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The Affordable Care Act (ACA), or “Obamacare,” is a law that has dramatically changed how health insurance works in America. Millions upon millions of people now have access to health insurance coverage as a result of the ACA. Additionally, the ACA has changed the affordability of health insurance for Americans. Overview Many Florida residents are feeling the impact of rising health care costs—especially adults under 65 who buy their coverage through the Affordable Care Act (ACA) marketplace. Premiums, deductibles, and out-of-pocket costs have increased steadily, and those who don’t qualify for subsidies often feel priced out altogether. This guide breaks down why ACA plans in Florida have become so expensive, who is most affected, and how to evaluate alternative coverage options, including private plans that may offer more predictable costs depending on your situation. Why Florida ACA Premiums Keep Rising ACA premiums rise due to several key factors—some national and some unique to Florida. 1. Medical Costs Continue to Increase Like the rest of the country, Florida faces higher medical costs due to: Rising hospital and provider prices Increased demand for care Higher prescription drug and medication costs More chronic conditions in the population, with many individuals requiring ongoing medications, which contributes to higher costs When healthcare costs rise, premiums follow. 2. Florida’s Demographics Drive Higher Utilization Compared to other states, Florida has a higher percentage of its population who are older or retired before age 65. This group typically uses: Use more medical services on average compared to younger populations. Require more specialist visits. Face more chronic health issues. The average healthcare costs and utilization for these individuals are higher than for other age groups. Higher utilization → higher claims → higher premiums for ACA insurers. 3. A Large Portion of Floridians Are Uninsured Many Floridians have a household income just above the subsidy cliff or experience income fluctuations that cause them to lose eligibility for subsidies. These individuals pay: Full price for premiums Full deductibles Higher out-of-pocket expenses For this group, ACA plans can become cost-prohibitive. 4. Narrow Networks Can Limit Value for Some Buyers To control costs, many ACA insurers introduce limited networks: Fewer doctors Fewer hospitals More HMO-style plans For people whose providers aren’t included, the perceived value drops—even as premiums rise. 5. Plan Structures Have Trended Toward Higher Deductibles It’s common to see: $9,000+ deductibles High out-of-pocket maximums Specialist visit restrictions Tiered drug formularies These designs help control premiums, but they also shift more of the cost burden to consumers. In many cases, high-deductible plans can still come with a significant monthly premium, further increasing the overall cost burden. Who Is Most Impacted by Rising ACA Costs Not everyone feels the premium increases equally. Some groups experience much bigger price shocks. 1. People Who Don’t Qualify for Subsidies If your income is: Above ~400% of the Federal Poverty Level Irregular (self-employed, commission-based) Not calculated correctly using marketplace rules …you may get little or no financial assistance, which means: Monthly premiums may be high, especially if you lose eligibility for a tax credit Deductibles may be difficult to meet Budgeting becomes unpredictable These individuals often explore alternative health insurance options. 2. Adults Ages 50 to 64 ACA pricing allows age-rating—meaning premiums rise as you get older. A 62-year-old often pays: 2–3× more than a 25-year-old on the same plan Even more if unsubsidized, with expected higher costs for adults ages 50 to 64 if ACA tax credits expire For many in this age group, ACA costs feel especially heavy. 3. Self-Employed Floridians People who are self-employed frequently: Earn variable income. Fall in and out of eligibility for subsidies. Face large tax-time adjustments when income doesn’t match estimates. Rely on tax deductions for health insurance premiums, but unpredictable income can complicate these deductions. This makes ACA budgeting extremely difficult year-round. 4. Early Retirees Under 65 Until they become eligible for Medicare at 65, retirees must find their own coverage. Those who do not qualify for Medicaid may face particularly high ACA premiums until they become eligible for Medicare. Without subsidies, ACA options can be one of their biggest expenses. When an ACA Plan Is Still the Best Fit Despite rising costs, ACA plans remain the right choice for many Florida residents. You may want to stay with an ACA plan if: You qualify for significant subsidies. You have chronic health conditions requiring broad health coverage. You need access to specific providers only in ACA networks. You expect high medical usage and want to ensure continuous health coverage. You prefer standardized protections (pre-existing conditions, essential benefits, etc.) ACA plans are especially valuable for: Lower-income households Individuals with ongoing medical needs who cannot risk gaps in health coverage Families with children and maternity needs When It Makes Sense to Explore Private Health Insurance Options There could be other individuals that live in Florida that might choose to obtain their private health insurance plan as an alternative (this option might provide them with a better mix between premium costs, benefits, and provider selections), while many employers will also provide hefty employer-subsidized health insurance benefits (which often means lower premiums for the employee and/or greater coverage because of the employer’s contribution and tax benefits associated with it). To better understand the importance of the role an employer plays in obtaining health insurance, individuals who do not receive employer-sponsored health insurance should consider purchasing a private plan, enrolling through the ACA, or both. Private plans may be worth comparing if: If you are not eligible for ACA subsidies. If you would like a monthly cost that is easier to estimate. If you want a more PPO-type of access to providers. If you want wider access to healthcare providers, i.e., greater access to hospitals. You want options outside the ACA open enrollment period. You’re relatively healthy and want coverage for larger medical events, not day-to-day usage. Important Note Private plans vary widely in structure and eligibility. They are not ACA plans and do not replace ACA protections. A licensed agent can explain

