Florida has no state-run exchange or state subsidy program for self-employed adults, so most self-employed Floridians get coverage through HealthCare.gov, with Florida KidCare for children, limited categorical Medicaid, and community health centers as safety nets. Florida has not expanded Medicaid, which creates a coverage gap for many low-income adults without children.
Florida’s health insurance landscape has some features that make it genuinely different from most other states — in ways that matter a lot if you’re self-employed and navigating coverage on your own. Whether you’re a solo contractor in DeLand, a freelancer in Orlando, a real estate professional in Jacksonville, or a small business owner in the Tampa Bay area, understanding Florida’s specific programs, rules, and resources can help you find coverage you might not know exists — or avoid gaps in coverage that are surprisingly common here.
Florida Medicaid: Important Eligibility Limits to Know
Florida Medicaid is frequently misunderstood, particularly by self-employed adults who assume it works like Medicaid in other states. Here’s the critical distinction: Florida has not adopted the full ACA Medicaid expansion for low-income adults.
In the states that have adopted the ACA Medicaid expansion, adults with income below approximately 138% of the federal poverty level (roughly $22,000/year for a single person using the 2026 HHS poverty guideline of $15,960) generally qualify for Medicaid based on income alone. Florida is one of a small number of states that did not adopt this expansion.
In Florida, Medicaid for adults requires meeting both an income threshold AND a categorical eligibility requirement. The categories include:
- Pregnant women
- Parents or caretakers of dependent children (with income and asset limits)
- Individuals who are aged (65+), blind, or disabled
- Children (covered separately through KidCare and Children’s Medicaid)
A self-employed single adult in Florida earning $18,000/year who doesn’t fit one of those categories does not qualify for Medicaid — even though they would in most other states. This coverage gap is a well-documented issue in Florida and affects a significant portion of the state’s self-employed and gig economy workforce.
Applications are handled through ACCESS Florida at myaccess.myflorida.com. If you think you may qualify based on a categorical requirement, it’s worth applying.
Florida KidCare: Coverage for Your Children
Even if you as a self-employed adult don’t qualify for Medicaid, your children may qualify for coverage through Florida KidCare — the state’s umbrella program for uninsured children under 19 whose families earn too much for Children’s Medicaid.
Florida KidCare includes four components that cover children at different income levels:
- Medicaid: For children in families with the lowest incomes
- MediKids: For children ages 1–4 in families with incomes slightly above Medicaid limits
- Children’s Medical Services (CMS) Network: For children with special healthcare needs
- Florida Healthy Kids: For children ages 5–18 whose family income is above Medicaid limits but below the program cap (with income limits set by the program)
Premiums through Florida Healthy Kids are low for families who qualify, and some families qualify for no-cost coverage through Medicaid. This is one of the most underutilized programs in Florida — many self-employed parents don’t realize their children may qualify even when the parents themselves cannot get Medicaid. Apply at floridakidcare.org.
The Florida Marketplace: Federal Platform, County-Specific Plans
Florida uses the federal marketplace at healthcare.gov — there is no state-run exchange. This means Florida residents enroll through the federal system, which operates under federal rules, open enrollment windows, and subsidy calculations. Open Enrollment for 2027 coverage runs November 1, 2026 – January 15, 2027; enroll by December 15, 2026 for coverage starting January 1. Our guide to enrollment deadlines and how to enroll covers the details.
What varies significantly by county is which carriers are available and at what prices. Florida Blue (Blue Cross Blue Shield of Florida) has the broadest statewide marketplace presence. Other 2027 individual-market carriers have more limited footprints:
- Ambetter from Sunshine Health: Available in many Florida counties, often offering competitive Silver plans
- Oscar Health: Available in select metro markets
- UnitedHealthcare, AvMed, AmeriHealth Caritas, and 22 Health: Available in certain markets; availability varies by county
Note for 2027: Cigna, Molina Healthcare of Florida, and Sunshine State Health Plan are leaving Florida’s individual market for 2027. If you’re enrolled with one of them, HealthCare.gov may auto-assign a replacement plan — choose your own plan instead. Proposed 2027 Florida individual rates are up an average of 15.3%, so comparing carriers matters more than usual.
In Volusia County (DeLand, Daytona Beach, New Smyrna Beach), available carriers and plan counts may differ from what’s available in Orange County (Orlando), Hillsborough County (Tampa), or Duval County (Jacksonville). Always use healthcare.gov’s plan comparison tool with your actual county and zip code to see real options and real prices.
