Many Floridians have new health insurance options because of the Affordable Care Act, and Florida Blue is a leading provider of qualified health plans in the state. Florida Blue health plans come from the company that used to be called Blue Cross and Blue Shield of Florida, and this insurer covers more individuals in the state than any other. If you need to purchase a new major medical policy for yourself, your spouse, and your kids, you should know that this company offers a wide variety of health insurance marketplace plans that can suit most health needs and budgets.

Our mission is to help our clients find the right coverage at the best possible price. Contact us at any time, and we will be happy to suggest the best options for your individual situation. You can also take advantage of the free online health insurance quotes on our website, and all you need to do to get started is enter your ZIP code, so the system can pull up the right plans for your local area.

Understanding Medical Provider Networks

PPO and HMO plans use a network of medical service providers in order to help simplify access and control costs. Medical service providers include doctors, specialists, hospitals, pharmacies, and other providers of covered services.

This outlines the main ways that HMO and PPO plans work differently:

  • With a PPO, you enjoy the highest level of coverage if you use network providers, but you are free to get treated outside the network if you accept higher out-of-pocket costs.
  • With an HMO, you must almost always use a network medical provider in order to have your health services covered. Most HMOs make exceptions for emergency or urgent care.
  • Additionally, you may need a referral from your primary care doctor to see specialists when you have an HMO, and you do not need a referral with a PPO.

This is important because choosing an insurance company and a health plan with a strong network in your local area is an important consideration when you are shopping for coverage. All Florida Blue health plans come with a good network, but some are different than others, and you will want to keep that in mind as you compare your choices.

Out-of-Pocket Costs

All of these plans provide comprehensive coverage, but no health insurance plan will pay for all possible out-of-pocket costs. These are some important terms to understand:

  • Deductibles: This is the amount of money that you must pay before coverage begins to pay medical bills.
  • Copays: Instead of using a deductible, you might be required to pay a copay for some services.

Why Choose Florida Blue?

Before considering different types and levels of major medical insurance, consider some common features and benefits that all of the plans offer:

  • You cannot be denied because of a pre-existing condition.
  • You can choose the Platinum, Gold, Silver, or Bronze level of coverage.
  • All plans provide essential benefits, and these include preventative care, Florida maternity insurance, care for chronic conditions, pediatrics, and more.
  • You can access nationwide emergency care.

Blue Care

If you live in an area with a lot of Florida Blue Care network providers, this plan can provide you with a lot of value for your money. Since it is an HMO that is only available in some parts of the state, it is important to be certain that you are comfortable with the local network though.

  • Type: HMO
  • Requires referrals from primary care doctor: Yes
  • Plan tiers: Platinum, Gold, Silver, and Bronze
  • Out-of-network coverage: Emergencies
  • Statewide: No
  • Nationwide emergency care: Yes

Blue Select

Blue Select plans give you access to a large network of medical providers and more flexibility than an HMO plan. However, it is only marketed in select parts of Florida, so you should verify that you have local access to the medical providers you need.

  • Type: PPO
  • Requires referrals from primary care doctor: No
  • Plan tiers: All the “metals”
  • Out-of-network coverage: Yes
  • Statewide: No
  • Nationwide emergency care: Yes

Blue Options PPO Plans

Blue Options PPO plans are available all over the state of Florida, and they even connect members to a nationwide network of Blue Cross and Blue Shield affiliates. This plan provides some of the broadest in-network coverage that you will ever find.

  • Type: PPO
  • Requires referrals from primary care doctor: No
  • Plan tiers: All the “metals”
  • Out-of-network coverage: Yes
  • Statewide: Yes
  • Nationwide BlueCard Network: Yes
  • Nationwide emergency care: Yes

Blue Options HSA Plans

The plans described above can be selected as low deductible or high deductible coverage. However, essential HSA plans work a little differently. Not only you would choose a bigger deductible major medical insurance policy, but you also set up a health savings account, or HSA, to work with your health insurance. These are considered essential plans because they do offer all of the benefits you would expect to find in any good health insurance policy, but coverage does not kick in until a higher deductible has been satisfied.

Blue Options HSA plans can help policy owners save money and control expenses in a few different ways:

  • A bigger deductible might make premiums cheaper.
  • Within limits, contributions to the HSA can be deducted from income tax.
  • Pre-tax money in the account can be spent on medical expenses or saved.