When shopping for health insurance in Florida, many people start with the Affordable Care Act (ACA) marketplace. What fewer people realize is that private health insurance plans—sometimes called off-exchange or non-marketplace plans—also exist and can be an option for certain individuals depending on income, health needs, and eligibility. Private health insurance can also be obtained through employers, making it accessible to many people as part of their employee benefits. This guide explains what private health insurance is, how it differs from ACA plans, when it may make sense to compare options, and what to consider before choosing a plan. What Is Private Health Insurance? Private health insurance refers to a type of health plan that provides medical coverage purchased outside the ACA marketplace directly through insurance carriers or with the help of a licensed agent. These plans: Are not subsidized by the federal government Are available year-round (not limited to Open Enrollment) May offer different network structures and benefit designs Eligibility for private health insurance may depend on the service area, which is the geographic region where coverage is available and enrollment is permitted. Private health insurance does not replace ACA plans, but it can serve as an alternative in specific situations. Florida Health Insurance Plans Florida’s health insurance market offers a range of plans, including family or single plans and varying levels of coverage. When selecting a plan, be sure to look for the minimum level of essential benefits offered by each plan, including prescription medications, hospital admissions, preventive health care, and physician visits. The Affordable Care Act mandates that all plans sold on the health insurance exchanges must include essential benefits, therefore providing access to adequate care for yourself and your family. With the Florida health insurance marketplace, you have the ability to review multiple insurance plan options side-by-side and see which plan best meets your health care and budget needs. If you are eligible to receive tax credits due to your household income being between 100% and 400% of the federal poverty level, you will be able to take advantage of these tax credits to reduce your monthly premium payment if you purchase your health coverage through the marketplace. Purchasing private insurance, either directly through an insurance company or with the assistance of a broker, provides you with additional coverage choices and provider networks. Generally speaking, if you qualify for premium tax credits, private insurance is likely to be more than marketplace plans when compared relative to the same coverage. As you evaluate the differences in the Florida health insurance marketplace, take time to evaluate your coverage needs, your out-of-pocket costs, and whether you prefer a larger number of providers to choose from or are willing to pay a lower premium for fewer provider options. Comparing health insurance plans will help you select one that best suits your needs and those of your family. How Private Plans Differ From ACA Marketplace Plans Recognizing the distinction between private and ACA Marketplace insurance plans helps us set realistic expectations from the start. Many regulations govern the ACA and private insurance plans, affecting coverage and eligibility under different circumstances. 1. Enrollment Periods ACA Plans: Enrollment Periods only for Open Enrollment and qualifying life events. Private Individual Health Insurance Options: Private plans are usually available year-round. People who do not complete ACA enrollment by the expiration date or experience a qualifying life event at another time can obtain coverage through private plans available year-round. 2. Subsidies ACA plans: May include premium tax credits based on income. Private plans: No subsidies available. For individuals who don’t qualify for ACA subsidies, private plans are sometimes considered for cost comparison. 3. Provider Networks Private plans often: Offer PPO-style access Provide broader provider networks, including a wider range of specialists. Allow out-of-network coverage (varies by plan) ACA plans are more commonly: Use HMO or EPO structures. Have narrower networks to control costs. 4. Benefit Structure ACA plans must include essential health benefits, such as maternity and mental health coverage. Private plans: May offer customizable benefit structures. Can focus on major medical coverage. Vary widely in covered services. Private plans may also include exclusions that differ from those in ACA plans, so it is important to review them carefully. A licensed agent can explain what is and isn’t included in a specific plan. Who Typically Explores Private Health Insurance in Florida? Private plans are not for everyone, but certain groups often compare them: Private health insurance may have specific eligibility criteria or coverage options for individuals with a disability, and may require proof of disability. 1. People Who Don’t Qualify for ACA Subsidies If you make too much money to qualify for meaningful ACA assistance, marketplace premiums can become costly. Many people in this situation want to look at private plans to shop for lower monthly premiums and find out which networks are offered. 2. Self-Employed Individuals Self-employed Floridians often have: Variable income Difficulty estimating ACA subsidy eligibility Changing coverage needs For some, private plans may offer a more reliable price structure. 3. Early retirees who are not yet eligible for Medicare (age 65 or younger) Those who retire earlier than their 65th birthday may look for the following from a private plan. Broader provider access Stable monthly premiums Year-round enrollment flexibility 4. Healthier Individuals Seeking Major Medical Coverage Some private plans are designed to protect against larger medical events rather than routine care, which can affect pricing and benefit design. Potential Advantages of Private Health Insurance Depending on the plan and individual profile, private health insurance may offer: More flexible enrollment timing PPO-style networks Access to providers outside ACA networks Different deductible and premium combinations Potential cost savings for unsubsidized individuals Private health insurance may also provide access to quality care by connecting members with high-quality doctors and hospitals. These features vary by carrier and plan type and should always be reviewed carefully. Important Limitations to Understand The following are important considerations with regard to Private Health Insurance: Most plans do not cover any

