19.15 Cover Florida Plan
Cover Florida is an initiative enacted in 2008 and administered by the Agency for Health Care Administration and the Office of Insurance Regulation to improve access to health care coverage to uninsured Floridians. It is designed to offer low-cost health care plans that will contain either basic or catastrophic coverage. Carriers approved to offer Cover Florida policies must provide an option for a basic plan without catastrophic coverage and a second option that must include catastrophic coverage, at a minimum.
Eligibility to enroll in a Cover Florida plan is limited to Florida residents who meet all of the following requirements:
- Are between 19 and 65 years of age, inclusive;
- Are not covered by a private insurance policy and are not eligible for coverage through a public health insurance program (such as Medicare, Medicaid, or Kidcare) unless eligibility for coverage lapses due to no longer meeting income or categorical requirements;
- Have not been covered by any health insurance program at any time during the past six months, unless coverage under a health insurance program was terminated within the previous six months due to:
- loss of a job that provided an employer-sponsored health benefit plan;
- exhaustion of coverage that was continued under COBRA or continuation-of-coverage requirements under Sec. 627.6692;
- reaching the limiting age under the policy; or
- death of, or divorce from, a spouse who was provided an employer-sponsored health benefit plan.
- Have applied for health care coverage through a Cover Florida plan and have agreed to make any payments required for participation, including periodic payments or payments due at the time health care services are provided.
Please see page 507 of the Florida study manual for plan coverages.
