🧾 Why Health Insurance Is Crucial for the Self-Employed.
Risk
Financial Impact
Medical emergency
Can cost $10,000–$50,000+ without insurance
Hospitalization
$2,000–$5,000 per night
Prescription drugs
High-cost meds often unaffordable without coverage
Preventive care
Screenings and vaccines often free with insurance
✅ A good health plan protects your health and your business from unexpected costs.
⚙️ Your Main Insurance Options
1. Marketplace/ACA Plans (USA)
Details
Description
Where
HealthCare.gov or your state’s exchange
Type
Bronze, Silver, Gold, Platinum (coverage tiers)
Premiums
Subsidized based on income level
Enrollment
Open Enrollment (Nov–Jan), or Special Enrollment if eligible
✅ Pros: Wide options, guaranteed coverage, subsidies available ❌ Cons: High deductibles for Bronze plans
2. Private Insurance Plans
Details
Description
Where
Direct from insurers (e.g., Cigna, Aetna, UnitedHealthcare)
Flexibility
More plan variety, may include better networks
Cost
Usually higher without subsidies
✅ Pros: Broader provider access, customizable ❌ Cons: No government subsidy, strict underwriting (some plans)
3. High-Deductible Health Plans (HDHP) + HSA
Details
Description
Deductible
$1,600+ (individual), $3,200+ (family) in 2025
HSA
Health Savings Account with tax benefits
Ideal For
Healthy individuals who want low premiums and tax breaks
✅ Pros: Low premiums, triple tax benefits with HSA ❌ Cons: High out-of-pocket until deductible is met
4. Health Sharing Plans (Not Insurance)
Details
Description
What
Member-based cost-sharing groups (e.g., Medi-Share, Sedera)
Coverage
Members share medical costs based on contributions
Regulation
Not regulated like insurance; limited legal protection
✅ Pros: Lower monthly cost ❌ Cons: No guarantee of payment, religious restrictions common
5. Freelancer/Professional Group Plans
| Providers | Freelancers Union, NASE, Chamber of Commerce groups | Benefits | Group buying power = better rates | May include | Health, dental, vision, life insurance
✅ Pros: Group discounts, tailored for self-employed ❌ Cons: Limited to members or specific professions
💰 How Much Does It Cost?
Plan Type
Monthly Premium (2025 Avg, Individual)
Bronze (ACA)
$320 – $450
Silver (ACA)
$450 – $650
Gold (ACA)
$600 – $850
Private PPO
$700 – $1,000
Health Sharing
$150 – $400
Premiums vary by age, location, income, and coverage level.
💵 Tax Benefits for the Self-Employed
Self-Employed Health Insurance Deduction
Deduct 100% of premiums (individual + family) from gross income
Applies even if you don’t itemize deductions
HSA Contributions Are Triple-Tax-Free
Pre-tax contribution
Tax-free growth
Tax-free withdrawals for medical expenses
Limit for 2025: $4,300 (individual), $8,550 (family)
Deduct Other Medical Expenses
If itemizing and they exceed 7.5% of adjusted gross income
📝 What to Look for in a Plan
Factor
What to Check
✅ Premium
Can you afford it monthly?
✅ Deductible
What must you pay before coverage starts?
✅ Out-of-pocket max
How much is your worst-case scenario?
✅ Network
Are your doctors & hospitals covered?
✅ Prescriptions
Are your medications on the formulary?
✅ Mental health
Does it include therapy or psychiatric coverage?
✅ Telehealth
Many plans now include virtual care as standard
👀 Best Providers (2025 – US & UK Mentioned)
🇺🇸 USA
Provider
Known For
Blue Cross Blue Shield
Wide network, state-based plans
Kaiser Permanente
Great for integrated care and wellness programs
Oscar Health
Tech-savvy, ideal for freelancers
UnitedHealthcare
Extensive national network
Cigna
Great global and expat coverage options
🇬🇧 UK (For Private Health Insurance)
Provider
Known For
Bupa
Comprehensive plans for self-employed
Aviva
Flexible policies, good dental add-ons
Vitality
Wellness-based rewards + coverage discounts
AXA Health
Quick access to private specialists
📋 Real-World Example
Name: Sarah, 35-year-old freelance graphic designer Location: California Income: $48,000/year