Can I Keep My Doctor After Aetna Leaves Florida? When an insurance company leaves Florida, one of the biggest worries people have is: “Will I still be able to see my doctor?” With Aetna, a CVS Health company, exiting Florida’s ACA Marketplace after December 31, 2025, and reducing certain Medicare Advantage plans, thousands of Floridians face this exact question. This decision normally will take into consideration business factors which include financial stability, markets, and the financial obligations required to operate in the marketplace of ACA. CVS health will also be eliminating some individual plans in 2026. The atmosphere regarding health insurance plans in Florida will be inconsistent and knowledge on the transition of a major insurance company is just one instance of fluctuation in the overall insurance marketplace. The good news is that you can keep your doctors and care—if you choose the right replacement plan. At SWFL Insurance, our licensed agents in Fort Myers, Naples, and Port Charlotte help you compare options like Florida Blue and other carriers to ensure your coverage aligns with your doctors and prescriptions. Understanding the Change: Why Is Aetna Leaving Florida? Aetna’s exit from the Florida Affordable Care Act (ACA) marketplace marks a major shift for individuals and families who depend on their health insurance plans for access to careThe primary driver for the insurance company’s decision is the added complexity and financial burden of navigating the ACA marketplace, which has made it difficult for some insurers to provide competitive health insurance plans in the state. Therefore based on this development, Aetna will discontinue offering all individual and family health insurance plans in Florida, and is effective January 1, 2026. This means that plan members will need to find a new health insurance plan to maintain continuous coverage and avoid unexpected out-of-pocket costs. Transitioning to a new health insurance plan will likely feel like a significant task, but if you break it down, know your options and plan accordingly you may save money and ensure that you and your family will continue to have access to the health care services that you need. Open enrollment for new health insurance plans starts on November 1 the year before, meaning you will be able to review insurance plans that are available and compare benefits, and select a plan that best meets your needs and budget. The exit of Aetna will also have an impact on health care professionals, like primary care providers and specialists, as many will be seeing changes to patient numbers and insurance plans. With fewer in-network providers contracted into Aetna, both patients and providers will need to become accustomed to an altered world of health care coverage and network providers. When deciding on a health insurance plan, it is very important to consider items such as prescription drug coverage, whether they can still access a preferred medical provider, and out-of-pocket expenses. The Inflation Reduction Act has provided changes that may ultimately influence the affordability and availability of your health insurance; therefore, it is important to stay informed of what implications these changes will have on your coverage. To help ease the transition, here are some next steps for plan members: Review your current health insurance policy to understand what changes will take effect in 2026. Explore new health insurance plans during the open enrollment period starting November 1, 2025. Consult with one of our licensed agents to review available insurance plans and find the best coverage for your health care needs and budget. Pay close attention to prescription drug coverage, network providers, and out-of-pocket costs when evaluating your options. Visit HealthCare.gov or reach out to a licensed agent for personalized assistance and to ensure you don’t miss important deadlines. By taking these proactive steps, you can maintain access to quality health care, avoid gaps in coverage, and manage your health insurance costs effectively as the Florida insurance landscape evolves. Why Networks Matter When Aetna Leaves Every health plan has a network – a group of doctors, hospitals, and pharmacies that contract with the insurance company. If you move from Aetna to another carrier, you’ll need to check if your preferred providers are in that carrier’s network. It’s essential to confirm whether your doctor is included in the plan’s network to maintain continuity of care. ACA (Marketplace) Members: Networks vary widely by carrier. Some are HMO-only with smaller networks, others offer broader PPO access. Medicare Advantage Members: Networks determine which doctors, specialists, and hospitals you can use. Choosing the wrong plan could mean losing access to your current care team. How to Make Sure You Can Keep Your Doctor Make a list of your current providers. Include your primary care provider, specialists, any medical facility you regularly use, and preferred hospitals. Work with a licensed agent. We check each doctor, primary care provider, and facility against multiple carriers’ networks and confirm if each accepts your new insurance. For Medicare plans, we also verify if the provider accepts Medicare. Confirm before you switch. Don’t assume your doctor is covered—verify with the carrier or through your agent that your provider is in-network and, if enrolling in a Medicare plan, that the provider accepts Medicare. Look at prescriptions too. Medications must be checked against the plan’s drug formulary to avoid surprises. Will Florida Blue Cover My Doctors? Florida Blue is one of the largest insurers in the state and partners with many top hospitals and medical groups. While most Floridians find their doctors in-network with Florida Blue, it’s not guaranteed. Florida Blue members have access to member-specific resources, such as the member website and customer support, to help verify provider participation. That’s why it’s critical to confirm before you enroll. SWFL Insurance will: Review your doctor list against Florida Blue’s network. Compare with other carriers like Ambetter, UnitedHealthcare, and Humana (if available). Ensure your plan covers both your providers and prescriptions. What Happens If My Doctor Isn’t In-Network? You have a few options: Choose another plan that includes your doctor (best option if available). Ask your

