Health Insurance in St. Augustine, Florida

Updated March 27, 2026 · Florida Plan Finder — Licensed Florida Health Insurance Agency

St. Augustine is the oldest continuously occupied European settlement in the United States and remains one of Florida's most visited destinations. But behind the historic charm is a community of roughly 16,000 residents who need health coverage — a mix of retirees, hospitality and tourism workers, small business owners, and young families in a county that has been among the fastest-growing in the Southeast for over a decade.

St. Johns County's affluence (it consistently ranks as the highest-income county in Florida by median household income) can mask the reality that many St. Augustine residents — particularly those in tourism-dependent jobs — earn modest incomes and often lack employer-sponsored coverage. For these residents, the ACA marketplace is the most reliable path to comprehensive health insurance.

For county-level plan and carrier information, see our St. Johns County health insurance guide.

ACA Marketplace Carriers in St. Augustine

St. Johns County is served by several ACA marketplace carriers in 2026, including Florida Blue, Ambetter from Sunshine Health, and Molina Healthcare. Florida Blue offers both HMO and PPO plan options in the Northeast Florida region, giving St. Augustine residents the flexibility to choose between lower-premium HMO plans with coordinated care and PPO plans that allow out-of-network access at higher cost sharing.

Ambetter and Molina typically offer the most competitively priced plans in the market, making them attractive options for younger, healthier residents or those who primarily need preventive care. However, their narrower provider networks mean that residents should verify that Flagler Hospital and their preferred physicians are covered before enrolling.

For residents who travel seasonally or split time between St. Augustine and other states, a Florida Blue PPO plan offers the most flexibility, as PPO networks typically provide some level of out-of-network coverage that HMO plans do not.

Tourism Workers and the ACA in St. Augustine

St. Augustine's economy revolves heavily around tourism — hotels, restaurants, tour operators, museums, and retail shops employ a significant share of the city's workforce. Many of these positions are part-time, seasonal, or offered by small businesses that are not required to provide health insurance under the ACA's employer mandate (which applies only to businesses with 50 or more full-time equivalent employees).

The good news for tourism workers is that moderate incomes — typically between $20,000 and $45,000 for a single adult — place them in the sweet spot for ACA subsidies. A hospitality worker earning $28,000 per year is at roughly 186% of the federal poverty level, qualifying for substantial premium tax credits and enhanced Silver plan cost-sharing reductions (CSRs). These CSRs lower deductibles, copays, and out-of-pocket maximums on Silver plans, making them significantly more valuable than a Bronze plan at a similar net premium.

Seasonal workers should be aware that ACA subsidies are based on projected annual income. If your hours or earnings fluctuate significantly throughout the year, work with a licensed agent to estimate your income accurately. Overestimating means you may miss out on credits you deserve; underestimating could result in a tax-time repayment.

Flagler Hospital and Provider Networks

Flagler Hospital is the primary acute-care facility serving St. Augustine and surrounding St. Johns County communities. Operated as part of the Flagler Health+ system, it provides emergency services, surgical care, cardiac services, and a range of outpatient specialties. Flagler Hospital is generally included in the networks of the major ACA carriers serving Northeast Florida, but network participation can vary by plan type and tier.

For residents who require specialty care not available at Flagler, Jacksonville's major health systems — Baptist Health, Mayo Clinic, and UF Health Jacksonville — are approximately 45 minutes to an hour north. If access to Jacksonville-based specialists is important to you, verify that your chosen plan's network includes these facilities. Florida Blue PPO plans typically offer the broadest cross-regional network access in Northeast Florida.

Retirees and Pre-Medicare Coverage in St. Augustine

St. Johns County attracts a significant number of retirees, many of whom settle in St. Augustine for its historic character, walkability, and coastal lifestyle. Retirees between ages 60 and 64 who have left employer-sponsored coverage face the highest unsubsidized premiums on the ACA marketplace due to age-based rating, but ACA subsidies scale to offset these higher costs. A 62-year-old St. Augustine resident earning $50,000 per year may find their net monthly premium for a Silver plan to be well under $250 after tax credits.

Retirees with substantial assets but moderate annual income should pay close attention to how they take distributions from retirement accounts. ACA premium tax credits are based on modified adjusted gross income (MAGI) — not net worth. Strategic management of IRA withdrawals, Roth conversions, and capital gains can meaningfully impact subsidy eligibility.

Health Insurance Costs in St. Augustine, Florida

St. Johns County's ACA premiums are broadly in line with the Northeast Florida region. A benchmark Silver plan for a 40-year-old in St. Augustine may cost approximately $450 to $510 per month before subsidies in 2026.

Estimates are for a single 40-year-old on a benchmark Silver plan. Actual premiums for older adults are higher; subsidies scale accordingly. These are illustrative figures, not guaranteed quotes.

Frequently Asked Questions

For more information, see our Florida ACA Plans guide, health insurance by county, or Florida health insurance guide. You can also browse plans directly at HealthCare.gov.