By choosing essential HSA plans, covered people can save and control their money if they are disciplined about saving. The health savings account can work really well so long as people are willing make regular contributions to it.

Which Type of Coverage is Best for You, Your Spouse, and Your Kids?

Again, you have to consider your own needs, preferences, and budget. Remember that all plans have to provide certain mandated benefits like maternity insurance, preventative care, and prescriptions, but they cover these medical services in different ways.

It might be helpful to group plans into four types:

  • Essential health plans: These protect you from financial problems because of serious health issues, but they may not cover the first dollar of all types of treatment. Monthly premiums should be cheaper.
  • Everyday Health Plans:  These are great for annual wellness visits as well as the occasional sick visit, and the benefits can be tailored to your preference for covering the unexpected events such as ER or hospital visits.
  • Predictable Cost Plans:  These provide predictable cost for the most utilized services including copays for the unplanned events like ER or ambulance services. They also provide a cap on total expenses should something more serious arise, making it easy to control you expenses.
  • All Copay plans: These are plans where almost every service can be accessed with one set copay. Premiums might be slightly higher, but they help control costs better.

Additionally, some options have more limited local networks for most medical services. If you live in an area where these networks are large and comprehensive, you should be very satisfied with your coverage. However, if you travel a lot or live outside of the limited networks, you might be a lot happier if you choose a plan with statewide and even nationwide coverage.

Consider some examples of people who might be happier with a certain plan type:

  • Young adults who are relatively healthy might prefer saving money with essential health plans that only provide basic coverage.
  • Those with young children and growing families might find “all copay plans” much better because they can help control the cost of all of those doctor visits and prescriptions. These plans are also very simple to understand and use.

Chronic Health Conditions

People who suffer from chronic health conditions like diabetes or arthritis may find that the comprehensive coverage and better access of an HMO is better for them because it gives them very good value for their money as long as they live where there are plenty of network doctors. The thing to keep in mind is that HMOs are restrictive, so you should make sure that any doctors and other service providers that you already like are on the network. If you do anticipate the need to visit a specialist outside of the network, you can keep that option open if you choose a PPO.

Of course, people who are relatively healthy are less likely to already rely upon a certain doctor or hospital in the first place. In this case, it will probably not be a problem to select a provider from a large network. The important thing to do before deciding to save money by choosing a plan with a more local network is to make sure that you live in an area with a good variety of providers to choose from. This can include doctors, hospitals, and pharmacies.

Child Only Health Insurance

In some cases, the adults can access group health insurance at work, but this coverage does not extend to their children. You can buy child only health insurance in Florida, and the premiums for minors are usually relatively inexpensive. If you can opt to extend group health insurance to your entire family, you should compare the costs and benefits against individual health insurance plans offered by Florida Blue. Some people are better off to keep everybody covered by one policy, but some of them save money by selecting different coverage options for different family members according to their individual needs.

For example, if one family member has special needs like autism or ADHD, he might be covered better by a low deductible that that can be found with an “everyday health plan”. Other family members might be fine with essential plans that only provide the basics.

How to Choose the Best Individual Health Insurance for Your Family

You might think that you still have a lot of hard choices to make. It is true that having a lot of choices can make the decision a hard one. But we are always here to help. You can always contact us with your questions about specific health conditions, provider networks, and choices available in different parts of Florida. We will be happy to take the time to help you select a plan that fits your needs and budget.

Using our online price comparisons or calling us for help does not obligate you in any way. Our agency has thrived because we work hard to find people the coverage they need, but we understand that we cannot offer the right solution for everybody. We are a leading health insurance resource in the state of Florida, and we are happy to help you buy coverage or direct you to another possible solution.

 Florida Health Insurance Quotes

You are also free to compare prices from the convenience of your home or office computer. Once you find plans that suit your needs and seem affordable, you can still call us to ask for more information. We can also help you apply for any coverage that you choose. People that end up truly satisfied with their health insurance have good access to the medical providers that they like and need, premiums that work within their family budgets, and predictable out-of-pocket costs. Our knowledgeable local agents have a lot of experience helping families find the best solution at the right price.