Suppose you live in Fort Myers, Naples, or Port Charlotte and have an Aetna health insurance plan. In that case, you may have already heard the news: Aetna is leaving Florida’s ACA Marketplace after December 31, 2025, and reducing certain Medicare Advantage plans. Aetna’s decision to pull out of the ACA Marketplace is part of a broader trend affecting the country, with major insurers reevaluating their participation in health insurance exchanges nationwide. For thousands of Southwest Florida residents, this means your coverage will soon come to an end, as Aetna, owned by CVS Health, is pulling out of the ACA Marketplace in Florida. But you don’t have to face this transition alone. At SWFL Insurance, we’ve been helping local families and seniors navigate health insurance changes for over 40 years—and we’re here to guide you every step of the way. CVS Health, Aetna’s parent company, made the strategic decision to withdraw from the exchange, impacting coverage options for many consumers. What Aetna’s Exit Means for SWFL Residents ACA Members (Under 65): Your Aetna plan will end December 31, 2025. You’ll need to enroll in a new Marketplace plan during Open Enrollment (November 1, 2025 – January 15, 2026). You will continue to have your current coverage for the rest of 2025 until the new plan year begins. Medicare Advantage Members (65+): Some Aetna Medicare Advantage plans will no longer be offered in 2025. You’ll receive a letter notifying you if your plan is ending, and you must act during Medicare AEP (October 15 – December 7, 2025). The beginning of the new coverage period will be January 1, 2026. Without taking action, you risk losing your coverage starting January 1, 2026. After receiving your letter, you will need to review your options and enroll in a new plan before the deadline. Why Local Help Matters Switching health insurance isn’t just about picking a new carrier—it’s about making sure your doctors, prescriptions, and hospitals are still covered. Online enrollment portals and 1-800 call centers don’t always give you the personalized answers you need. That is where SWFL Insurance comes in. We have offices in Fort Myers, Naples and Port Charlotte so we can provide in-person support based on our local knowledge. Because of our dedicated service, we are able to provide South Florida residents support and access to services that are his/her needs. Your Options After Aetna We help you compare the availability of alternative health insurance plans: Florida Blue: The most stable alternative, with large doctor networks and ACA & Medicare plans. They offer a variety of plan options for both individual coverage and family plans. The costs and availability of plans may vary depending on your location and needs. The ACA Marketplace program is designed to offer a range of plan options for individuals and families. SWFL Insurance can help you review the different offers from insurers to find the best fit. As an independent agency, we’re not tied to one company. We shop around for you. Contacting Aetna If you have questions about your current Aetna health insurance plan or would like assistance with your health coverage, it is easy and convenient to contact Aetna. If you are a member, you can call the Aetna member services number at 1-877-858-6507, Monday through Friday, from 7 AM to 7 PM Eastern Standard Time. If you are hard of hearing, Aetna has a separate TDD number at 800-628-3323. The Aetna member services representatives are able to assist if you need help understanding your plan, have questions about your coverage, or want to discuss your options as your current plan comes to an end. Member services will be able to speak with you when you call the member services number and provide assistance directly to you to answer your questions and/or provide information and options. Aetna wants all its members to reach out with questions or concerns about their health insurance, plan benefits, or services. So, please do not hesitate to call Aetna directly by phone for the support you may want or need during this transition. Open Enrollment Season The Open Enrollment period is your opportunity to review your health insurance choices and select a new plan for 2026. Starting November 1, 2025, you can compare health insurance plans from different companies and select the health insurance plan that best fits your needs and budget. This is the time to make sure you have the right health insurance plan in place before your current Aetna coverage ends. You can use HealthCare.gov or your state marketplace during Open Enrollment to view your available plans, compare plans and benefits, and see what other options are available to further reduce your overall costs for health coverage. Licensed health insurance agents and brokers are available to help you explore your options, follow up on your questions, and guide you through the enrollment process. If you would like help or have questions you can call the toll-free number located on the back of your ID card, and you can also use chat services to get help. How SWFL Insurance Helps Free Enrollment Help: As a licensed broker, SWFL Insurance assists you at no cost—carriers pay us, not you. Doctor & Prescription Check: We verify your providers and medications before you switch, and guide you through choosing or changing your primary care provider within the network. Steps to Change Your Plan or Provider: We outline the steps for changing your health plan or provider, including updating personal information, selecting new coverage, or switching doctors during open enrollment or after a qualifying life event. Employer-Based Coverage: If you have health insurance through your employer and need to make a change, we can help you review your options and complete the process. Local Offices: Stop by in Fort Myers, Naples, or Port Charlotte. Trusted Advisors: 40+ years serving Southwest Florida families and seniors. Frequently Asked Questions Have a question? Please send us a message or call our office. Do I have to drive to Tampa or Miami

