Market Overview — Pinellas County 2026
Key metrics and market context for St. Petersburg area individual health insurance
5
Top Carriers Available
in Pinellas County
0
Aetna Plans in 2026
Exited FL market Dec 31, 2025
$626
Avg Silver Premium
Pre-subsidy, Pinellas County
$298
Avg After Subsidy
~$35K income, age 28
623
Total FL Plans 2026
All carriers, all tiers
+25%
Premium Increase
vs. 2025 avg (subsidy expiry)
🔗 GHL Contact Query Context
This research was triggered by the following GHL contact fields. Adjust filters below to personalize recommendations.
Contact Age
ZIP Code
County
Pinellas (St. Pete)
Custom Values
Research Date
Feb 22, 2026
Plan Year
2026 (ACA)
Top 5 Carrier Profiles
Detailed analysis of each carrier available in the St. Petersburg / Pinellas County area
FB
Florida Blue
Blue Cross Blue Shield of Florida
#1 Market Leader
Silver Premium (Age 40)
$580–$720/mo
Silver Deductible
$650/person
OOP Maximum
$3,350/person
PCP Copay
$10 / $0 virtual
-
Strengths
- Widest provider network
- PPO option (no referrals)
- BayCare + TGH access
- Most plan options
-
Weaknesses
- Higher premiums
- Complex plan choices
OS
Oscar Health
Tech-Forward HMO · Tampa Bay Expansion
#2 Rising Star
Silver Premium (Age 40)
$480–$650/mo
Silver Deductible
$2,000–$4,500
OOP Maximum
$7,000–$8,700
PCP Copay
$0 virtual + PCP
-
Strengths
- $0 virtual + PCP visits
- Oswell AI agent
- Condition-focused plans
- Competitive premiums
-
Weaknesses
- HMO only (referrals req.)
- Higher deductibles
- Narrower network
AM
Ambetter Health
Sunshine State Health Plan · Centene
#3 Budget Pick
Silver Premium (Age 40)
$420–$580/mo
Silver Deductible
$3,500–$6,000
OOP Maximum
$8,100–$10,150
PCP Copay
$30–$55
-
Strengths
- Lowest premiums
- Premier plans for 2026
- Expanding in FL
-
Weaknesses
- Narrowest network
- High deductibles
- Exchange-only
- Less brand recognition
MO
Molina Healthcare
Value-Focused · Strong CSR Plans
#4 CSR Champion
Silver Premium (Age 40)
$400–$560/mo
Silver Deductible
$0–$6,000 (varies)
OOP Maximum
$2,200–$10,150
PCP Copay
$0–$40 (Silver)
-
Strengths
- Excellent CSR Silver plans
- $0 deductible options
- Teladoc included free
- Vision/dental extras
-
Weaknesses
- Exchange-only
- Narrower network
- Less name recognition
UH
UnitedHealthcare
National Brand · Digital Tools
#5 National Brand
Silver Premium (Age 40)
$500–$680/mo
Silver Deductible
$2,500–$5,000
OOP Maximum
$7,000–$9,100
PCP Copay
$20–$40
-
Strengths
- National brand recognition
- Solid digital tools
- Broad national network
-
Weaknesses
- Fewer FL plan options
- Higher than Ambetter/Molina
- HMO only in FL
Interactive Data Visualizations
Compare premiums, deductibles, and plan counts across carriers
Monthly Silver Premiums by Carrier
Estimated unsubsidized premium range for a 40-year-old individual, Silver tier
Silver Plan Deductibles Comparison
In-network individual deductible — lower is better for frequent care users
Florida Plan Count by Carrier (2026)
Total statewide plans filed with FL OIR — reflects plan variety and market commitment
Carrier Scorecard Radar
Multi-dimensional comparison: Network · Affordability · Technology · Plan Variety · CSR Value
Premium by Metal Tier — Pinellas County
Estimated unsubsidized monthly premium ranges for a 40-year-old individual
Subsidy Impact on Monthly Premium
Silver plan premium before and after federal subsidy at various income levels (age 40)
Full Carrier Comparison Table
Side-by-side features, costs, and network details for all 5 top carriers
| Carrier | Plan Types | On-Exchange | Off-Exchange | Telehealth | Referral Req. | Special Programs | FL Plans |
|---|---|---|---|---|---|---|---|
| 🔵 Florida Blue | HMO/PPO/EPO/POS | ✓ Yes | ✓ Yes | $0 Virtual | HMO: Yes / PPO: No | Medicare Advantage, Dental, Vision | 180 |
| 🔴 Oscar Health | HMO only | ✓ Yes | ✓ Yes | $0 Virtual + PCP | Yes (HMO) | Oswell AI, HelloMeno, Condition Plans | 43 |
| 🟢 Ambetter | HMO only | ✓ Yes | Limited | Included | Yes (HMO) | Premier Plans 2026 | 34 |
| 🟣 Molina | HMO only | ✓ Yes | No | Teladoc Free 24/7 | Yes (HMO) | CSR 94/87/73, Vision, Dental (select) | 40 |
| 🔷 UnitedHealthcare | HMO only | ✓ Yes | Limited | Included | Yes (HMO) | UHC App, Virtual Visits | 23 |
| Carrier | Silver Premium (Age 40) | Silver Deductible | Silver OOP Max | PCP Copay | Specialist Copay | Generic Rx | Best For |
|---|---|---|---|---|---|---|---|
| 🔵 Florida Blue | $580–$720/mo | $650/person | $3,350/person | $10 / $0 virtual | $40/visit | Low-cost tiered | Broadest access |
| 🔴 Oscar Health | $480–$650/mo | $2,000–$4,500 | $7,000–$8,700 | $0 virtual + PCP | $40–$60/visit | Low-cost home delivery | Tech-savvy, $0 care |
