Key facts
~16,000
Population
County seat: Cross City
ACA carrier: Florida Blue
Suwannee River reaches the Gulf through Dixie County
One of Florida's least developed Gulf Coast counties
Fanning Springs and Suwannee River State Park nearby
Dixie County is where the Suwannee River — immortalized in Stephen Foster's song — finally meets the Gulf of Mexico. The Suwannee's mouth cuts through Dixie County's wetland coast in one of the most ecologically rich and undeveloped river delta environments on the eastern Gulf Coast. Cross City is the county seat; Horseshoe Beach and Suwannee are the tiny coastal fishing communities.
With approximately 16,000 residents, Dixie County is one of the most sparsely populated counties in Florida. The county has no hospital, limited commercial development, and an economy built on fishing, hunting, timber, and the small service industries that support the county seat of Cross City. Health insurance access in Dixie County requires traveling to Gainesville (Alachua County), Ocala (Marion County), or sometimes Tallahassee for specialty care.
Dixie County's Gulf Coast is essentially wilderness — a network of tidal creeks, marsh islands, and estuary that makes it one of the finest shallow-water fishing destinations on the Gulf. The county's remoteness means that most residents who have insurance purchased it themselves through the ACA marketplace. Uninsured rates are among the highest in Florida.
Dixie County ACA marketplace options are extremely limited in 2026. Florida Blue is the primary carrier. Use your Cross City zip code on HealthCare.gov to verify exact availability.
Health insurance in Dixie County
The following income thresholds govern 2026 ACA subsidy eligibility (using 2025 FPL). Florida has not expanded Medicaid — adults in Dixie County below 100% FPL without dependent children fall into the coverage gap.
| Household Size | 100% FPL | 150% FPL | 200% FPL | 300% FPL | 400% FPL |
|---|---|---|---|---|---|
| 1 person | $15,060 | $22,590 | $30,120 | $45,180 | $60,240 |
| 2 people | $20,440 | $30,660 | $40,880 | $61,320 | $81,760 |
| 3 people | $25,820 | $38,730 | $51,640 | $77,460 | $103,280 |
| 4 people | $31,200 | $46,800 | $62,400 | $93,600 | $124,800 |
Dixie County has no hospital. Residents travel to Shands at UF Health (Gainesville), HCA Florida Ocala Hospital, or Doctors Memorial Hospital (Perry) for hospital care. Florida Blue's statewide network covers all three facilities. When selecting an ACA plan, Gainesville hospital coverage should be the primary consideration for Dixie County residents.
Fishing, shrimping, and crabbing support a small commercial seafood economy along Dixie County's Gulf coast. These workers — many of whom are self-employed or work for small boat operations — have no employer-sponsored insurance and earn irregular annual incomes. ACA marketplace plans with premium tax credits are their primary private coverage option.
The Medicaid coverage gap is particularly acute in Dixie County given the county's below-average median income. A significant share of adult residents likely earn below 100% FPL and fall into the gap between Medicaid eligibility (not expanded in Florida) and ACA subsidy eligibility. Community health center access in neighboring counties provides limited primary care as a safety net.
Explore ACA coverage across the region: Southern Plan Finder — Florida Gulf Coast Health Insurance — Levy County Health Insurance.