Florida Blue Replacing Aetna: Why It’s the Top Alternative in Florida With Aetna leaving Florida’s ACA Marketplace after December 31, 2025, and reducing certain Medicare Advantage plans, many Floridians are wondering: “What’s the best replacement for my Aetna plan?” Major life events—such as losing a job, getting married, or having a child—can qualify you for a special enrollment period, allowing you to change your health plan outside of open enrollment. For most, the answer is clear—Florida Blue. As the state’s largest and most stable health insurer, Florida Blue offers a wide range of ACA and Medicare Advantage plans, strong local networks, and the stability Aetna members are looking for. If you experience a qualifying life event, such as a change in family status or job loss, you may be eligible to switch plans before the standard enrollment window. At SWFL Insurance, we’re licensed, independent agents in Fort Myers, Naples, and Port Charlotte. We’ll help you with changing your plan if you end up losing coverage due to a life event, such as welcoming a new child or other family changes, and transition from your ending Aetna plan to the best Florida Blue option—or another carrier if it fits you better. Why Florida Blue? Florida Blue (Blue Cross Blue Shield of Florida) is the leading health insurer in Florida, serving nearly one-third of the state’s health insurance market. Here’s why so many Aetna members are expected to switch: Stability: Florida Blue has been in the Florida market for decades and continues to expand coverage. Large Networks: They partner with major hospitals, primary care doctors, and specialists across the state. Florida Blue’s service area is among the largest in Florida, ensuring broad access to doctors and hospitals. Plan Variety: From ACA Marketplace bronze-to-platinum tiers to Medicare Advantage HMO and PPO plans, Florida Blue has options for every budget. Florida Blue plans generally offer a range of monthly premiums, deductibles, and out-of-pocket costs to fit different budgets and help manage overall costs. Extra Benefits: Many Florida Blue plans include wellness perks like dental, vision, fitness memberships, and telehealth. Members can enjoy savings on wellness services, fitness memberships, and even discounts on items like jerseys and other items. Florida Blue covers a wide array of healthcare services, and members can review plan details, shop for plans, and pay premiums easily online. ACA Marketplace Members: Switching from Aetna to Florida Blue If you’re under 65 and enrolled in an Aetna ACA plan, here’s what switching to Florida Blue looks like: Coverage Ends: Your Aetna plan ends December 31, 2025. You will need to cancel your current Marketplace plan and sign up for a new plan during the open enrollment period. Switch Window: If you want to select a Florida Blue ACA plan, you will have the opportunity to do so when the open enrollment period is open. For the 2026 plan year, the open enrollment period is from November 1, 2025, until January 15, 2026. If you experience a qualifying event (for example, getting married, having a baby, moving, or losing other coverage) you may enroll outside of the open enrollment period. Subsidy Transfer: Any Marketplace subsidy you currently qualify for automatically applies to your new Florida Blue plan. If you experience changes, such as losing Medicaid or another qualifying event, you may be eligible for a special enrollment period. Plan Options: Florida Blue offers broad networks and coverage that works for individuals, families, and early retirees. You can contact SWFL Insurance for help with plan changes, to review your eligibility, or to get assistance with the enrollment process. If you previously managed your plan through Aetna Health, you will need to transition to Florida Blue’s member portal for your new plan. Medicare Advantage Members: Why Florida Blue Is a Strong Choice For seniors losing an Aetna Medicare Advantage plan, Florida Blue offers: Medicare Advantage HMO & PPO plans with broad networks. Florida Blue also offers Medicare Part D prescription drug coverage and options for those transitioning from Original Medicare. Extra benefits like dental, vision, hearing, and fitness programs. These services can help with emergencies and routine care alike. Local support: Florida Blue’s Medicare plans are designed specifically for Floridians. Visit the Florida Blue website or contact SWFL Insurance for details about plan services, eligibility, and out-of-pocket costs. SWFL Insurance can help you review your age and eligibility, compare plan details, and understand how much you may need to pay out of pocket. Policy Management and Customer Support When you’re dealing with health insurance, having dependable policy management tools and proactive customer support can be a game changer. When stacked up against other health insurance companies, Florida Blue is the best health insurance company in Florida to assist members’ efforts to manage their health plan and understand plan benefits. Their valuable online portals and mobile applications allow members to view their coverage, investigate claims, and find important documents at any time; making it easy to maximize access to health care sources. Another area that Florida Blue stands out is customer support. If you have general questions about your health plan, questions about your bill detail, or even just if you have an understanding of something on your coverage and you want clarification, the different support teams are there to assist. The representatives also receive training specific to how to and teach members how to use plan benefit packages, and to find solutions quickly, while supporting the ability to get care when needed. Comparatively, unlike other companies (including Aetna), Florida Blue has a walk-in presence, there are different representatives dedicated to member care, and so it is nice that you never feel lost in your insurance. Choosing a health plan isn’t just about the coverage—it’s about knowing you have a partner in your health. With Florida Blue, you can expect top-tier policy management and customer support every step of the way. Frequently Asked Questions Will Florida Blue automatically replace my Aetna plan? No. You must actively enroll in a Florida Blue plan during Open Enrollment

