Can I Keep My Doctor After Aetna Leaves Florida?
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



