We’re here to provide information and expert guidance about Marketplace health insurance

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In 2025, the federal government made changes to health insurance that caused monthly costs to go up for many people.

If you enrolled in a Marketplace plan, your 2026 monthly cost is likely higher than last year due to less government financial help and other market changes that caused insurance premiums to increase across the country. Having health insurance is still one of the best ways to protect your family from having to pay the full cost of health care and prescription drugs. As health care costs continue to rise, it’s more important than ever to stay covered.

If you need to enroll outside of the fall Open Enrollment Period (November 1 – January 15) and you qualify for a Special Enrollment Period, it’s smart to learn about the changes so you know what to expect.

Many people may want to explore coverage options, have questions about how to use their benefits, or want tips to save money on health care this year. The government may continue to make changes to health insurance and financial help. As always, we provide this information and expert guidance at no additional cost. We’re here to guide you so you can stay covered for 2026.

Here are some government changes to health insurance that went into effect in the fall of 2025:

The enhanced subsidies, extra financial help that the government put into place during the COVID-19 pandemic, expired on December 31, 2025, leaving many people with less government financial help to pay their monthly health insurance premium.

For example, a 40-year-old in Volusia County making $22,590 could see his/her payment go from $0 per month in 2025 to $85 in 2026 for the same plan.

These numbers are Florida Health Care Plans estimates for a 40-year-old in the lowest cost Florida Health Care Plans plan in Volusia County. This estimate is for illustrative purposes only. Other insurers may vary. The 2025 150% Federal Poverty Level was used to calculate the income level. This assumes the person is making $23,475 in 2026 and does not make a change to their plan.

More steps and information may be required when you enroll to be able to keep your subsidy.
Starting in 2026, anyone who underestimates their annual income and gets more of a subsidy than they should have must repay 100% of the extra amount. It’s important to update your Marketplace application any time your income changes.
You must have filed your taxes and reconciled them using IRS form 8962 for any year that you’ve received a subsidy up to 2024, to get a subsidy for 2026.
There are fewer opportunities to enroll in health insurance outside of the fall Open Enrollment Period. Those who don’t enroll during this time must qualify for a Special Enrollment Period to enroll in insurance during the year.

How to qualify for a Special Enrollment Period

Individuals and families can enroll in Marketplace plans after January 15 if they’ve had certain life changes, like:

Losing insurance from your employer
Getting married or divorced
Having or adopting a baby
Moving to a new ZIP code
And more

How does Marketplace health insurance protect families from high health care and prescription costs?

Enrolling in health insurance on the Marketplace is a smart investment that gives you security and peace of mind, knowing that you’re not alone in paying for your medical care and prescription drug needs.

More predictable expenses:

Florida Health Care Plans Marketplace health insurance plans cover important services like yearly wellness checkups, routine bloodwork, and vaccinations, plus cancer screenings like mammograms and colonoscopies. These services, which could cost thousands of dollars without insurance, are covered at a $0 copay with Marketplace plans.

Protection for the unexpected:

When there’s a sudden diagnosis or medical emergency, insurance offers added financial protection from high health care costs. In Florida, the average ER visit without insurance can cost a staggering $3,100,²and the average hospital stay can cost around $30,000.³ Having health insurance is a safety net, so you’re not alone when facing unexpected medical bills.

A large network of doctors, pharmacies, and specialists:

For those with chronic conditions or ongoing health needs, health insurance is a vital lifeline connecting you to dedicated health care providers in your area. With the negotiating power of a health insurance plan, you can save on doctor and specialist visits, imaging, and prescription drugs.

The best way to save time and money is by understanding how your health insurance plan works. Check out these resources and log in to your member account to watch personalized videos about how to use your benefits for the least cost out of your pocket.

We’re here to guide you through the changes

When you’re with Florida Health Care Plans, you’re never alone. Our agents are licensed and specially trained to explain all the government changes and help find the best plan for your family’s needs. With the enhanced subsidies set to expire at the end of the year, and market changes causing premiums to increase across the country, you may want to find a plan with a lower monthly cost. An agent can help. And there’s never an extra cost to work with them.

We have a wide range of plans to fit many budgets, and our agents know how to help you get the most financial help you can qualify for. Plus, all our plans include personalized care programs, special discounts, and more at $0 extra cost.

Having the right health insurance gives you security and peace of mind that you’re not alone in paying for your medical care and prescription drug needs. If you have a FHCP agent, contact them to set up your appointment. If not, you can find an agent near you, connect with an agent at a local Florida Health Care Plans in person or through a virtual chat, or call us at 386-676-7110.

