Your Health is the Main Character

Without your health, the rest of the story stops. Whether you are self-employed, between jobs, or retiring early, we help you navigate the Marketplace to find a plan that fits your budget, doctors, and prescriptions.

Start a Marketplace Health Quote

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The Alphabet Soup of Florida Healthcare.

HMO, EPO, PPO, POS. The acronyms alone are enough to raise your blood pressure. In Florida, the Individual Market (often called "Obamacare" or the ACA) is robust, but it is strictly managed. Picking the wrong plan doesn't just cost you money—it could mean your preferred hospital turns you away at the door.

Many Floridians qualify for "Advanced Premium Tax Credits" that significantly lower monthly premiums.

The Catch: If you calculate your income incorrectly, the IRS will ask for that money back next April.

At Novel Insurance, we act as your navigator. We calculate your credits accurately, check your doctors, and ensure you understand exactly how your plan works before you need it.

Our Coverage Menu

The "Gatekeeper" Plan. The most common plan type in Tampa Bay.
- How it works: You pick a Primary Care Physician (PCP). You must get a referral from them to see a specialist.
- Pros: Usually the lowest premiums and copays.
- Cons: No out-of-network coverage; requires coordination.
The "Middle Ground." Increasingly popular for those who want flexibility without the high cost of a PPO.
- How it works: You do not need a referral to see a specialist, but you must stay in the network.
- Pros: Freedom to book your own appointments directly.
- Cons: If you go out-of-network (non-emergency), you pay 100% of the bill.
The "Freedom" Plan. The gold standard for flexibility.
- How it works: You can see any doctor you want, in or out of network, without a referral.
- The Florida Reality: In the Individual Market, true PPOs are extremely rare and often come with significantly higher premiums.
- Best for: Clients who travel frequently or need access to specific out-of-state specialists.
The "Bridge" Plan. Missed Open Enrollment? Need coverage for just 3 months while changing jobs?
- How it works: Catastrophic coverage for a defined period.
- Warning: These are not ACA-compliant. They do not cover pre-existing conditions or maternity. We only recommend these for healthy individuals in transition.

How We Review Your Policy

A computer algorithm can show you the cheapest price, but it can't tell you if the plan is actually good. We review the details that matter:

The "BayCare vs. AdventHealth" Split: In Tampa Bay, most plans cover either the BayCare hospital system or the AdventHealth system—rarely both. We ensure your plan aligns with the hospital you trust.
Drug Formularies: Is your medication in "Tier 1" (Cheap) or "Tier 4" (Expensive)? We run your exact prescriptions against the 2026 formulary lists to prevent sticker shock at the pharmacy.
Subsidy Reconciliation: We help you project your "Modified Adjusted Gross Income" (MAGI) conservatively to avoid a surprise tax bill at the end of the year.

Frequently Asked Questions

Still have questions? Take a look at the FAQ or contact us anytime.

A: Open Enrollment runs from November 1st to January 15th. This is the only time you can sign up unless you have a "Qualifying Life Event" (like getting married, having a baby, moving to Florida, or losing employer coverage).
A: Yes. All ACA-compliant Marketplace plans must cover pre-existing conditions (diabetes, cancer, pregnancy) with no waiting periods and no extra cost. You cannot be denied coverage based on your health history.
A: You can still buy a Marketplace plan, you just won't get a subsidy. However, recent laws have expanded subsidies to higher income brackets, so don't assume you don't qualify until we run the numbers.
A: This is the most important number in the contract. It is the absolute most you will pay in a year (deductibles + copays) for covered services. Once you hit this wall, the insurance company pays 100% for the rest of the year. It protects you from bankruptcy.
A: Generally, no. While pediatric dental/vision is required by law, adult coverage is almost always an optional add-on. We can help you purchase a separate, low-cost "stand-alone" Dental/Vision policy that covers cleanings, fillings, and eyewear.
A: Only if you select a specific "HSA-Eligible" High Deductible Health Plan. Not all high-deductible plans qualify. If tax-free savings are part of your financial strategy, let us know so we can filter the search results for HSA-compatible options.
A: This is a common point of confusion. Doctors often accept "UnitedHealthcare" or "Blue Cross" generally, but they may only accept the Employer/Group networks, not the Individual/Marketplace networks. We always verify your specific doctor against the specific Exchange network before you enroll.
A: You can cancel your Marketplace plan at any time, there are no contracts. However, once you become eligible for affordable employer coverage, you generally lose your eligibility for the Marketplace subsidy. We help you time the cancellation to ensure you don't have a gap in coverage or a tax penalty.
A: Yes. Thanks to recent fixes to the "Family Glitch," if your spouse's employer plan costs more than roughly 8.39% of your household income to cover the family, you may now qualify for subsidies on the Marketplace. We can run the math to see if splitting your coverage saves you money.