Florida Blue Health Insurance Review, Pros and Cons, Coverage, How to Apply

Health insurance is an important consideration for individuals and families seeking affordable, quality healthcare coverage. Florida Blue is one of the major health insurance providers in the state of Florida, offering a range of plan options to over 4 million members. As the state’s Blue Cross and Blue Shield affiliate, Florida Blue has a long history and strong brand recognition in the region.

When researching health insurance plans, it is helpful to understand the key factors like coverage, costs, provider networks, and customer satisfaction ratings. This article provides an in-depth look at Florida Blue health insurance, including the pros and cons, plan options, costs, and reviews from current members. Read on for a comprehensive guide on what to know about Florida Blue plans in Florida.

About Florida Blue Health Insurance

Florida Blue, previously known as Blue Cross and Blue Shield of Florida, has been operating in the state since 1944. Headquartered in Jacksonville, it is a private mutual insurance company serving residents in Florida.

Florida Blue offers health insurance plans directly to individuals, families and employers, as well as administering government-sponsored programs like Medicare Advantage and the Federal Employee Program. They have an extensive network of doctors, hospitals and pharmacies across the state.

Compared to other insurers in Florida, Florida Blue tends to offer very competitively priced plans. They provide traditional PPO and HMO plans along with high-deductible health plans (HDHP) compatible with Health Savings Accounts (HSAs). Florida Blue coverage options include individual and family health insurance, Medicare plans, and group health insurance for employers.

Some key facts about Florida Blue:

• 4+ million members as of 2022
• 90,000+ in-network doctors and providers
• Over 170 local, walk-in Florida Blue Centers
• Accredited by the National Committee for Quality Assurance (NCQA)
• Rated “A” (Excellent) for financial strength by A.M. Best Company

Pros and Cons of Florida Blue Health Insurance

Pros of Florida Blue Health Insurance

There are many advantages to choosing Florida Blue for health insurance:

• Large provider network: With thousands of in-network doctors and hospitals across Florida, it’s easier to find nearby in-network providers. This gives members more choices for their healthcare.
• Affordable rates: Florida Blue premiums tend to be very competitively priced compared to other major insurers in the state. They offer options to fit a range of budgets.
• Choices of plans: From HMO to PPO to HDHP and Medicare Advantage, Florida Blue offers a variety of plan types depending on your coverage needs and budget. Families can often find coverage for around $300-$400 per month.
• Member perks: Members get access to fitness and wellness programs, vision and dental discounts, health coaching, and the ability to earn rewards points for gift cards through their Better You program.
• Strong financial ratings: Florida Blue has maintained ‘A’ ratings for financial strength from rating agencies like A.M. Best. This indicates they are in a good position to pay out member claims.
• Local service: With numerous Florida Blue Centers located around the state, members can get in-person support at their local branch when needed.

Cons of Florida Blue Health Insurance

Some potential downsides to consider about Florida Blue plans:

• Regional provider network: The provider network for Florida Blue is concentrated in the state of Florida. Those who travel out of state frequently may find more limited coverage options.
• Medicare plan ratings: Florida Blue Medicare Advantage plans tend to score below average in many regions of Florida when compared to competitors, according to Medicare.gov’s star ratings.
• Claims processing delays: Some members have complained about delays in claims processing and reimbursement from Florida Blue. However, the company has worked to improve in this area.
• Price increases: While typically affordable, Florida Blue premiums and out-of-pocket costs can rise year-over-year, like most health insurers. Comparing new rates annually is important.
• Pre-authorization requirements: Florida Blue may require pre-authorization and referrals for certain services, which can be an inconvenience for members when seeking care.

Plans and Coverage Offered by Florida Blue Health Insurance

Florida Blue offers a wide variety of individual and family health insurance plans for residents in Florida:

Individual and Family Plans

• PPO Plans: With Preferred Provider Organization (PPO) plans from Florida Blue, members can see any doctor or hospital without needing a referral. Out-of-network care is covered but at a higher cost. Copays apply for office visits and prescriptions.
• HMO Plans: Health Maintenance Organization (HMO) plans require members to select a primary care physician (PCP) to coordinate care. Referrals are needed for specialists. Out-of-network care is not covered except emergencies. Lower deductibles and copays apply.
• HSA Plans: High Deductible Health Plans (HDHPs) are compatible with a Health Savings Account (HSA). Preventative care is covered at no charge before the deductible. Members can contribute tax-free dollars to an HSA.
• Catastrophic Plans: These bare-bones plans are an low-cost option for younger individuals. They have very high deductibles but cover preventative services and three primary care visits per year. Best for emergency coverage.
• BlueSelect Plans: A subset of Florida Blue’s PPO plans for individuals under age 30 or those with a hardship exemption. Lower monthly premiums and choice of any doctor are offered.