What to do before you meet with your agent:

Step 1: Be sure you’ve filed your 2024 income taxes and reconcile your tax credit using IRS Form 8962. You must file your taxes for any year you received a subsidy in order to get a subsidy for the upcoming year. The Marketplace may look at your 2024 tax return to determine your 2026 subsidy.

Step 2: Gather the documents that are required to enroll and get a tax credit this year:

Name, address, Social Security Number, date of birth for everyone covered by your plan, including Immigration status, Citizenship confirmation, and Adoption, foster care placement, or court order confirmation
The name of your agent, broker, or other professional helping you with enrollment this year
Information about how you file your taxes (filing separately or jointly, names of dependents)
Employer and Household income information for everyone in your household (You may not be able to self-attest to your income.)
Your current health insurance information
Any job-based health insurance your employer has offered, including Health Reimbursement Arrangements (HRAs)

Connect With Us <>

Reach out to our dedicated team if you need to enroll in coverage or have questions about your current plan.

Frequently asked questions

Changes to Enrollment and Financial Help

Do the federal government health insurance changes affect all insurers in Florida?

Yes. The federal government oversees the Health Insurance Marketplace (HealthCare.gov), and they determine who qualifies for financial assistance and how much, what paperwork is required to enroll or renew, and when people can enroll. The changes they make, including the expiration of the enhanced subsidies, apply to every insurance company in Florida.

Did all subsidies (tax credits) go away in 2025?

No, the subsidies for plans sold on the Health Insurance Marketplace did not go away totally.

The 2021 American Rescue Plan Act increased the amount of financial help that some people received, and it allowed others over a certain annual income to get subsidies for the first time. These enhanced subsidy levels were planned to be in place for two years, but The Inflation Reduction Act later extended them for another two years. The enhanced subsidies, extra financial help the government put in place during the COVID-19 pandemic, expired at the end of 2025. In January 2026, subsidy levels went back to their pre-2021 American Rescue Plan Act levels.

With this change, millions of Americans lost some portion or all their financial help, making their monthly insurance costs more expensive.

What can Florida Health Care Plans do to help me find more affordable coverage?

When you’re with Florida Health Care Plans, you’re never alone. Our agents are licensed and specially trained to explain all the changes and find the best plan for your family’s needs. And there’s never an extra cost to work with them. We have a wide range of plans to fit many budgets, and our agents know how to help you get the most subsidy you can qualify for. Plus, all our plans include personalized care programs, exclusive discounts, and more at $0 extra cost. We’ll do everything we can to help you find a plan that fits your needs and your budget.

Marketplace rules and filing your taxes

Who makes the rules for Affordable Care Act health insurance?

Centers for Medicare & Medicaid Services (CMS), which is part of the federal government, is responsible for implementing and administering the Affordable Care Act. CMS determines who is eligible for financial assistance, how much they qualify for, what they must provide to prove they are eligible, and when they can enroll. The changes they make affect all insurance companies.

Why does the Marketplace need me to file my taxes?

You must file your taxes for every year that you received a subsidy. When you enroll in or renew your insurance and apply for financial help, you estimate how much money you’ll make that year. When the year is over, you’ll need to confirm whether your estimate was correct.

You do this by filing your taxes and comparing your actual income to what you predicted. This is referred to as IRS form 8962. If you got more of a subsidy than you should have, you’ll have to pay back all of the extra financial assistance. On the other hand, if you got less of a subsidy than you should have, you could get some money back. The Marketplace may look at your taxes up to 2024 when you apply for a tax credit for plan year 2026.

My income fluctuates. What do these changes mean for me?

When you enroll in or renew your insurance and apply for financial help, you estimate how much money you’ll make that year. When the year is over, you’ll need to confirm whether your estimate was correct. You do this by filing your taxes and comparing your actual income to what you predicted. If you got more of a subsidy than you should have, you’ll have to repay 100% of the extra amount. In the past, there was a limit on what you’d have to repay.

So, if your income fluctuates, you’ll need to update your Marketplace application during the year to avoid owing anything back. Don’t wait! From your online member account, choose My Plan & Insurance to see the link to update your application. Log in now to get started.

When, how, and why to enroll

When can I enroll in a new health plan?

The annual Open Enrollment Period is a time when individuals and families can enroll in a health insurance plan or renew their current plan for the upcoming year. In 2025, Open Enrollment ran from November 1, 2025, through January 15, 2026. Those who enrolled by December 15, 2025, have coverage starting on January 1, 2026. Those who enrolled between December 16, 2025, and January 15, 2026, have coverage starting February 1, 2026.

