No employer plan? You're not alone — millions of freelancers, contractors and gig workers buy their own health insurance. The good news: the ACA marketplace often makes it far cheaper than people expect, especially with subsidies. Here's how to navigate your options.
In this guide
Your 4 main options
| Option | Best for | Watch out for |
|---|---|---|
| ACA marketplace plan | Most self-employed people — subsidies can slash costs | Must enroll during open enrollment (or a qualifying life event) |
| Private off-exchange plan | Higher earners who don't qualify for subsidies | No subsidies available; shop carefully |
| COBRA | Recently left a job with great coverage | You pay the full premium + 2% — often $700+/month |
| Health sharing ministry | Healthy people wanting low monthly cost | Not insurance — no guaranteed coverage, no ACA protections |
The ACA marketplace and subsidies
The marketplace (HealthCare.gov or your state's exchange) is where most self-employed workers should start. Premium tax credits are based on your income — and thanks to expanded subsidy rules, many middle-income freelancers now qualify for meaningful help.
Key point for the self-employed: your income is your net business income (after business expenses, before taxes). Estimate carefully — underestimate and you'll owe money back at tax time; overestimate and you leave subsidy dollars on the table.
Metal tiers explained
- Bronze: lowest premium, highest deductible (~$7,000). Best if you're healthy and want catastrophic protection.
- Silver: the sweet spot for most — and the ONLY tier where cost-sharing reductions apply (extra savings if your income is under 250% of poverty level).
- Gold: higher premium, much lower deductible. Worth it if you have ongoing prescriptions or expect procedures.
- Platinum: highest premium, lowest out-of-pocket. Rarely the best value.
7 ways to lower your premium
- Claim every subsidy dollar — update your income estimate if business slows; lower income = bigger credit.
- Pick Silver if your income is modest — cost-sharing reductions can make Silver better than Gold.
- Consider a high-deductible plan + HSA — HSAs are triple tax-advantaged and the money is yours forever.
- Check your doctors are in-network — out-of-network care is where surprise bills come from.
- Deduct your premiums — self-employed workers can deduct health insurance premiums from taxable income.
- Time your enrollment — open enrollment is typically Nov–Jan. Miss it and you wait a year (unless you have a qualifying event).
- Re-shop every year — plans and prices change annually; last year's best deal often isn't this year's.
Traps to avoid
- Short-term plans as primary coverage — cheap, but they can exclude pre-existing conditions and cap payouts.
- "Too good to be true" private plans — some discount cards masquerade as insurance. Verify it's a real insurance product.
- Ignoring the network — the cheapest premium with your doctors out-of-network is the most expensive plan of all.
Frequently asked questions
Can I get marketplace coverage mid-year?
Only with a qualifying life event — losing other coverage, moving states, marriage, or having a baby. Otherwise, wait for open enrollment.
What counts as income for subsidies?
Your modified adjusted gross income — for freelancers, that's net business profit plus any other income. Track it quarterly and update the marketplace if it changes.
Is COBRA ever worth it?
Occasionally — if you're mid-treatment with specialists only covered by your old plan, a few months of COBRA can bridge you to open enrollment.