Navigating health insurance as a self-employed professional can feel overwhelming, but finding the right plan is crucial for your well-being and peace of mind. Whether you’re a freelancer, consultant, or small business owner, understanding your coverage choices can save you money and stress. The best health insurance options are tailored for self-employed individuals, helping you make smart, confident decisions.
Being self-employed is a dream for many—setting your hours, chasing your passions, and building something that’s entirely yours. But there’s a catch: no employer means no cushy group health insurance plan handed to you on a silver platter. Juggling freelance gigs and wondering how to keep myself covered without breaking the bank. If you’re in the same boat, you’re not alone—millions of Americans are self-employed, and finding affordable, reliable health insurance is a top concern.
The good news? You’ve got options. From the Affordable Care Act (ACA) Marketplace to lesser-known alternatives like health-sharing plans, there’s a way to get covered that fits your budget and lifestyle. In this guide, You through the best health insurance options for self-employed folks in the U.S., pulling from top-ranking sources like Forbes, HealthCare.gov, and Ramsey Solutions. Coverage, pros, cons, and even toss in some personal insights to help you decide. Let’s get started!
Why is health insurance important when you’re self-employed?
When you’re your boss, there’s no HR department to rely on. If you get sick or injured, especially without coverage, the bills can pile up quickly. According to a 2024 Kaiser Family Foundation report, the average uninsured person has more than $1,000 in medical debt, and that’s just for routine expenses. For something serious? You could be looking at millions.
And, in some states (like California), there’s still a personal mandate—drop insurance, and you’ll have to pay a penalty at tax time. But beyond that, it’s about peace of mind. As a freelancer, I’ve lost sleep at night worrying about what would happen if I broke my leg or needed surgery. Insurance isn’t just a safety net; it’s a way to keep your business — and your life — running smoothly.
1: The ACA Marketplace – Your Go-To Starting Point
When I first went solo, the ACA Marketplace was my lifeline. It’s the most popular choice for self-employed folks, and for good reason—it’s flexible, subsidized, and packed with plans to fit your needs. Here’s the scoop, based on insights from HealthCare.gov and Forbes Advisor.
How It Works
The Marketplace, launched under the Affordable Care Act, lets you shop for individual health plans online at HealthCare.gov. Open Enrollment runs from November 1 to January 15 each year (mark your calendar!), but if you lose other coverage, like a job-based plan, you can enroll during a 60-day Special Enrollment Period (SEP).
Costs and Subsidies
Here’s where it gets interesting: subsidies. If your income is between 100% and 400% of the federal poverty level (about $14,580 to $58,320 for a single person in 2025), you might qualify for premium tax credits. Forbes notes that over 90% of Marketplace enrollees get these, slashing monthly costs significantly. For example:
- A 40-year-old making $40,000 a year might pay $50-$150/month after subsidies, versus $500+ without them.
- Full-price silver plans average $450-$600/month, per Forbes’ 2025 analysis.
- Deductibles vary by plan tier—Bronze (high deductible, low premium), Silver (balanced), Gold (lower deductible, higher premium), and Platinum (top-tier coverage). Out-of-pocket maximums for 2025 cap at $9,200 for individuals or $18,400 for families.
Top Providers (Per Forbes)
Forbes ranks Blue Cross Blue Shield (BCBS) and Kaiser Permanente as the best for self-employed folks:
- BCBS: Available in all 50 states, with average silver plan premiums around $500/month and deductibles at $4,000. They’ve got a massive network—1.7 million providers—so finding a doctor is easy.
- Kaiser Permanente: Only in 8 states plus D.C., but their integrated system (doctors and insurance under one roof) keeps premiums low ($439/month for silver plans) and earns a 4.2/5 from the National Committee for Quality Assurance (NCQA).
Pros
- Subsidies make it affordable if you qualify.
- Covers essentials like doctor visits, hospital stays, and prescriptions.