If it’s outside of the Open Enrollment Period, you must have a qualifying life event, which includes situations like losing your existing health insurance, getting married, having a baby, or moving to a new ZIP code to get coverage. If you miss Open Enrollment and do not qualify for a Special Enrollment Period (SEP), you may have to wait until the next Open Enrollment to get coverage. A Florida Health Care Plans agent can help determine if your life change qualifies you for an SEP.

I usually buy insurance myself on the Marketplace and don’t want to work with an agent. How do I find an agent if I need help?

We have knowledgeable agents standing by to answer your questions at no extra cost and there’s no obligation to buy a plan from them. Our agents are licensed and specially trained to explain all the changes and find the best plan for your family’s needs. Having this expert guidance at no extra cost is a perk of working with Florida Health Care Plans. It’s easy to find an agent near you, connect with an agent at a local Florida Health Care PlansCenter in person or through a virtual chat, or call us at 386-676-7110.

Why is health insurance important?

No one plans to get sick or hurt, but most people will need medical care at some point. Having insurance means you won’t have to pay expensive medical bills on your own, whether you have a simple stomach bug or a serious accident or illness. For example, without health insurance, here are some common out-of-pocket costs:

Average ER visit at a Florida hospital: $3,100²
To treat a broken leg: $7,500³
Average three-day hospital stay: $30,000³
Cost of comprehensive cancer care: More than $100,000³

A recent report shows that 40% of adults in the United States have some type of health care debt.⁴ Medical debt shows up on your credit report, and medical bills contribute to nearly 70% of bankruptcies in the U.S.² Having health insurance helps protect you and your loved ones from potentially huge health care expenses.

Health insurance is more than just a financial safety net — it can be a tool for getting healthier. Many insurance plans offer added personalized services, like help managing ongoing health conditions, for no extra cost. This can help you get the quality care you need for the least out of your pocket. Plus, with insurance, your checkups, vaccinations, yearly bloodwork, and annual cancer screenings are covered at no extra cost.

Are there other options for coverage besides a Marketplace plan?

You may have heard of other types of health insurance plans, like short-term or accident and critical illness plans. These are very different types of policies. Marketplace plans are comprehensive health coverage that cover preventive care at a $0 copay plus government-required essential health benefits, and you can get this coverage even if you have pre-existing health conditions. These plans have no yearly dollar limit on what they could spend for your coverage.

Accident and critical illness plans are meant to be supplements to health insurance – they’re not substitutes for it. These types of plans typically pay a cash benefit if you are injured or become ill from a covered accident or illness. They don’t cover preventive care, routine sick care, or prescription drugs.

Short-term, limited-duration policies are designed to cover emergency and unexpected health issues over a short time period. They’re not required to cover preventive care and the essential health benefits listed above. They typically only cover conditions that come up after the plan’s effective date. So, if you have a pre-existing condition, you’ll likely have to pay the full cost of your care related to it.

Everyone’s situation and needs are unique. Florida Health Care Plans agents are experts at finding the right plan for you and your family’s needs and budget. They’ll work with you to get as much financial help as you can qualify for. There is no cost to get their guidance to be sure you understand what you’re buying and how it will work for you.

Other resources

¹These numbers are Florida Blue estimates for a 40-year-old in the lowest cost Florida Blue silver plan in Miami-Dade county. This estimate is for illustrative purposes only. Other insurers may vary. The 2025 150% Federal Poverty Level was used to calculate the income level. This assumes the person is making $23,475 in 2026 and does not make a change to their plan.
²www.debt.org/medical/emergency-room-urgent-care-costs/

³www.healthcare.gov/why-coverage-is-important/protection-from-high-medical-costs/?adlt=strict

⁴pmc.ncbi.nlm.nih.gov/articles/PMC6366487/

Policies have limitations and exclusions. Premiums vary with the amount of benefits selected.

Disclaimer

The information provided on this website is for educational and informational purposes only. The content is intended to provide general knowledge and understanding of various topics and should not be considered or relied upon as legal or tax advice. If you are seeking legal or tax advice, you should consult with a qualified attorney or tax professional who is licensed to practice in your jurisdiction. You should not make any decisions based solely on the information provided on this website without first consulting with a qualified professional. The website's owners, authors, affiliates, subsidiaries, and contributors are not responsible for any errors or omissions in the content, and do not guarantee the accuracy, completeness, or timeliness of the information. The website's content is subject to change without notice and may not reflect the most up-to-date information.

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