Aetna Medicare Florida Exit: Advantage Changes in Florida for 2025 – What Seniors Need to Know Florida seniors face significant changes in 2025 as Aetna adjusts its Medicare Advantage offerings. Many Aetna plans will no longer be available in Florida, leaving thousands of beneficiaries needing to make a switch during the Medicare Annual Enrollment Period (AEP), October 15 – December 7, 2025. The exit of health insurer Aetna, a major insurance company in the Medicare market, highlights the shifting landscape for both policyholders and the broader industry. At SWFL Insurance, we’ve been guiding seniors in Fort Myers, Naples, and Port Charlotte for over 40 years. We gave licensed Medicare agents ready to help you compare alternatives—including Florida Blue, so you don’t lose coverage, doctors, or peace of mind. Recent healthcare policy changes, such as the Inflation Reduction Act, have also impacted the Medicare landscape and may have influenced insurance company decisions regarding plan availability. Introduction to Aetna Medicare Aetna Medicare is a pre-eminent provider of health insurance coverage which provides a comprehensive range of Medicare Advantage plans, Medicare Supplement plans, and prescription drug coverage specifically tuned to the unique needs of seniors and individuals who are eligible for Medicare. Aetna Medicare provides members with options for doctors, hospitals and all healthcare locations across a large network, which means as a member, you will have access to quality care across the state of Florida. In addition, Aetna Medicare makes it easy and secure to manage your plan. Aetna accepts premium payments through Instamed, so you can rest easy knowing you are paying your premiums using a trusted payment service. Members can visit the secure member site and log in to view their plan details, claims, and management of benefits any time. Aetna Medicare’s robust insurance product offering is a successful mixture of short and long-term health coverage. Whether you’re looking for a more expansive Medicare Advantage plan or a short-term Medicare Supplement plan that fills in some of the gaps in Original Medicare, Aetna Medicare will offer you flexible options to stay healthy and secure. Why Is Aetna Changing Its Medicare Advantage Plans? Aetna has scaled back its Florida Medicare Advantage options because of financial pressures and market shifts. They expect to lose roughly 10% of their Medicare Advantage membership in 2025. This means that many seniors will receive letters this fall notifying them that their plan will not be renewed. What Does This Mean for Aetna Medicare Members? If your Aetna Medicare Advantage plan is ending, you should receive an Annual Notice of Change (ANOC) in September 2025. You must choose a new plan during Medicare AEP (October 15 – December 7). If you do nothing, you may be reassigned to a different plan that might not meet your needs—or you could lose coverage entirely. Plan Benefits and Features for 2025 Aetna Medicare Advantage plans for 2025 are designed to support your health and lifestyle with a wide range of valuable benefits. In addition to robust prescription drug coverage, many plans include dental, vision, and hearing benefits to help you maintain your overall well-being. Staying active is easy with access to fitness classes and instructors through the popular SilverSneakers program, which offers instructor-led group fitness classes at locations across Florida. For added peace of mind, Aetna Medicare Advantage plans provide 24/7 access to a registered nurse hotline, so you can get health advice whenever you need it. Prescription home delivery is also available for many covered medications, making it convenient to stay on track with your treatment. With these features, Aetna Medicare Advantage plans are built to help you live your healthiest life. Changes to Special Needs Plans for 2025 In 2025, Aetna is expanding its Special Needs Plans (SNPs) to deepen the commitment to serve Medicare members with special health needs, as well as members who are eligible for a dual eligible special needs plan. Special needs plans are developed specifically to meet the needs of individuals with unique medical and financial challenges and also offer additional benefits and care coordination. Aetna is introducing new enhanced services for certain SNPs, which may include additional services like transportation for doctor visits and food delivery, specifically to assist members in overcoming barriers to care and healthcare access. Aetna’s Resources for Living can help connect members to local services and resources so that members can find help in their community. If you or someone you love has a complex health need, Aenta’s dual eligible special needs plans may help give you the additional services and benefits you need. What Are the Alternatives to Aetna Medicare Plans? Florida Blue (Blue Cross Blue Shield of Florida): The most stable Medicare carrier in the state, with a broad doctor and hospital network. Our role as independent agents is to compare all carriers in your county to find the plan that best matches your doctors, prescriptions, and budget. It’s also important to review and compare prescription drug plan (Medicare Part D) options, as coverage and premiums can change each year. Can I Keep My Doctors and Prescriptions? Yes—if you choose a plan with the right network and formulary. Every Medicare Advantage plan is different. At SWFL Insurance, we: Check your primary care and specialists against plan networks. Confirm your prescription medications are covered affordably. Review any extra benefits (dental, vision, hearing, gym memberships, and the SilverSneakers® fitness benefit, which helps seniors stay active and healthy by providing access to thousands of fitness facilities). Key Dates for Aetna Medicare Members September 2025: Aetna mails Annual Notices of Change (ANOC). October 15, 2025: Medicare Annual Enrollment Period (AEP) begins. December 7, 2025: Last day to choose a new plan. January 1, 2026: New coverage takes effect. Frequently Asked Questions Why is Aetna scaling back Medicare Advantage in Florida? Due to financial losses and market pressures, Aetna is reducing its plan offerings in the state. How do I know if my plan is ending? In September 2025, you will get an Annual Notice of Change (ANOC) from Aetna.