Group Health Insurance

Florida Blue also offers group health insurance plans for businesses and employers. Companies can choose from PPO, HMO, POS, HDHP, HSA-qualified plans, and more based on their budget and benefits needs. Self-funded plan administration is also available.

Medicare Plans

For seniors in Florida, Florida Blue offers a range of Medicare Advantage and Medicare Supplement plans:

• Medicare Advantage plans (Part C)
• Prescription drug plans (Part D)
• Medicare Supplement (Medigap) plans
• Special Needs Plans (SNPs)

Their Medicare HMO and PPO plans includes extras like dental, vision, hearing benefits. However, out-of-state coverage may be limited.

How to Apply for Florida Blue Health Insurance

If you are interested in getting a Florida Blue health insurance policy, here is a step-by-step guide to applying:

1. Shop plans and compare: Go to the Florida Blue website or speak with an agent to review different plan options and pricing. Compare benefits, premiums, and deductibles across various plans.

2. Choose a plan: Select the plan that best matches your coverage needs, budget, and preferred provider network. HMO plans often cost less, but restrict your provider choices.

3. Start your application: Begin the online application through Florida Blue or Healthcare.gov. You will need information like birthdates, social security numbers, and income handy.

4. Complete enrollment: Finish filling out all sections of the application and select payment options. Your initial premium payment will be due to activate coverage.

5. Accept terms and conditions: Review and electronically sign the policy documentation sent by Florida Blue. Your insurer will mail you insurance cards and full policy details.

6. Activate benefits: Once your application is approved and first payment received, your Florida Blue policy will be active on your coverage start date. You can begin using your benefits.

Be sure to pay close attention to open enrollment periods which determine when you can apply for coverage each year. Outside of open enrollment, a special enrollment period is required to obtain health insurance unless you have a qualifying event.

Florida Blue Health Insurance Reviews and Customer Satisfaction

Florida Blue health insurance gets mixed reviews from current policyholders. On the Better Business Bureau (BBB) website, they are currently accredited and hold an overall 3.2 out 5-star rating based on 143 customer reviews. Positive reviews highlight the affordability of premiums and good variety of plan options. Negative reviews mention issues with claims processing, billing errors, and poor customer service.

According to the National Association of Insurance Commissioners (NAIC), Florida Blue had 1,135 complaints lodged against it in 2021 and held a complaint index of 0.97. This is a bit higher than the industry average complaint index. The primary complaint categories were issues with claims, billing/premiums, and marketing/sales.

Third-party reviews sites like TrustPilot give Florida Blue a 3 out 5 star overall rating based on 100+ member reviews. Positive testimonials mention good coverage at reasonable rates. Negative reviews complain about denied claims, billing errors, and long customer service wait times over the phone.

So while Florida Blue offers very affordable pricing and good plan choices, they still have some room for improvement when it comes to claims processing accuracy, responding to customer issues quickly, and improving support channels like phone customer service. However, they remain competitively rated compared to other major health insurers in Florida.

Florida Blue Health Insurance Alternatives

Florida Blue is a great option for health insurance but may not be the right fit for everyone’s needs. Here are a few alternatives to consider if you want to compare plans:

• AvMed: A Florida-based non-profit insurer with competitive rates and member perks like gym rewards and discounts. They offer individual, family, Medicare and group health plans.
• Cigna: A large national insurer with a range of PPO and HMO options. They have well-rated Medicare Advantage and prescription drug plans for seniors.
• Aetna: Another national insurer that offers Florida plans on and off the Health Insurance Marketplace. Aetna has a broad network of healthcare providers.
• UnitedHealthcare: This big insurer provides health plans in Florida with options for employer groups and individuals. They are known for tools and resources that help members make informed healthcare decisions.
• Oscar Health: A newer provider with comprehensive online tools, telemedicine benefits and wellness rewards. Oscar provides both Marketplace and off-Marketplace plans.

Conclusion

Florida Blue has been a trusted health insurance provider in the state for over 75 years. Their affordable premiums, extensive network of providers, and variety of plans make them a competitive choice for Florida residents. While they still have some room for improvement in customer service and claims response times, Florida Blue offers quality coverage for individuals, families, employers, and seniors. Their wide range of plans and member perks like fitness rewards are added advantages. For those wanting an alternative, insurers like AvMed, Cigna, Aetna, UnitedHealthcare and Oscar Health also provide options for shoppers. Consider your specific health needs and budget to determine which Florida health insurance company may be best for you.