- No denial for pre-existing conditions.
Cons
- Limited enrollment windows unless you qualify for a SEP.
- High deductibles on cheaper plans (Bronze can hit $6,000+).
- Kaiser’s limited coverage area might leave you out.
My Take
I snagged a Silver plan through the Marketplace in my first year of freelancing. The subsidy dropped my premium from $480 to $120—a game-changer. But I had to plan for Open Enrollment, which felt like a part-time job itself.
2: Short-Term Health Insurance – A Temporary Fix
Sometimes you need a quick fix—maybe you missed Open Enrollment or just started gigging. Short-term health insurance is like a Band-Aid: it’s cheap and fast, but it’s not a full solution. Ramsey Solutions and HealthCare.gov cover this well.
How It Works
These plans, offered by companies like UnitedHealthcare, last up to 4 months (starting September 2024, per federal rules). You can apply anytime—no enrollment periods—and coverage kicks in within days.
Costs
Ramsey highlights the appeal: premiums can be as low as $100-$200/month for a healthy individual. But there’s a catch—deductibles are sky-high (think $5,000-$10,000), and coverage is bare-bones.
Pros
- Super affordable upfront.
- Quick to enroll, great for gaps.
- Flexible terms (1-4 months).
Cons
- Doesn’t cover pre-existing conditions.
- Limited benefits—often skip prescriptions, mental health, or maternity.
- Not ACA-compliant, so no tax credits or mandate protection.
My Take
I considered this when I missed Open Enrollment once, but the skimpy coverage scared me off. It’s fine for a healthy 20-something, but if you’ve got ongoing health needs, steer clear.
3: Medicaid – Free or Low-Cost If You Qualify
If your income’s tight—especially when you’re just starting—Medicaid might be your golden ticket. HealthCare.gov and PeopleKeep emphasize its value for low-income earners.
How It Works
Medicaid is a federal-state program offering free or low-cost coverage. Eligibility varies by state, but most cover adults under 65 with income up to 138% of the poverty level ($20,120 for one person in 2025). Check your state’s rules at HealthCare.gov.
Costs
Zero to minimal premiums (some states charge $10-$20/month), with low copays ($1-$5). No deductibles in most cases.
Pros
- Dirt cheap or free.
- Covers a ton—doctor visits, hospital care, and even dental in some states.
- No enrollment deadlines.
Cons
- Income caps mean you might outgrow them as your business takes off.
- Smaller provider networks in some areas.
- Paperwork can be a hassle.
My Take
I didn’t qualify, but a friend swore by Medicaid when she launched her Etsy shop. It kept her afloat until her income climbed. If you’re scraping by, it’s worth a look.
4: Spouse’s Plan – Lean on Your Partner
Got a spouse with a 9-to-5? Their employer plan could be your easiest option. HealthCare.gov and Ramsey Solutions both flag this as a smart move.
How It Works
Most employer plans let you join as a spouse during their Open Enrollment (set by the employer) or within 30 days of a qualifying event (like losing your coverage).
Costs
Varies wildly—some employers subsidize family plans, dropping your share to $100-$300/month. Others? You’re footing the full bill, which could top $1,000 for a family.
Pros
- Often cheaper than Marketplace plans with subsidies.
- Bigger networks than HMOs.
- Simple—your spouse’s HR handles it.
Cons
- Dependent on their job stability.
- Costs can spike if their employer skimps on contributions.
My Take
My partner’s job saved us here. We added me to her plan for $200/month—way less than I’d pay solo. If this is an option, jump on it.
5: Health Savings Accounts (HSAs) with High-Deductible Plans
This one’s a bit of a combo deal, and I love it for the tax perks. Forbes and Ramsey dive deep into HSAs paired with High-Deductible Health Plans (HDHPs).
How It Works
An HDHP has lower premiums but a higher deductible (at least $1,650 for individuals in 2025). Pair it with an HSA, where you stash pre-tax cash to pay medical bills. Max contributions for 2025: $4,150 solo, $8,300 family.
