By Eric Rosenberg, WCI Contributor
As an employee of a company, there’s a good chance you will have an option to buy health insurance through your employer. However, when you’re self-employed, it’s up to you to figure out the best methods to cover yourself and your family with health insurance. You can’t be your own doctor (and if you can, you probably shouldn't be for anything serious), after all, and you may need medical care ranging from prescription medications to surgeries and hospital stays. Without insurance, as you know, those services can be costly.
Self-employed health insurance is available through several sources. Here’s a look at the main options you have for buying health insurance when you’re self-employed.
What Is a Self-Employed Health Insurance Plan?
A self-employed health insurance plan is a type of healthcare coverage for you and your dependents if needed. Due to the high cost of healthcare and the likelihood you will need medical care at some point, it’s extremely unwise to go without health insurance in the United States. Plan on paying for health insurance until you qualify for Medicare at age 65, when your options are different.
As with other kinds of insurance, your costs are broken down into a premium that’s paid to get coverage, plus potential deductibles, copays, or coinsurance. Depending on where you get your insurance, you will have a range of options for choosing healthcare providers, monthly costs, deductibles, and out-of-pocket costs. It’s worth spending time researching your options to make sure you have the right balance between price and coverage.
You can find self-employed health insurance directly from some health insurance companies, through an insurance agent or broker, or using one of the government exchanges—like the national marketplace at HealthCare.gov.
How Much Is Health Insurance for Self Employed?
The cost of health insurance varies by age and coverage. Remember, you don’t have an employer to pay for a portion, so you may have sticker shock the first time you get quotes when running your own business.
Self-employed health insurance is priced per covered individual, so you’ll pay more as your family gets bigger, up to certain limits. The average cost of health insurance is around $500 per month for an individual and $1,200 per month for a family. However, that can vary widely based on location and coverage. For my family of five in Southern California [in 2022], we pay about $2,000 per month for a Silver plan. We’ll go into more detail on what a Silver plan means—and other options—below.
If you buy insurance from a marketplace, you won’t pay for any more than three children age 20 or younger. Additional children are insured without any extra premiums. Because insurance costs go up with age, you will likely pay less for kids than yourself and a spouse.
Health Insurance Options for Self-Employed
You can find health insurance through several sources. Each has pros and cons worth considering. We’ll get into those more below. Here is a closer look at the kinds of plans you may come across.
The marketplaces use four “metal” categories: Bronze, Silver, Gold, and Platinum. Higher tiers require a higher monthly premium and cover a greater percentage of medical costs. I’m a fan of the Silver tier for my family’s needs. If you are generally healthy and have few medical needs, you may do OK with a Bronze plan. Anyone with ongoing conditions, medication needs, or requiring high levels of care should consider a higher-tiered plan.
What Health Insurance Is Best for Self-Employed?
As a physician or other healthcare professional, you likely employ efficient and judicious use of the healthcare system. A Bronze-level marketplace plan could make sense if you are healthy and if you will likely have few annual medical costs. A Silver plan, or maybe even a Gold plan, could be a better fit for those with more needs. Platinum plans probably won’t make sense.
Another benefit of buying health insurance through a marketplace comes from tax savings. In addition to deducting your health insurance premiums, those with a qualifying High Deductible Health Plan (HDPD) can save and invest through a Health Savings Account (HSA), the most tax-advantaged type of account for long-term investing.
Does Self-Employed Health Insurance Include Dental?
Self-employed insurance for your health is not the same as for your teeth. Unfortunately, like insurance through an employer, self-employed health insurance probably won’t include dental coverage.
In addition to self-employed insurance plans, you should consider shopping for additional dental coverage. Many people go without dental insurance and choose to pay for these needs out-of-pocket, which may be more feasible with a high income. However, for around $20-$30 per month, you can get your biannual teeth cleanings covered along with a portion of additional dental needs. Dental plan costs and coverage also vary.
How to Choose Health Insurance for Self-Employed?
If you’re on the fence between multiple plans, consider these significant factors:
- Healthcare needs: First, consider your healthcare needs and those of your family. If you have extensive medical needs, you may want higher coverage.
- Premium: This is the monthly cost you’ll pay for health insurance no matter what. Even if you’re not sick and never go to the doctor, you’ll have to pay your premiums.
- Coverage: Your coverage explains how much you have to pay out-of-pocket when you need care, the annual limits, and where you can go for coverage. For example, an HMO may offer lower costs but have a much more limited network of providers. A PPO may cost more but gives you more flexibility in where you get care.
- HSA eligibility: Plans with a qualifying high deductible allow you to open and contribute to an HSA. Qualifying contributions are pre-tax, and withdrawals for eligible healthcare costs are tax-free. You can also wait years, perhaps until retirement, to reimburse yourself. That means you can save and invest tax-free for retirement. That’s the best tax deal around.
How to Get Health Insurance for the Self-Employed?
These are the places you’re most likely going to find success shopping for health insurance while self-employed:
- Insurance agent or broker: An agent or broker can show you several plans and walk you through various options. However, they may be limited to working with specific insurers and may be more interested in earning a commission than getting you the best policy. Only work with a trusted agent who works independently of any particular insurer.
- Direct from an insurance company: Some insurance companies offer coverage directly through their websites or other means. It’s great to have the opportunity to browse multiple options and to get quotes from the comfort of your home computer.