Aetna Will Leave Florida Effective End of 2025: What Marketplace Customers Must Know There are going to be notable changes in Florida health insurance beginning in 2025. Aetna’s exit from the Affordable Care Act (ACA) Marketplace in Florida after December 31, 2025 will have direct implications for customers who are enrolled in Aetna ACA plans. As a customer enrolled in the coverage, you would now need to select new coverage effective for 2026 during Open Enrollment next year. Aetna pulled out of the Florida ACA marketplace, therefore, affecting customers who use their ACA plans by having to determine new insurance options, impacting their coverage options and costs. At SWFL Insurance, we’re here to make that transition smooth. As a local, independent agency serving Fort Myers, Naples, and Port Charlotte for 40+ years, we’ll walk you through your options—including Florida Blue and other trusted carriers—so you don’t lose coverage or benefits. Aetna’s decision is a business move in response to market pressures and changing conditions in the healthcare industry. Understanding the ACA Marketplace The Affordable Care Act (ACA) marketplace is the central hub where individuals and families can search for health insurance coverage that fit their needs and budget. Developed to make health care coverage more accessible and affordable, the ACA marketplace—sometimes called the exchange—offers a variety of plan options from trusted insurance companies like Blue Cross Blue Shield, and Molina Healthcare. Plans are organized into multiple tiers (bronze, silver, gold, and platinum), each option offering different levels of coverage and monthly premiums to suit a range of healthcare needs and financial situations. The ACA marketplace offers one of the best advantages of being able to apply for tax credits and subsidies which can greatly reduce your health insurance costs. There are many Floridians who qualify for enhanced subsidies making health insurance more accessible than ever. The Marketplace offers a transparent way to compare plans, review benefits, and make the right choice for either individual or family coverage. Revisit how the ACA marketplace works to help you prepare for Aetna’s exit so you can make informed choices about your next health insurance plan. Why Is Aetna Leaving Florida’s ACA Marketplace? Aetna’s decision comes down to financial pressure. Recently, CVS reported earnings that highlighted ongoing challenges in the ACA marketplace, which contributed to the decision to exit. Rising medical costs and ongoing losses made it unsustainable for them to stay in the ACA market. While this may sound alarming, the good news is that other insurers remain active in Florida, and many offer plans with strong networks and affordable premiums. Parent Company and Implications CVS Health, Aetna’s parent company, has decided to leave the ACA marketplace. This impacts roughly one million Aetna members across the country. CVS Health is able to invest its energy elsewhere, as its more profitable pharmacy services and new treatments (i.e., weight-loss medication) provide the basis for the Aetna exit. As consumers are faced with higher costs and fewer plan options in the ACA marketplace, opportunity also opens for other insurance companies—such as Blue Cross Blue Shield and Molina Healthcare—to replace existing plans from Aetna. This will require Aetna members to undergo another thorough assessment of any alternative health insurance coverage for 2026. While this exit may create some interruption in case, the marketplace under the ACA was created to provide a valve for continuing access to health care. There are other companies to continue engaging with competitive plans. CVS Health’s exit mirrors social trends in many sectors of the health insurance industry. Rest assured there are still viable resources for your health and budget needs. When Does Aetna Coverage End? Your Aetna ACA Marketplace plan is expected to end on December 31, 2025. Open enrollment is scheduled to begin in the fall, specifically in November 2025. You will need to enroll in a new plan between November 1, 2025, and January 15, 2026. If you do nothing, you’ll lose health coverage starting January 1, 2026. What Should I Do If My Aetna ACA Plan Is Ending? Here are the steps to take: Review your Aetna notice — you’ll get official mail explaining when your plan ends. Compare new health plans available on ACA exchanges — Florida Blue, Ambetter, Oscar, and other carriers will still be on the Marketplace. Check your doctors and prescriptions — make sure they’re covered under your new plan. Apply for subsidies — your income will determine your eligibility for subsidies, and your current subsidy (if you qualify) will transfer to your new plan. Get help enrolling — working with a licensed local agent or broker can help you compare health plans and save money, making the process faster and less stressful. Policy Management and Customer Experience During the Transition As Aetna approaches its departure from the ACA marketplace, Aetna members will need to take an active role in paying attention to their health insurance policies and getting new coverage for 2026. Aetna is providing Aetna members with various methods to help facilitate this transition, including various online tools and the Aetna Health app, which allow you to access your plan information, review coverage information, and pay claims. These digital services are meant to empower members to stay informed and organized throughout the process of transitioning to another health plan. In addition to Aetna’s assistance, health insurance brokers and the federal government will provide assistance and outreach to help you through this process. Licensed brokers will be able to answer questions, perform apples-to-apples plan comparisons, and facilitate enrollment so that you can have the coverage that suits your needs. Aetna will closely monitor the customer experience throughout this newly established process and ensure high standards in service, complaint resolution, and ratings for quality in Medicare plans. The goal is to guide you through the transition to another ACA plan with as little disruption and stress as possible. Will My Subsidy Carry Over? Yes. If you qualify for ACA subsidies, your eligibility is based on your income, and subsidies will be transferred to your