Costs
HDHP premiums average $300-$400/month (Forbes), with deductibles from $1,650-$7,000. HSA funds roll over year to year—sweet!
Pros
- Tax triple-play: contributions are pre-tax, growth is tax-free, and withdrawals for medical costs are tax-free.
- Lower premiums than traditional plans.
- You control the money.
Cons
- High deductibles mean big upfront costs if you get sick.
- Requires discipline to save in the HSA.
My Take
I’ve got an HDHP now, and the HSA is my secret weapon. I sock away $200/month, and it’s covered routine stuff like checkups. Plus, that tax deduction? Chef’s kiss.
6: Health Sharing Plans – A Non-Insurance Alternative
Ever heard of health sharing? It’s not insurance, but it’s gaining traction. PeopleKeep explains it well.
How It Works
You join a group (often faith-based, like Medi-Share) and pay a monthly “share” that helps cover members’ medical bills. They reimburse you for eligible costs.
Costs
Shares range from $100-$500/month, depending on age and plan. Annual “personal responsibility” (like a deductible) can be $500-$5,000.
Pros
- Cheaper than traditional insurance.
- No enrollment periods—join anytime.
- The community vibe appeals to some.
Cons
- Not regulated like insurance—coverage isn’t guaranteed.
- Often excludes pre-existing conditions or lifestyle-related costs (e.g., smoking).
- No ACA compliance.
My Take
A buddy swears by Medi-Share, saving him $200/month over the Marketplace. I’m skeptical—too many “what ifs”—but it’s worth researching if you’re healthy and align with their values.
How to Choose the Right Option for You
Picking a plan feels overwhelming, but it’s about matching your needs. Ask yourself:
- Budget: Can you swing $400/month, or is $100 your max?
- Health: Got chronic issues? Skip short-term or sharing plans.
- Income: Low earners, check Medicaid; mid-range, aim for Marketplace subsidies.
- Location: Kaiser’s great, but only in 8 states.
- Taxes: Self-employed? HSA deductions and premium write-offs (100% of premiums, per Ramsey) are gold.
Start at HealthCare.gov—plug in your income and see what subsidies you snag. Then compare HDHPs or spousal plans if they’re in play.
Conclusion
Health Insurance Options for Self-Employed, Health insurance as a self-employed person isn’t sexy, but it’s a must. Whether you go Marketplace, lean on a spouse, or roll the dice with health sharing, the key is doing your homework. I’ve bounced between plans over the years, and each taught me something—mostly that peace of mind is worth every penny.
FAQ
What type of insurance should a self-employed person have?
Health Insurance Options for Self-Employed, A self-employed person should have health insurance—ideally through the ACA Marketplace for flexibility and subsidies. Consider liability insurance too, especially if you’re in consulting or freelancing, to protect against lawsuits. Disability insurance is smart to cover lost income if you can’t work due to injury or illness.
Can you write off health insurance if you are self-employed?
Yes, if you’re self-employed, you can write off 100% of your health insurance premiums on your taxes! It’s a sweet deal—just report it on your Schedule C. No itemizing is needed, but you can’t double-dip with subsidies. Check with a tax pro to maximize this perk.
Is $200 a month a lot for health insurance?
$200 a month isn’t bad for health insurance—it’s below the U.S. average of $450 for individual plans. If you’re young and healthy, it’s decent; for older folks or families, it’s a steal. Subsidies or a high-deductible plan might get you there, so shop around!
What is the best health insurance for small business owners?
Health Insurance Options for Self-Employed, The best health insurance for small business owners is often the ACA Marketplace—affordable with subsidies and solid coverage. Blue Cross Blue Shield rocks for wide networks, while Kaiser Permanente’s a gem if you’re in their area. Pair it with an HSA for tax savings—flexible and smart!
