Health Insurance in Florida

Health insurance plans typically cover preventive care.

Health insurance is intended to help protect individuals and families in the event of health problems, illness or accidents. Health insurance also provides individuals the ability to visit doctors for routine checkups and annual physicals while keeping costs for medical care at a reasonable rate. In Florida, there are many types of insurance policies that are available to the residents. The main types of insurance in Florida are comprehensive or "major medical" coverage, managed care and limited benefit policies.

Comprehensive Coverage

Major medical or comprehensive policies are the most expensive types of policies because they provide the widest range of benefits. Typically employer-paid group health policies fall under this category. A major medical policy typically pays for a portion of your medical expenses. Most common major medical policies cover between 70 to 80 percent of allowable expenses after your deductible is paid. Comprehensive plans often have maximum out-of-pocket rates. When you have paid the maximum rate, your insurance then covers 100 percent of the remaining charges.

Managed Care Policies

Managed care policies are typically less expensive than comprehensive care plans because your choice of doctors and hospitals are limited to providers with whom the managed care system has negotiated rates. In a managed care policy, the network controls the services you receive, and treatment is generally determined by your primary care physician. Types of managed care networks include Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs) and Point of Service (POS) plans.

Limited Benefit Plans

There are a few different types of health insurance plans that are available in Florida that provide coverage for very specific expenses. The most common types of limited benefit plans are basic hospital expense plans, basic surgical expense plans, specified disease plans and hospital indemnity plans. Basic Hospital Expense plans reimburse individuals for expenses related to time spent in a hospital. In Florida, coverage is mandated for at least 31 days for any one hospital stay. Basic Surgical Expense plans provide reimbursement for expenses related to surgery and cover surgeon's fees, anesthesia and post-op care. Specified disease coverage provides reimbursement for specific illnesses such as cancer or heart disease. In Florida, these plans cannot have a deductible higher than $250. Hospital Indemnity plans provide a fixed reimbursement for hospitalization no matter what the costs incurred. In Florida, the rate has to be at least $10 per day and for no less than 31 days.

Discount Plans

Another type of coverage that individuals and families may opt to participate in are discount plans. While discount plans are not technically insurance plans, they offer members who join the plan discounted rates on prescriptions, eye exams, dental exams and other common services. Typically, the cost to join a discount plan is low; however, the benefits may be minimal as well.

References

• Florida Health Insurance Overview
• Find Insurance Options