Florida’s High-Risk Pool: No Longer Active
Before the ACA, Florida operated a high-risk pool called the Florida Comprehensive Health Association (FCHA) — a last-resort insurance option for Floridians who were denied individual coverage due to pre-existing conditions. The ACA eliminated pre-existing condition exclusions in 2014, making the high-risk pool unnecessary. FCHA was subsequently wound down and is no longer active.
Today, no insurer can deny you coverage or charge you more because of a pre-existing condition if you enroll through the marketplace. This protection is one of the most significant ACA provisions for self-employed people — particularly those managing chronic conditions, recent health events, or ongoing treatments.
Florida Office of Insurance Regulation (OIR)
The Florida Office of Insurance Regulation (OIR) licenses and regulates insurance companies operating in Florida, including health insurers. If you have a complaint about a licensed carrier — billing errors, claim denials, coverage disputes — the OIR handles consumer complaints and can intervene in some cases. Visit floir.com to file a complaint or look up a carrier’s license status.
Important caveat: the OIR does not regulate health sharing ministries or ERISA self-funded employer plans. If you purchase a product from a health sharing ministry (sometimes marketed as an insurance alternative), you have fewer consumer protections and no OIR recourse if something goes wrong.
Federally Qualified Health Centers (FQHCs) in Florida
If you’re uninsured or underinsured, Florida’s network of Federally Qualified Health Centers (FQHCs) is one of the most important resources available. FQHCs are community health centers that receive federal funding and are required to serve all patients regardless of insurance status or ability to pay, using a sliding-scale fee structure based on income.
Florida has a large network of FQHC organizations operating clinic sites across the state — in urban areas like Orlando, Tampa, and Jacksonville, as well as in more rural communities. Services typically include primary care, preventive care, mental health services, dental, and some specialty referrals.
To find an FQHC near you, use the federal locator at findahealthcenter.hrsa.gov. This is not a substitute for comprehensive insurance coverage, but it is a meaningful safety net for self-employed Floridians who are between coverage options or waiting for open enrollment.
Florida’s Uninsured Rate and the Self-Employed
Florida consistently ranks among the states with the highest uninsured rates in the country. Florida’s uninsured rate has historically been above the national average, and roughly 440,000 Floridians lost marketplace coverage in the first two months of 2026. Self-employed individuals, independent contractors, and gig workers are disproportionately represented among the uninsured population.
The reasons are predictable: no employer to share the cost, variable income that makes budgeting for premiums difficult, limited awareness of subsidy availability, and the state’s Medicaid coverage gap for childless adults. The marketplace and Medicaid (for those who categorically qualify) are the two primary solutions for this population — and many self-employed Floridians between 100% and 400% FPL still qualify for premium tax credits. The enhanced subsidies expired after 2025, though, so households above 400% FPL (about $63,840 for a single person) now pay full price. See do self-employed people qualify for subsidies and free and low-cost health insurance options in Florida.
Frequently Asked Questions
Did Florida expand Medicaid?
No. Florida has not adopted the ACA Medicaid expansion. Adults generally must fit a category, such as pregnant, a parent or caretaker with low income, aged, blind, or disabled, to qualify. Many low-income childless adults fall into a coverage gap, earning too little for marketplace subsidies (below 100% FPL) but not qualifying for Medicaid.
Does Florida have its own health insurance exchange?
No. Florida uses the federal marketplace at HealthCare.gov. For 2027 coverage, Open Enrollment runs November 1, 2026 through January 15, 2027, and you must enroll by December 15, 2026 for coverage starting January 1. Carrier options and prices vary by county, so always compare using your own ZIP code.
Can my children get coverage if I don’t qualify for Medicaid?
Often, yes. Florida KidCare covers uninsured children under 19 through Children’s Medicaid, MediKids, Florida Healthy Kids, and the Children’s Medical Services network. Children may qualify at income levels where their parents do not, and family premiums are low for those who qualify. Apply at floridakidcare.org.
Which carriers are leaving Florida’s individual market for 2027?
Cigna, Molina Healthcare of Florida, and Sunshine State Health Plan are leaving Florida’s individual market for 2027. Carriers still offering individual plans include Florida Blue, Ambetter from Sunshine Health, Oscar, UnitedHealthcare, AmeriHealth Caritas, AvMed, and 22 Health, depending on your county.
Get Florida-Specific Guidance for Your Situation
Between Medicaid categorical rules, county-specific carriers, KidCare eligibility, and 2027 carrier exits, your best option depends on your income, household, and county. Michael McAllister, owner of Choice Health Insurance Brokers in DeLand, is a licensed broker appointed with 200 carriers (NPN 18229135) and there is no cost to work with him. Call or text 321-230-9536 or visit choice.healthcare to get started.