Posted by Jane Moerlie, Owner of Florida Insurance Boutique
As we wrap up another year here at Florida Insurance Boutique, I wanted to reflect on the conversations I’ve had with clients across the Sunshine State. Health insurance can be a complex topic, especially with ongoing changes in regulations, coverage options, and costs. In 2025, we fielded hundreds of inquiries from individuals, families, and small businesses seeking clarity on their options. Drawing from those interactions, I’ve compiled the top five most frequently asked questions we received this year. My goal is to provide straightforward answers that can help you navigate your own health insurance needs. If any of these resonate with you, please don’t hesitate to reach out—I’m here to help tailor solutions specifically for Florida residents.
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What Are the Key Differences Between HMO and PPO Plans?
This question came up repeatedly, especially from first-time buyers or those switching jobs. In simple terms, HMO (Health Maintenance Organization) plans require you to choose a primary care physician and get referrals for specialists, which helps keep costs down but limits your provider choices. PPO (Preferred Provider Organization) plans offer more flexibility—you can see specialists without referrals and have access to a broader network, though out-of-network care costs more.
In Florida, where we have a mix of urban and rural areas, many clients preferred PPOs for the freedom to visit specialists in cities like Miami or Tampa without jumping through hoops. However, HMOs often won out for budget-conscious families due to lower premiums. If you’re unsure which fits your lifestyle, we can review your needs and compare plans from top carriers.
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How Has the Affordable Care Act (ACA) Evolved in 2025, and What Subsidies Are Available?
The ACA continued to be a hot topic in 2025, with updates to premium tax credits and expanded eligibility for subsidies. Many callers wanted to know if they qualified for financial assistance through the Marketplace. Generally, subsidies are based on your household income (up to 400% of the federal poverty level) and can significantly reduce monthly premiums—sometimes to zero for lower-income households.
Florida saw a surge in enrollments this year due to enhanced subsidies for middle-income earners. One common misconception is that you must buy through the Marketplace to get coverage; in reality, we can help you shop both on and off the exchange for the best deals. If your income changed in 2025, it’s worth reassessing your eligibility to avoid overpaying
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What Should I Know About Medicare Supplements and Advantage Plans?
With Florida’s large retiree population, Medicare-related questions dominated our inbox. Medicare Supplement (Medigap) plans help cover gaps in Original Medicare, like deductibles and copays, while Medicare Advantage plans bundle everything into one package, often including extras like dental or vision.
In 2025, we noticed more interest in Advantage plans due to their zero-premium options and added benefits, but Supplements remain popular for those who want unrestricted access to any doctor accepting Medicare. A key tip: Enrollment periods matter—missing your initial window could mean higher costs later. If you’re turning 65 or reviewing your current plan, let’s discuss what’s best for your health profile and budget.
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How Do Rising Healthcare Costs Affect My Insurance Premiums?
Economic pressures in 2025 led many to ask about premium hikes and cost-saving strategies. Premiums rose about 5-7% on average due to inflation in medical services, but this varied by plan and location. Factors like age, tobacco use, and family size play a big role.
To combat this, we recommended high-deductible plans paired with Health Savings Accounts (HSAs) for tax advantages, or exploring short-term plans for temporary coverage. In Florida, where hurricanes can disrupt healthcare access, we also advised considering plans with robust telehealth options to manage costs without in-person visits. Proactive planning, like annual reviews, can help lock in savings before rates climb further.
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What Options Are There for Self-Employed Individuals or Small Business Owners?
Freelancers and entrepreneurs in Florida’s vibrant gig economy often inquired about individual vs. group plans. Self-employed folks can deduct premiums as a business expense, and many qualify for Marketplace subsidies. For small businesses, options like SHOP (Small Business Health Options Program) allow grouping employees for better rates.
This year, we helped several startups in Orlando and Jacksonville set up affordable group plans that included wellness incentives. If you’re self-employed, don’t overlook association health plans, which can offer competitive pricing. Customizing coverage to your work-life balance is key—whether you need portable plans for travel or family-inclusive options.
As we head into 2026, these questions highlight the ever-changing landscape of health insurance. At Florida Insurance Boutique, my team and I are committed to providing personalized guidance without the jargon. Whether you’re in Miami, Tampa, or anywhere in between, we’re your local experts for navigating Florida’s unique market. If you have a question that wasn’t covered here or need a quote, contact me at Florida Insurance Boutique today. Here’s to a healthier year ahead!