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Florida Health Insurance

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Updated August 17, 2013

Florida Office of Insurance Regulation

The Florida Office of Insurance Regulation is responsible for regulating all types of insurance sold in the Florida - including health insurance policies.

If you are looking for health insurance coverage, they have lists of insurance agents and insurance companies licensed to do business in Florida. Go here to find out if your insurance company is licensed to do business in Florida. You can also check for licensed agents here.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Office of Insurance Regulation. They have an online consumer complaint form here.

Florida Office of Insurance Regulation
200 East Gaines Street
Tallahassee, FL 32399
Phone: 850.413.3140
http://www.floir.com/

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees - for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage - for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan - contact your regional EBSA office.

U.S. Department of Labor Employee Benefits Security Administration
Atlanta Regional Office (Northern Florida)
61 Forsyth Street, SW, Suite 7B54
Atlanta, GA 30303
Howard Marsh - Director
Tel 404.562.2156
Fax 404.562.2168
http://www.dol.gov/ebsa/

U.S. Department of Labor Employee Benefits Security Administration
Miami District Office (South Florida)
8040 Peters Road, Bldg H, Suite 104
Plantation, FL 33324
Isabel Colon - Supervisor
Tel 954.424.4022
Fax 954.424.0548
http://www.dol.gov/ebsa/

Buying Individual Policies in Florida

As a general rule, insurers in Florida are allowed to reject your application for coverage based on your health status. There are several exceptions to this general rule:

  • If you have had at least 3 months of coverage under a group plan, you may be eligible to buy a conversion policy. This will convert your group plan into an individual policy.
  • If you had coverage under an individual policy or HMO, and your coverage was terminated because the insurer became insolvent, dropped all individual coverage in Florida, or you moved out of your policy's service area, you may be eligible to buy an individual health insurance policy.
  • If you are HIPAA-eligible but do not qualify for a conversion policy, you are guaranteed the right to buy an individual health policy. This is a rare situation, as HIPAA-eligible individuals are those who have been covered under a group plan AND have exhausted all COBRA continuation coverage available to them.
If you are not sure whether you are eligible to buy an individual policy or a conversion policy, your insurance agent or the Office of Insurance Regulation can help you find out.

Florida KidCare - the state Children's Health Insurance Program

Florida KidCare provides health insurance coverage for children under age 19 whose family meets certain income guidelines.

Florida KidCare
P.O. Box 980
Tallahassee, FL 32302-0980
Phone: 850.224.5437
http://www.floridakidcare.org/

Florida Serving Health Insurance Needs of Elders (SHINE)

The Florida SHINE program provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the new Part D prescription drug benefit, or Medigap coverage.

Florida SHINE Program
Phone: 1.800.963.5337

Florida Medicaid

Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about eligibility, contact the Department of Children and Families, Office of Economic Self Sufficiency.

Florida Medicaid
Phone: 866.762.2237
http://www.fdhc.state.fl.us/Medicaid/index.shtml

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