Common Open Enrollment Mistakes to Avoid in Florida

By the Florida Plan Finder Team | Licensed Florida Health Insurance Agency | (877) 224-8539 | Last Updated: April 8, 2026

Florida's ACA marketplace is the largest in the nation, with over 4 million enrollees and more than a dozen carriers competing in many counties. That level of competition is good for consumers — it means more options and more opportunities to find affordable, comprehensive coverage. But it also means there are more ways to make a costly mistake during open enrollment.

The following 10 mistakes are the ones that cost Florida marketplace enrollees the most money and cause the most frustration. According to research from KFF and CMS, many of these errors are widespread, and the financial consequences can add up to hundreds or even thousands of dollars over the course of a plan year. Each one is avoidable with a small amount of preparation.

Mistake 1: Auto-Renewing Without Reviewing Your Options

If you are already enrolled in a marketplace plan and take no action during open enrollment, healthcare.gov will auto-renew you into the same plan — or a similar one if yours was discontinued. This is the single most costly mistake marketplace enrollees make.

Why it matters: insurance carriers file new rates with the Florida Office of Insurance Regulation every year. Your plan's premium may increase, but a competing carrier may have introduced a similar plan at a lower price. Your subsidy amount may also change based on shifts in the benchmark Silver plan for your area. KFF research consistently shows that consumers who actively shop and switch plans save significantly compared to those who passively renew.

Even if you decide to stay on the same plan, make that an active decision after reviewing alternatives — not a passive default.

Mistake 2: Choosing the Lowest Premium Without Calculating Total Cost

Monthly premium is the most visible number when shopping for plans, so many people sort by lowest premium and choose the cheapest option. But the lowest-premium plan almost always has the highest deductible and out-of-pocket costs.

Consider a real-world example: A Bronze plan might cost $45 per month after subsidies but have a $9,200 deductible. A Silver plan might cost $110 per month but have a $2,000 deductible with $30 copays for doctor visits. If you visit a doctor four times, fill monthly prescriptions, and have one lab test, the Silver plan could cost you far less over the year despite the higher premium.

The correct comparison is total estimated annual cost: (monthly premium times 12) plus expected deductible spending, copays, and coinsurance based on your typical healthcare usage. Healthcare.gov's plan comparison tool lets you enter your doctors and prescriptions to estimate total costs — use it.

Mistake 3: Not Verifying Your Doctors Are In-Network

Provider networks change every year. A doctor who was in-network last year may not be this year. Different plans from the same carrier can have different networks. And seeing an out-of-network provider — even accidentally — can result in bills that do not count toward your deductible or out-of-pocket maximum.

Before enrolling, search the specific plan's provider directory (not just the carrier's general directory) to confirm your primary care doctor, specialists, and preferred hospitals are included. Then call the provider's office to double-check. Online directories are sometimes outdated, and a phone call takes five minutes that could save you thousands.

Mistake 4: Not Checking the Drug Formulary

Every marketplace plan has a formulary — a list of covered prescription drugs organized into tiers. Tier 1 (usually generics) has the lowest cost-sharing. Tier 4 or 5 (specialty drugs) can cost hundreds of dollars per fill even with insurance. A drug that was on Tier 2 last year could be moved to Tier 3 this year, or removed from the formulary entirely.

If you take any prescription medications, check the formulary of every plan you are considering. Look up each drug by name, note the tier, and factor the cost into your total annual estimate. This is especially important for people taking brand-name medications or specialty drugs where the difference between tiers can be significant.

Mistake 5: Not Applying for or Updating Your Premium Tax Credit

The Advance Premium Tax Credit (APTC) is the subsidy that reduces your monthly marketplace premium. It is based on your projected household income for the coverage year. Two common mistakes occur here:

• Not applying at all. Some people assume they will not qualify and skip the application. The income threshold for APTC eligibility is higher than many expect — especially with the enhanced subsidies that have been available in recent years. Apply and let the marketplace determine your eligibility.
• Not updating income when it changes. If your income increased or decreased since you first applied, your subsidy amount may be wrong. An outdated income estimate can result in owing money back at tax time (if you underestimated income) or leaving money on the table each month (if you overestimated). Update your marketplace application when your income changes.

According to CMS, roughly 90 percent of Florida marketplace enrollees receive APTC. If you are one of the few who are not, it is worth confirming that your income information is accurate and up to date.

