Health insurance for the self-employed

No employer plan means no default option — but it also means more choice than most freelancers realize, plus a deduction that can meaningfully offset the cost.

Losing access to an employer health plan is one of the biggest anxieties new freelancers report — and one of the most misunderstood. The ACA Health Insurance Marketplace exists specifically to serve people without employer coverage, and income-based subsidies mean many self-employed households pay less than they expect for a solid plan.

On top of that, the self-employed health insurance deduction lets many freelancers write off 100% of their premiums, which materially changes the real cost of coverage compared to the sticker price. This section covers how to shop for a plan, what a subsidy actually depends on, and the accounts (like HSAs) worth pairing with the right plan type.

Start here

Health insurance guides

Cornerstone guide

Health Insurance Options for the Self-Employed in the US

Marketplace plans, subsidies, and alternatives compared plainly.

12 min read

Guide

ACA Marketplace Plans Explained

Bronze, Silver, Gold, Platinum — how metal tiers work.

9 min read

Guide

HSA for Freelancers

The triple tax advantage, explained.

7 min read

Guide

Short-Term Health Insurance: Risks

What you trade away for a lower premium.

7 min read

Guide

How ACA Subsidies Work with Variable Income

Estimating, reconciling, and updating income.

7 min read

Guide

Freelancer Guild Health Plans

Association coverage as an alternative option.

6 min read

Keep going

Guide

Tax Deduction Checklist

See where premiums fit into your deductions.

Guide

SEP IRA vs Solo 401(k)

Benefits planning goes beyond health coverage.

Guide

Budgeting on Irregular Income

Build premiums into a variable-income budget.

FAQ

Common health insurance questions

Most self-employed people buy an individual plan through the ACA Health Insurance Marketplace (Healthcare.gov or a state exchange), which may include income-based subsidies that lower the premium.

Many self-employed people can deduct 100% of health insurance premiums for themselves and their family as an above-the-line adjustment to income, subject to specific IRS eligibility rules.

Open Enrollment typically runs November through mid-January. Outside that window, you generally need a qualifying life event — like losing other coverage or leaving a job — to enroll through a Special Enrollment Period.

If you're enrolled in an HSA-eligible high-deductible health plan, a Health Savings Account offers triple tax advantages — deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses.