverage under ACA regulations so that you don’t find yourself facing a penalty for failure to comply with federal laws.