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Health Insurance Alternatives: Florida FAQ

Straight answers to the questions Floridians ask most.

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Frequently asked questions

Is health care sharing the same as health insurance?

No. Health care sharing is a group of members who agree to share each other's eligible medical bills under written guidelines. Nobody is required to pay, so sharing isn't guaranteed. It isn't regulated as insurance, and it isn't Minimum Essential Coverage under the ACA.

Is it legal in Florida?

Yes. Section 624.1265 of the Florida Statutes exempts qualifying health care sharing organizations from the Florida Insurance Code, which also means they aren't covered by its consumer protections. Florida's direct health care agreement law (§ 624.27) says direct primary care agreements aren't insurance. There's no state penalty for going without insurance.

What is an Initial Unshareable Amount (IUA)?

It's the part of each medical Need you pay yourself before other members can share the rest. It works per Need, not per year, so it isn't a deductible. With the program we most often recommend, you choose the amount when you join (our price table shows $500 to $2,500), and no more than three IUAs apply in a membership year.

What isn't shared?

Routine and preventive care (except some screenings), most ongoing prescriptions after the first 120 days, routine dental, glasses and contacts, alternative medicine, and counseling above $750 a year. That's why we pair sharing with primary care and a dental plan.

What about pre-existing conditions?

Conditions with symptoms, treatment or medication in the 36 months before joining are phased in: not shareable in year one, up to $25,000 in year two, up to $50,000 in year three, and fully shareable after that.

Can I use any doctor or hospital?

For health sharing, yes, including hospitals across the state line. There's no provider network, so you pay as a self-pay patient and submit eligible bills. The virtual primary care membership is a specific practice that you reach by video and phone.

How do I pay a big bill?

You pay the provider up to your IUA, open a Needs case and upload itemized bills within six months. The program negotiates bills over $1,000, and shared money is paid to you so you can pay the provider.

Is there an age limit?

New members must be 18 to 64. At 65, members need Medicare Parts A and B to stay.

What happens if I evacuate for a hurricane?

Health sharing has no network, so you can use any licensed hospital wherever you are, and your virtual primary care team is a phone or video call away. For an emergency, notify the sharing program within 48 hours.

I fall in Florida's coverage gap. Can you help?

Check HealthCare.gov and Florida Medicaid first, because there are exceptions for children, pregnant women and some parents. Community health centers charge on a sliding scale. Health sharing isn't insurance, but some households in the gap use it; we'll talk it through honestly.

Can I keep my HSA?

Generally no. Health sharing isn't a high-deductible health plan, so you usually can't add new money to an HSA while you rely on it. Money already in an HSA stays yours. Ask your tax preparer about your situation.

Do you charge for help?

No. There's no cost to talk with us. We may be paid by some programs we recommend; our Referral Marketing Disclosure explains how.

Sources

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Free, no obligation. Florida households only.

Health care sharing
Health care sharing ministries are not insurance and are not regulated as insurance. Sharing of medical expenses is voluntary and not guaranteed. Review each organization's guidelines for details, limitations, and state-specific notices.

Florida notice (§ 624.1265(3), Florida Statutes)
Florida law requires health care sharing organizations to give this notice with their applications and guidelines: “Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor its plan of operation is an insurance policy. Membership is not offered through an insurance company, and the organization is not subject to the regulatory requirements or consumer protections of the Florida Insurance Code. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant is compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.” Health care sharing is not Minimum Essential Coverage.

Direct primary care
Direct primary care is a membership with a primary care practice. Under Florida's direct health care agreement law (§ 624.27, Florida Statutes), these agreements are not health insurance and are not subject to the Florida Insurance Code. A DPC membership does not pay for specialists, hospital care or emergencies, and it is not Minimum Essential Coverage.

Discount plans
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. Florida disclosure (§ 636.212, Florida Statutes): The plan is not insurance. The plan provides discounts at certain health care providers for medical services. The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. Discount plan organization: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034. Discount plans are not ACA Qualified Health Plans.

How we're paid
We may receive compensation from some organizations we recommend. This does not change our evaluation of how they work. See our Referral Marketing Disclosure.

Not advice
This page is general information, not medical, legal, tax or financial advice. Prices are examples, not quotes; they depend on your household and can change. Affordable Healthcare Florida is not an insurance agency and does not sell insurance. We help individuals and families explore alternatives to insurance, including direct primary care, health care sharing and discount plans.