- Marketplace plans: The federal and state health insurance marketplaces were established through the Affordable Care Act in 2010. Anyone is guaranteed coverage through a marketplace plan regardless of preexisting conditions. Plans have specific minimum coverage requirements and fall into tiers based on the monthly cost and coverage. Depending on your income and location, you may qualify for subsidies when buying insurance through a marketplace.
A note on health ministries: You can find healthcare coverage for a lower cost through religious health plans, sometimes called health ministries or similar. These are not real health insurance. They don’t include medications, preventative care, birth control, or primary care visits. If you choose to use one of these health-sharing ministry plans, be sure you read the fine print. It is critical that you understand how they work and especially what they don't cover that health insurance traditionally does. Learn more here.
How Do You Apply for Health Insurance If Self-employed?
When buying insurance through a marketplace, head to your state’s exchange website or the national healthcare exchange at HealthCare.gov. It’s easy enough to apply online and get your coverage underway.
To apply for coverage from a health insurer, head to their website or call customer service for more details. A broker or agent will supply your application and anything else needed to get covered.
Is Health Insurance Tax Deductible for Self-Employed?
Can a self-employed person deduct health insurance premiums? Yes! Depending on your business structure and how you pay for your premiums, you have a couple of options for handling the deduction.
A corporation (even an S Corp) generally pays for the insurance itself. If your business is a sole proprietor or partnership, you deduct your health insurance premiums on Schedule 1 of Form 1040. When in doubt, contact a trusted tax professional.
What Qualifies for Self-Employed Health Insurance Deduction?
There are two requirements to deduct your health insurance premiums. First, you must have no other health insurance coverage. Second, you must have business income. That’s it.
Additional medical costs are possibly deductible, but that depends on your income, total qualifying expenses, and other factors. Your tax software or accountant can help you determine what additional medical costs are tax-deductible.
Where Do I Deduct Health Insurance Premiums for Self-Employed?
If you pay using a personal credit card or bank account, you can deduct the costs on your personal tax return. If your business pays for the coverage, your business gets the tax deduction, which is passed on to you as tax savings as the business owner.
Finding Affordable Health Insurance for Self-Employed
That’s the end of our primer to health insurance options for self-employed doctors and medical workers. It’s essential to take the time to choose the best health insurance plan for your household's unique needs. If you don’t, you could wind up wasting thousands of dollars unnecessarily. Once you have the right insurance, you can get back to work saving and investing for your financial future.
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If I am self employed and go under my wife’s plan for health insurance but she now has to pay more $800 to add me can I deduct from my self employment taxes. I am paying her to put me under her health insurance plan. I am assume the answer is no. Her plan is better than anything on the marketplace through her job. Her job pays 90% of her costs but only a minimal amount of mine.
Thank you
You are correct. The answer is no. You can’t deduct those premiums, but there’s a good chance they’re still your best deal. If not, then buy on the open market.
My husbands company has a ICHRA (reimbursement style insurance assistance) through a company called Take Command. His employer give us $480 total monthly reimbursement, and we all able to choose any plan off the marketplace in our area of Reno/Carson City/Tahoe. We pick the insurance and we pay the monthly premium in full entirely separate from his employer and are given the $480 on his following paycheck once Take Command has verified our premium was paid to the Insurer. We are looking at high deductible plans that are HSA qualified but wondering if the difference of our Premium and his reimbursement is tax deductible. I do not see why it wouldn’t be since its our coverage that we are paying for minus what his company reimburses us for, so its not like anyone is double dipping.
TIA
As an employee? No. Sorry.
Hello
I was wondering what options are available to self employed individuals besides the exchange at age 60-65 or 70 depending up whether they change Medicare there are not a lot of options. I considered working for government but lately government jobs are hard to get and the insurance would start coverage at age 62 if you worked for 5 years. I am wondering how I would pay those premiums and premiums for Medicare unless they change the retirement age.
Are there are other options other than the Marketplace for self employed individuals? Should I look at citizenship internationally for insurance. If they raise the Medicare age the marketplace plans look to be very expensive.
Thank you
Here are your options for ages 60-65:
Health sharing ministries
PPACA marketplace plans
COBRAing your employers’ plan
Buying your own plan on the open market (usually via a health insurance broker)
Yes, health insurance is expensive. Many people who have never paid full freight for it get sticker shock when they retire before age 65. My family of 6 is like $1200 a month, but I’ve run into plenty of couples in their 50s and 60s paying twice that.
Hello
What about government plans from working with the Federal government? Are those the best plans out there?
I am wondering about co-operatives that might offer insurance, are there any forums you have hosted or links to the other than ACA plans?
Thank you
Sure, if you’re going to work still there are many options available to you by different employers.
Insurance plans aren’t secret or hidden. You don’t need special links. Just Google “[Your home town} health insurance broker”. There are probably five within 2 or 3 miles of you. Just call one up. Be prepared for sticker shock.
I’m not sure what you mean by “best plan”. For some, the best plan is the cheapest. For others, the best is the most comprehensive. But a broker can show you what’s available and help you make an informed choice.
In a few months, I’m joining a private practice where I’ll be a W2 employee for the first couple years before I can buy into ownership. Practice is small enough they do not offer health insurance (and most of the employees have insurance through their military spouses since it’s close to an army base.) Do you know if my premiums would still be deductible since I’d be paying out of pocket through the marketplace, even though I’m still an employee? Thanks!