Key facts
~760,000
Population — Southwest Florida's largest county
County seat: Fort Myers; largest city: Cape Coral
ACA carriers: Florida Blue, Ambetter, Molina, UnitedHealthcare, Oscar
Hurricane Ian (September 2022) caused catastrophic damage across the county
Cape Coral: largest city in Florida by land area
Growing retirement and healthcare destination
Lee County is Southwest Florida's most populous county and the commercial, healthcare, and cultural hub of the region. Fort Myers is the county seat; Cape Coral — the largest city by land area in all of Florida — sits across the Caloosahatchee River. The county's Gulf Coast identity is defined by barrier islands (Sanibel, Captiva, Fort Myers Beach), the Caloosahatchee River, and a climate that has made it one of America's premier retirement destinations.
Hurricane Ian made catastrophic landfall in Lee County on September 28, 2022 as a Category 4 storm with category 5 winds, causing approximately $112 billion in damage — the costliest hurricane in Florida history. The storm devastated Fort Myers Beach, Sanibel, Pine Island, Cape Coral, and numerous inland communities. Recovery continues, and the storm's impact on housing costs, population displacement, and economic disruption continues to shape the county's health insurance landscape.
Five ACA marketplace carriers compete in Lee County for 2026, giving Southwest Florida residents excellent plan choice. This competition keeps premiums relatively affordable compared to markets with fewer carriers, and it means comparison shopping is particularly valuable. A difference of one carrier tier can mean $80–$150/month in premiums for the same-age enrollee.
Lee County has five ACA marketplace carriers in 2026: Florida Blue, Ambetter, Molina, UnitedHealthcare, and Oscar. Southwest Florida's large population supports robust carrier competition. Compare all five at HealthCare.gov using your Fort Myers or Cape Coral zip code.
Health insurance in Lee County
The following income thresholds govern ACA marketplace subsidy eligibility for 2026, using the 2025 federal poverty level. Florida has not expanded Medicaid — adults in Lee 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 |
Lee Health is the dominant healthcare system in Lee County, operating Cape Coral Hospital, Gulf Coast Medical Center, HealthPark Medical Center, and Lee Memorial Hospital. All Lee Health facilities participate in Florida Blue and most other ACA carrier networks. Physicians Regional (Collier County) also serves southern Lee County residents. Verify specific facility coverage before enrolling.
Hurricane Ian's aftermath created unusual health insurance situations for many Lee County residents: displacement to other Florida counties or states, loss of employment, insurance gaps during rebuilding, and increased mental and behavioral health needs. If you experienced a qualifying life event during Hurricane Ian recovery (loss of job-based coverage, displacement to another zip code), you may have or may have had a Special Enrollment Period.
Cape Coral's large Canal District and the broader Cape Coral community — heavily represented by retirees, snowbirds, and working families — has high ACA marketplace enrollment rates. Many Cape Coral residents who are too young for Medicare rely on ACA marketplace plans. The five-carrier competition in Lee County is particularly beneficial for this population.
Explore coverage across the region: Southern Plan Finder — Florida Panhandle Health Insurance — Collier County Health Insurance.