Aetna Exiting Florida 2025: What it Means For You And How To Stay Covered In 2026 Aetna Coverage in Florida Is Ending Aetna has announced it will be exiting Florida’s ACA Marketplace after December 31, 2025, and scale back some Medicare Advantage plans in Florida for 2025. Aetna is exiting the ACA exchange in Florida, impacting Individual and Family plans. If you are an Aetna member, your coverage will end before 2026 unless you take action. At SWFL Insurance, we’re a local, independent agency that has served the Fort Myers, Naples, and Port Charlotte communities for more than 40 years. As a broker, we help Florida residents smoothly transition from ending Aetna plans to new coverage options—including Florida Blue and other trusted insurers, as well as alternative programs like Medicaid or CHIP—so you won’t lose access to doctors, prescriptions, or benefits. Our services are designed to help you navigate your choices and ensure you have the support you need. Get Free Enrollment Help The Facts About Aetna Leaving Florida ACA Marketplace: Aetna’s individual health plans end December 31, 2025. Members must select a new plan during Open Enrollment (November 1, 2025 – January 15, 2026). There is concern about ongoing federal policy uncertainty, as decisions by the federal government—including Congress and the Department of Health and Human Services—continue to shape the ACA marketplace. Enhanced subsidies have significantly improved affordability, however the loss of subsidies can increase costs for enrollees and reduce insurers participation. As a consumer, a plan switch will incur consumer resources, time, and effort understanding the options and understanding your continuity of care. Changing policy can direct resources to patients and the healthcare system more efficiently and reduce costs. Medicare Advantage: Aetna is reducing availability in Florida for 2025, and some plans will no longer be offered. Why: Financial losses, rising costs, and ongoing regulatory hurdles were reasons for CVS’s decision. There have been substantial profit increases reported in other areas of the business, but Aetna’s ACA business was stagnant. There is potential for individuals to lose money transitioning from a lower-cost plan to a higher-cost plan. This exit will impact thousands of Floridians, particularly the patients that count on Aetna for coverage. There are limitations to this analysis, as it focuses on specific plans and populations and may not capture the full impact on all affected individuals. The bottom line: Aetna’s exit will disrupt coverage, increase uncertainty, and require additional resources from consumers and the healthcare system. Impact of Aetna’s Exit on Florida Residents Aetna’s decision to leave the Affordable Care Act (ACA) marketplace in Florida means that thousands of individuals and families will need to find a new health insurance plan for 2026. If you currently rely on Aetna for your health coverage, please note that your current plan will no longer be available after the end of 2025. This change may reduce the number of insurance companies and plan options in the state, making it even more important to review your choices during the open enrollment period. Although Aetna exiting Florida may seem troublesome, eating the competition Aetna leaves behind are other health insurance companies, like Ambetter or Oscar Health, that are entering Florida and offering new plans, both for individuals and families. Whether it is with HealthCare.gov or licensed agents who can help you explore and examine of all the plans available and help you identify the best new plan for you, if you act on the open enrollment period, you will be able to prevent a gap in coverage, and protect your family’s health safety and financial coverage. Your Options After Aetna We can help you transition to: Florida Blue: The largest and most stable health insurer in Florida. Individual coverage: Options available if you need a plan outside of employer-sponsored insurance. Personalized plan comparison: We match your doctors, prescriptions, and budget to the right plan. Shop for new plans: You can shop and compare plans during open enrollment. If you have access to coverage through your employer, consider enrolling in an employer-sponsored plan. Compare Plans Now Exploring the ACA Marketplace The ACA marketplace, aka health insurance exchange, is your portal to affordable health insurance plans for individuals and families. Review plan options, including bronze, silver, gold, and platinum hospitals, each providing the same coverage but providing different costs based on your specific needs and budget. By visiting HealthCare.gov, you can start to compare plans, check which doctors and hospitals are in-network, and see if you qualify for valuable tax credits or other savings. If you or your family are eligible, the ACA marketplace can also provide access to Medicaid and the Children’s Health Insurance Program (CHIP). With Aetna’s departure, it’s a good time to check out the marketplace and learn about your new coverage. CVS Health, Aetna parent company, will continue supporting the members until 2025.Still, you’ll need to enroll in a new health insurance plan during the open enrollment period to maintain uninterrupted coverage in 2026. Take advantage of this opportunity to review your plan options, compare costs, and ensure you have the health benefits you need for the year ahead. Qualifying Life Events and Special Enrollment Life can change quickly, and certain events—known as qualifying life events—can make you eligible to enroll in a new health insurance plan or make changes to your current coverage outside the standard open enrollment period. Common qualifying life events include losing your job-based coverage, getting married, having a baby, or moving to a new area. When one of these events occurs, you may qualify for a special enrollment period, giving you the chance to secure a new plan and maintain your health coverage without waiting for the next open enrollment window. Understanding what counts as a qualifying life event and how to navigate the special enrollment process is key to protecting your health and plan benefits. If you experience a qualifying life event, visit HealthCare.gov or reach out to licensed agents for guidance on your plan options and the steps to enroll. By