If you’re shopping for Affordable Care Act (ACA) Marketplace health insurance in Florida, two major providers you’ll likely encounter are Ambetter and Florida Blue. Both offer a range of individual and family plans, but they differ in network size, benefits, cost structure, and member experience.
In this detailed comparison, we break down Ambetter vs Florida Blue to help you choose the best health insurance provider for your needs in Florida in 2025.
Company Overview
Ambetter
Ambetter is a product of Centene Corporation, one of the largest Medicaid and ACA health insurers in the U.S. It offers ACA Marketplace plans in more than 25 states, including Florida through Ambetter from Sunshine Health.
Highlights:
- Serves 3+ million Marketplace members
- Known for affordable Bronze and Silver plans
- Offers virtual care, wellness rewards, and Flex Cards
- Strong focus on low-income and subsidy-eligible enrollees
Florida Blue
Florida Blue, a member of the Blue Cross Blue Shield (BCBS) Association, is the largest health insurer in Florida, with deep provider relationships and decades of experience.
Highlights:
- Covers over 5 million Floridians
- Offers BlueSelect, BlueOptions, and myBlue plans
- Known for broad provider networks and PPO access
- Provides dental, vision, and wellness programs
Plan Availability & Types
| Feature | Ambetter (Sunshine Health) | Florida Blue (BCBS) |
| Plan Types | Bronze, Silver, Gold | Bronze, Silver, Gold |
| Plan Levels Focus | Emphasis on Bronze & Silver tiers | Strong offerings across all tiers |
| State Availability | Florida + 25+ other states | Florida only |
| Network Types | EPO (Exclusive Provider Organization) | HMO, PPO, EPO (varies by plan) |
Verdict: Florida Blue offers more network flexibility, while Ambetter focuses on affordability and simplicity in lower-tier plans.
Cost & Premiums (Florida, 2025)
| Category | Ambetter (avg.) | Florida Blue (avg.) |
| Monthly Premiums | $0 – $400+ (after subsidies) | $0 – $450+ (after subsidies) |
| Deductibles | $1,200 – $7,500 | $1,000 – $7,000 |
| Out-of-Pocket Max | $5,500 – $9,450 | $4,900 – $9,100 |
| Telehealth Copays | Often $0 with select plans | Included (varies by plan) |
| Generic Rx Copays | $0 – $15 (varies by tier) | $0 – $10 (at preferred pharmacies) |
Verdict: Ambetter generally has lower monthly premiums, while **Florida Blue often provides better value with broader networks and slightly lower out-of-pocket costs.
Provider Networks & Access
| Category | Ambetter | Florida Blue |
| Primary Care Provider | Required (EPO network) | Required (HMO/EPO); optional in PPO |
| Specialist Access | Referral usually not required | Referral may be needed (HMO plans) |
| Out-of-Network Coverage | Not covered (EPO plans only) | Available in PPO plans |
| Hospital Partnerships | Regional, often limited to FL Medicaid partners | Statewide hospital networks |
Verdict: Florida Blue wins on network breadth, especially if you’re looking for PPO flexibility or out-of-state access.
Member Benefits & Extras
| Feature | Ambetter | Florida Blue |
| 24/7 Telehealth | Yes (Teladoc) | Yes |
| Wellness Rewards | Yes – My Health Pays® | Yes – Better You Strides® |
| OTC Benefit Cards | Yes (in some Silver/Gold plans) | Available in select plans |
| Dental/Vision for Adults | Optional add-ons | Available through Florida Blue Dental/Vision |
| Chronic Condition Management | Yes (care coordinators) | Yes (dedicated support programs) |
Verdict: Both providers offer wellness rewards and virtual care, but Florida Blue offers more built-in features and optional upgrades for adult dental and vision.
Customer Service & Experience
Ambetter:
- Mixed reviews based on region
- Known for affordability, not customer support
- Portal and app offer easy access to claims and telehealth
Florida Blue:
- High marks for member support in Florida
- Offers local service centers and brokers
- Strong online tools, cost estimators, and plan education
Pros and Cons
Ambetter (Sunshine Health)
Pros:
- Affordable premiums and deductibles
- Wellness rewards with My Health Pays®
- Free virtual care included
- Ideal for healthy, budget-conscious enrollees
Cons:
- EPO-only network = no out-of-network coverage
- Limited provider network in rural areas
- Varying customer service quality
Florida Blue
Pros:
- Large provider network (HMO, PPO, EPO plans)
- Excellent local support and service centers
- Better coverage for chronic care and adult benefits
- PPO plans allow more provider choice
Cons:
- Slightly higher premiums in some areas
- PPO plans may be more expensive than EPO
Which Should You Choose?
Choose Ambetter if:
- You’re price-sensitive and qualify for ACA subsidies
- You want a simple, affordable EPO plan with virtual care
- You live in a region where Ambetter’s network is strong
Choose Florida Blue if:
- You want broad access to doctors, hospitals, and specialists
- You value local support and PPO flexibility
- You have chronic conditions or need out-of-network care options
Both Ambetter and Florida Blue provide solid health insurance options on the Florida ACA Marketplace in 2025. Ambetter is best for individuals seeking affordable, virtual-first care, while Florida Blue excels in network access, plan customization, and customer service.
Before enrolling:
- Visit HealthCare.gov or FloridaBlue.com to compare plans by ZIP code
- Review each plan’s provider directory, formulary, and cost breakdown
- Confirm that your preferred doctors and hospitals are in-network