Mistake 6: Being CSR-Eligible but Not Choosing a Silver Plan

Cost-Sharing Reductions (CSR) are one of the most valuable and most misunderstood benefits in the ACA marketplace. If your household income is between 100 and 250 percent of the federal poverty level, you qualify for CSR — but only if you enroll in a Silver-tier plan.

CSR does not reduce your premium (that is what APTC does). Instead, it lowers your deductible, copays, coinsurance, and out-of-pocket maximum. The savings can be dramatic:

A CSR-enhanced Silver plan at 94 percent actuarial value is better than most employer plans. If you are CSR-eligible and choose a Bronze plan because the premium is lower, or a Gold plan because the deductible looks lower, you are almost certainly paying more overall than you would on a CSR Silver plan.

Mistake 7: Not Comparing Across All Available Carriers

Many Florida counties have 10 or more carriers on the marketplace, including Florida Blue, Ambetter, Molina Healthcare, Oscar Health, Aetna CVS Health, Cigna, UnitedHealthcare, and others. Some enrollees pick a carrier they recognize and never look at alternatives.

This is a mistake because pricing varies significantly between carriers for similar plan designs. A Silver HMO from one carrier might cost $150 per month while a similar Silver HMO from another carrier in the same county costs $85 per month. Networks differ, too — a carrier with a lower premium might still include your doctors.

Take 30 minutes to review plans from every carrier available in your county. Healthcare.gov shows all of them side by side. You might find a better plan from a carrier you have never heard of.

Mistake 8: Waiting Until the Last Day to Enroll

Every year, a significant percentage of marketplace enrollees wait until the final days of open enrollment to sign up. This creates several risks:

• Healthcare.gov traffic spikes on the last day, causing slow load times, timeouts, and errors.
• Call center wait times increase dramatically — sometimes exceeding an hour.
• Identity verification delays can hold up your application. If the marketplace cannot verify your identity online, you may need to submit documents — which takes time you do not have on the last day.
• No time to fix errors. If you enter incorrect information or there is a system glitch, there is no buffer to resolve it before the deadline.

Start shopping early in November. If you want January 1 coverage, aim to complete enrollment by December 10 — well before the December 15 deadline. If you miss December 15, you still have until January 15 (with a February 1 start date), but do not cut it closer than necessary.

Mistake 9: Not Understanding Individual vs. Family Deductibles

If you are enrolling a family, your plan will have both an individual deductible and a family (aggregate) deductible. Many people do not understand how these interact, which leads to unpleasant surprises.

Here is how it works on most marketplace plans: each family member has an individual deductible, and the family has a combined deductible. If one family member reaches the individual deductible, the plan starts paying for that person's covered services — even if the family deductible has not been met. Once the family deductible is met in total (from the combined spending of all members), the plan starts paying for everyone.

Some plans use an embedded deductible structure (where individual deductibles are embedded within the family deductible), while others use an aggregate-only structure (where no one gets coverage until the full family deductible is met). For the 2026 plan year, the ACA requires that no individual within a family plan face a deductible higher than the individual out-of-pocket maximum ($9,200). Always check whether your family plan uses embedded or aggregate deductibles — this matters more than most people realize.

Mistake 10: Ignoring Plan Type Differences (HMO vs. PPO vs. EPO)

Plan type determines how you access care and what happens if you see an out-of-network provider. Many first-time enrollees ignore this distinction and focus only on premium and deductible. That can lead to problems.

• HMO (Health Maintenance Organization): Requires a primary care physician (PCP) and referrals to see specialists. No out-of-network coverage except emergencies. Typically the lowest premiums. Most common plan type on the Florida marketplace.
• PPO (Preferred Provider Organization): No PCP or referral requirement. Covers out-of-network care at a higher cost. Higher premiums. More flexibility but fewer options on the Florida marketplace.
• EPO (Exclusive Provider Organization): No PCP or referral requirement, but no out-of-network coverage except emergencies. A hybrid between HMO and PPO — more flexibility than HMO, lower premiums than PPO.

If you travel frequently, split time between Florida and another state, or have established specialist relationships, an HMO's restrictions may cause problems. If you rarely leave your local area and want the lowest cost, an HMO is likely the best fit. Match the plan type to how you actually use healthcare.

Frequently Asked Questions

Related reading: How to Prepare for Open Enrollment | First-Time Enrollment Guide | What Happens If You Miss Open Enrollment