Health insurance when you move to Miami: your options by immigration status

If you've just arrived in Miami, or are about to, health insurance is one of the first things to sort out: in the U.S., an emergency room visit without insurance can cost thousands of dollars. Your options depend mostly on your immigration status, and in 2027 the rules change for many immigrants. Here's what you can get in your situation, when to apply and what to do in the meantime, based on official sources.

Your options by situation

This table sums up the main route for each case. It's general guidance: your situation may have details that matter, and HealthCare.gov will tell you exactly what you qualify for when you apply.

If you work for a company, start there. It's the most common way to be insured in the U.S.: the employer usually pays part of the premium, and you enroll when you start the job, without waiting for the annual period. Ask HR which plans they offer, how much comes out of each paycheck and from which day you're covered.

The Marketplace (Obamacare) in Florida

The Marketplace, known as Obamacare, is the health insurance market created by the Affordable Care Act (ACA). Florida doesn't run its own and uses the federal platform, HealthCare.gov.

To enroll, you must live in Florida and be a citizen, national or lawfully present immigrant. According to HealthCare.gov, lawfully present includes permanent residents, people with humanitarian status (refugee, asylee, TPS and others) and people with a valid nonimmigrant visa, among other cases. Marketplace plans can't refuse to cover you or charge you more because of a pre-existing condition.

Dates for 2027 coverage

A 2025 federal rule would have shortened open enrollment starting in 2027, but a court vacated it in 2026 and the dates remain November 1 to January 15. The case is still on appeal, so check the dates on HealthCare.gov before you enroll.

What changes in 2027

The federal law passed in July 2025, known as the One Big Beautiful Bill Act, changes who gets help paying for coverage. On top of that, the enhanced subsidies that existed through 2025 have not been extended. This is what matters if you've just arrived:

• From January 1, 2027, only three groups of immigrants can get the premium tax credit that lowers your premium: permanent residents, Cuban and Haitian entrants and Compact of Free Association (COFA) migrants. Other lawfully present immigrants, including refugees, asylees, TPS holders and people on work or student visas, can still buy a plan, but at full price.
• Since 2026, immigrants with income below the federal poverty line no longer get help. Through 2025 they could if their immigration status kept them out of Medicaid.
• The 400% cliff is back. Because the enhanced subsidies were not extended, anyone earning more than 400% of the federal poverty line gets no credit at all, and premiums for those who do get help are higher than in 2025.
• Estimate your income carefully. Starting with the 2026 tax year, there is no longer a cap on what you'll have to repay if you got more help than you were due. If your income changes during the year, update it on HealthCare.gov.

If you arrive outside open enrollment

Outside the annual dates you can only enroll with a special enrollment period, which opens after certain life changes. For people arriving in Miami, the most common are:

• Moving to the U.S. from abroad. It counts as a permanent move. You usually need to have had coverage for at least one day in the 60 days before, but according to CMS there's an exception if you lived outside the country for at least one of those days.
• Gaining lawful presence or citizenship, if it makes you eligible for the Marketplace.
• Losing other coverage, such as a job-based plan.

As a rule you have 60 days from the change to pick a plan, and you'll be asked for documents proving it, such as your Miami lease or immigration documents. If you pick a plan by the 15th, coverage usually starts on the first of the next month.

Medicaid and KidCare in Florida

Florida has not expanded Medicaid. That means adults without minor children or a disability can't get Medicaid, however low their income, and parents only if their income is very low. In addition, from October 2026 federal law limits Medicaid to permanent residents, generally after five years, Cuban and Haitian entrants and COFA migrants.

For children there's a wider path. Florida KidCare covers children under 19 who live in Florida and are citizens or eligible immigrants. Florida uses the federal option to cover lawfully present children without the five-year waiting period, and the 2025 law did not change that option. Premiums depend on income and family size, and you can estimate them on the Florida KidCare website. If you apply through the Marketplace, HealthCare.gov also checks whether your children qualify for KidCare or Medicaid.

Visitor insurance, for the gap

If you're visiting, or you've arrived and can't enroll in the Marketplace yet, visitor or travel medical insurance covers unexpected accidents and illnesses for a few weeks or months. It's useful so you're not left with nothing while you sort out the rest, but it isn't full health insurance:

• It usually excludes pre-existing conditions or covers them only in a limited way.
• It has maximum benefit limits and doesn't cover preventive care or routine checkups.
• It doesn't meet ACA standards, so it doesn't count as Marketplace coverage.

Read what the policy excludes, the maximum it pays per illness or accident and whether you have to pay upfront.

If you have no insurance

• Community health centers. Federally funded health centers see you even without insurance and charge based on your income, on a sliding fee scale. You can find the ones in Miami-Dade with the official HRSA locator.
• Emergencies. Under federal law (EMTALA), hospitals with an emergency department that participate in Medicare must screen and stabilize you in an emergency, whether or not you can pay. That doesn't make it free: you'll be billed later, so ask about the hospital's financial assistance programs.
• Ask for the price first. For non-urgent visits and tests, ask for the self-pay price: it's usually lower than the standard rate.

Common mistakes

• Assuming you'll get a subsidy. In 2027 it depends on your immigration status, not just your income.
• Missing the 60 days after you move. If you do, you'll have to wait for the next open enrollment.
• Lowballing your income to pay a smaller premium. You'll repay it on your tax return, with no cap.
• Relying on travel insurance for months. It doesn't cover pre-existing conditions or preventive care.
• Not checking the plan's network. Before you choose, see whether your doctors and the nearest hospital are in network.

If you're planning your move, see our guides to your first 90 days in Miami, the cost of living in Miami and the ITIN, which you'll need to file taxes if you don't have a Social Security number.

Frequently asked questions

Method note

This guide summarizes information published by HealthCare.gov and the Centers for Medicare & Medicaid Services (CMS), Florida KidCare and the Health Resources and Services Administration (HRSA), reviewed in October 2026. For the 2025 law's changes and the status of the enhanced subsidies, we checked those sources against specialist analyses, cited below. Rules can change and every case is different: confirm your eligibility on HealthCare.gov or with a licensed agent before you decide.