AvMed vs. Florida Blue

By the Florida Plan Finder Team | Licensed Florida Health Insurance Producer | Last Updated: May 25, 2026

Key Takeaways

AvMed is Florida's oldest nonprofit health plan, founded in Gainesville in 1969, and its 24.5% approved increase is one of the lowest of any 2026 Florida carrier. Florida Blue is the only major 2026 marketplace carrier offering true PPO plans, and it sells in 60+ of Florida's 67 counties. Both compete on Florida's 2026 ACA marketplace, where 16 insurers now participate and the statewide weighted-average rate rose roughly 31.5% before subsidies — but the two carriers take very different approaches to networks, plan types, and price.

This comparison breaks down how AvMed and Florida Blue differ on county availability, provider networks, plan types, 2026 premiums, and member experience — and which type of Florida enrollee each one fits best.

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A licensed Florida agent can pull AvMed and Florida Blue quotes for your ZIP and confirm whether your doctors are in-network with each — at no cost to you.

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AvMed — Strengths

Florida-domiciled and Florida-only: AvMed is headquartered in Florida and sells only in Florida — founded in Gainesville in 1969, it is the state's oldest nonprofit health plan. Decisions, provider relationships, and member service are all Florida-based rather than run from a national headquarters.

Nonprofit mission and member service: As a nonprofit, AvMed reinvests in members and is known for member-service and care-management quality, including its WELLfluent wellness programs.

One of the lowest 2026 increases: AvMed's 24.5% approved rate increase for 2026 is among the lowest of any Florida carrier, which can make it competitive in the counties it serves.

Florida Blue (Blue Cross Blue Shield) — Strengths

Broadest provider network: As a Blue Cross Blue Shield company, Florida Blue contracts with the majority of hospitals and physicians in the state — AdventHealth, Baptist Health, HCA Florida, Orlando Health, Memorial Healthcare, Tampa General, and BayCare all participate in Florida Blue networks. No 2026 marketplace carrier comes close to its provider breadth.

PPO availability: Florida Blue is the only major Florida ACA carrier offering true PPO plans for 2026. PPOs add out-of-network coverage, no specialist referrals, and access to the national BlueCard network — a real advantage for snowbirds and frequent travelers.

Statewide reach and retail centers: Florida Blue operates in 60+ of Florida's 67 counties and runs Florida Blue Centers across the state where members get face-to-face help with enrollment and claims. In many rural counties it is the only carrier on the exchange.

Side-by-Side Comparison

Feature AvMed Florida Blue
Founded / status 1969 — Florida's oldest nonprofit health plan 1944 (80+ years in FL)
Plan types HMO HMO + PPO
Florida county availability Florida-only; select counties 60+ of 67 counties (statewide)
Telehealth Virtual visits included Available; copays vary by plan
Provider network Florida-focused; strong in home regions Broadest in Florida
Out-of-network coverage Emergency only PPO: Yes / HMO: Emergency only
Signature feature Florida-domiciled nonprofit; WELLfluent wellness Statewide retail centers; BlueCard national network
2026 approved rate change +24.5% (one of the lowest in FL) +29.6% (HMO +29%)

Network Differences

AvMed runs Florida-only HMO networks that are strongest in its home regions — South Florida, parts of Central Florida, the Gainesville/Alachua area, and Jacksonville — with out-of-network care covered for emergencies only. Its footprint is far smaller than statewide Florida Blue, so county availability is the first thing to check.

Florida Blue's network is among the broadest of any carrier in any state. Nearly every major Florida health system participates, so enrollees rarely face access problems — the trade-off is that its 2026 approved rate increase of 29.6% (29% for the Health Options HMO line) keeps premiums above the lowest-cost value carriers.

The network gap between these two carriers is the single most important thing to check before you enroll, because an ACA plan only pays in full when you stay in its network.

Check Your Doctors Before You Switch Because both plans cover out-of-network care only in limited situations, search each carrier's provider directory for every doctor and hospital you use before enrolling. A plan is only a bargain if your providers are in its network.

2026 Premium Comparison

Sticker premiums rose across the board for 2026 — Florida's statewide weighted average climbed about 31.5% before subsidies. The illustrative Silver-plan figures below show how AvMed and Florida Blue compare in counties where both compete.

County (35-yr-old, non-smoker, Silver) AvMed Florida Blue
Miami-Dade County ~$500/mo ~$545/mo (HMO) / ~$615/mo (PPO)
Orange (Orlando) County ~$475/mo ~$510/mo (HMO) / ~$580/mo (PPO)
Alachua (Gainesville) County ~$470/mo ~$520/mo (HMO)

Approximate 2026 unsubsidized premiums for a 35-year-old non-smoker, before APTC subsidies. What you actually pay is set by the benchmark Silver plan in your rating area; more than 95% of Florida enrollees qualify for a subsidy. As a reference point, regulators cited a 28-year-old in Duval County on a Silver plan moving from about $149 to roughly $281 per month for 2026.

Who Should Choose AvMed

Who Should Choose Florida Blue

Frequently Asked Questions

Are both AvMed and Florida Blue available in my Florida county?

AvMed is a Florida-domiciled nonprofit HMO that sells only in Florida, in select counties concentrated in South Florida, the Gainesville/Alachua area, Jacksonville, and parts of Central Florida. It is not statewide, so confirm availability by ZIP code before enrolling. Florida Blue is the most widely available marketplace carrier in the state, selling in 60+ of Florida's 67 counties for 2026, including rural areas where it is often the only option. It offers both HMO (through its Health Options subsidiary) and PPO plans.

What makes AvMed different from national carriers?

AvMed is Florida's oldest nonprofit health plan, founded in Gainesville in 1969, and it sells only in Florida. Unlike national carriers, its decisions, provider contracts, and member service are entirely Florida-based, and as a nonprofit it reinvests in members rather than shareholders. For 2026 its approved rate increase of 24.5% is also among the lowest of any Florida carrier.

Which costs less in Florida for 2026, AvMed or Florida Blue?

It depends on your county and subsidy. For 2026, AvMed's approved rate change was +24.5% (one of the lowest in FL) and Florida Blue's was +29.6% (HMO +29%), but what you actually pay is set by the benchmark Silver plan in your rating area after the Advance Premium Tax Credit. More than 95% of Florida marketplace enrollees receive a subsidy, so compare the net premium for the specific Silver plans offered at your ZIP code rather than the sticker price.

Should I choose AvMed or Florida Blue?

Choose AvMed if you want a florida-based nonprofit insurer. Choose Florida Blue if you want ppo flexibility and out-of-network coverage. The deciding factors are usually county availability, whether your doctors are in each network, plan type (HMO vs. HMO + PPO), and the net premium after subsidies.

A licensed Florida health insurance agent can compare your 2026 options county by county and check whether your providers are in-network — at no cost to you.

Compare Plans in Your County

Related reading: Florida ACA Guide Hub | Oscar vs. Florida Blue | HMO vs. PPO in Florida | SunState Coverage

Licensed Florida Health Insurance Producer · NPN #21249133 ·
This resource is maintained by a licensed Florida health insurance producer. Information on this page is for general reference and is not legal or financial advice. Verify current plan details at HealthCare.gov before enrolling.