| 🟢 Ambetter | $420–$580/mo | $3,500–$6,000 | $8,100–$10,150 | $30–$55/visit | $60–$80/visit | Tiered | Budget-conscious |
| 🟣 Molina | $400–$560/mo | $0–$6,000 (varies) | $2,200–$10,150 | $0–$40 (Silver) | $10–$65/visit | $0–$25 generic | CSR-eligible, low income |
| 🔷 UnitedHealthcare | $500–$680/mo | $2,500–$5,000 | $7,000–$9,100 | $20–$40/visit | $50–$70/visit | Tiered | Brand loyalty |
| Hospital / Health System | Florida Blue | Oscar Health | Ambetter | Molina | UnitedHealthcare |
|---|---|---|---|---|---|
| BayCare (St. Anthony's, Morton Plant, Mease) | ✓ Primary | Limited | Limited | Limited | Limited |
| AdventHealth Tampa Bay | ✓ | ✓ Primary | ✓ | ✓ | ✓ |
| HCA Healthcare (St. Pete General, etc.) | ✓ | ✓ Primary | ✓ | ✓ | ✓ |
| Tampa General Hospital | ✓ | ✓ | Limited | Limited | ✓ |
| USF Health / Moffitt Cancer Center | ✓ | Limited | Limited | Limited | Limited |
| Teladoc / Virtual Care | ✓ $0 | ✓ $0 (PCP + Urgent) | Included | ✓ Teladoc Free | Included |
| Network Size (Pinellas) | Largest | Moderate | Narrow | Narrow | Moderate |
Eligibility Quick Reference
Age-based and income-based eligibility guide for GHL contact routing
Under 26
Young Adult
May remain on parent's plan. ACA marketplace available. All 5 carriers eligible. Check Medicaid if income is low.
26–64
Standard ACA Eligible
Full ACA marketplace access. All 5 carriers available in Pinellas. Subsidy eligibility based on income. Open Enrollment Nov 1 – Jan 15.
65+
Medicare Eligible
ACA plans NOT applicable. Must use Medicare (Parts A, B, C, D) or Medicare Advantage. Florida Blue Medicare and Humana Medicare Advantage available in Pinellas.
Low Income
Medicaid / CSR Eligible
Under 138% FPL (~$20K single): Medicaid. 138–250% FPL: Cost-Sharing Reductions (CSR) on Silver plans. Molina and Florida Blue have excellent CSR options.
Subsidy
Premium Tax Credit
Enhanced credits EXPIRED Jan 1, 2026. Standard APTC still available for 100–400% FPL. Avg subsidy ~$328/mo for Pinellas County Silver plan.
Aetna
No Longer Available
Aetna exited Florida ACA market Dec 31, 2025. Former Aetna members must choose a new carrier. Florida Blue is the top recommended replacement.
2026 Subsidy Eligibility by Income (Single Individual)
Note: Enhanced subsidies expired Jan 1, 2026. Standard APTC applies. Pinellas County Silver benchmark ~$626/month.
| Annual Income | % of FPL | Subsidy Type | Est. Monthly Subsidy | Est. Your Premium (Silver) | Recommendation |
|---|---|---|---|---|---|
| Under $15,060 | Under 100% | Medicaid Eligible | Full coverage | $0 | Apply for FL Medicaid |
| $15,060–$21,000 | 100–139% | Large APTC + CSR 94 | ~$576–$626 | $0–$50 | Molina Silver Core 94 or Florida Blue |
| $21,000–$30,000 | 139–200% | Moderate APTC + CSR 87 | ~$400–$576 | $50–$226 | Molina Silver Core 87 or Ambetter |
| $30,000–$45,000 | 200–300% | Moderate APTC + CSR 73 | ~$200–$400 | $226–$426 | Oscar or Florida Blue Silver |
| $45,000–$60,000 | 300–400% | Small APTC | ~$50–$200 | $426–$576 | Florida Blue or UHC |
| Over $60,000 | Over 400% | No Subsidy | $0 | $626+ (full premium) | Ambetter or off-exchange options |
Quick Premium Estimator
Estimate monthly premiums and subsidy eligibility for a Pinellas County contact
Your Estimated Results
Based on Pinellas County 2026 benchmark data. Actual amounts may vary.
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Full Monthly Premium
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Est. Monthly Subsidy
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Your Monthly Cost
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Annual Cost
GHL Workflow Integration Guide
How to use this research in your GoHighLevel automation workflows
🔗 Recommended GHL Workflow Steps
Use these steps to build an automated carrier research and recommendation workflow in GoHighLevel for Florida health insurance leads.
1
Trigger: New Contact / Form SubmissionCapture , , (income, household size, health conditions)
2
Age Check BranchIf age ≥ 65 → Route to Medicare workflow. If age < 65 → Continue to ACA workflow.
3
ZIP / County ValidationConfirm ZIP is in Pinellas County (33701–33716, 33755–33786). All 5 carriers confirmed available.
4
Income / Subsidy BranchUnder $21K → Molina CSR 94 or Medicaid. $21K–$45K → Oscar or Florida Blue Silver. Over $45K → Florida Blue PPO or UHC.
5
Send Personalized Carrier SummaryUse this report URL + contact merge fields to send a personalized email/SMS with top 3 carrier recommendations.
6
Schedule Follow-UpBook a 15-min consultation call. Tag contact with carrier preference and subsidy eligibility for CRM segmentation.