Can self-employed people get health insurance?

Yes. Self-employed individuals can buy coverage through the ACA marketplace (Healthcare.gov), private insurers, health sharing ministries, or spouse's employer plan. Many qualify for premium subsidies on the marketplace.

Is self-employed health insurance tax deductible?

Yes. Self-employed individuals can deduct 100% of health insurance premiums for themselves, spouse, and dependents as an above-the-line deduction—you don't need to itemize to claim it.

How much does health insurance cost for self-employed?

ACA marketplace costs average $400-$800/month for individuals before subsidies. With subsidies based on income, many pay $0-$200/month. Family plans range $800-$2,000+ monthly before subsidies.

What is the best health insurance for freelancers?

For most freelancers, ACA marketplace plans offer the best combination of comprehensive coverage and subsidies. Those with higher income may find private plans or health sharing ministries more cost-effective.

Self-Employed Health Insurance Guide (2025)

Health Insurance Options for Self-Employed

Overview of Options

Option	Coverage Type	Typical Monthly Cost	Best For
ACA Marketplace	Comprehensive	$0-$800+ (with subsidies)	Most self-employed
Spouse’s employer plan	Comprehensive	$200-$700 (employee share)	If spouse has job
COBRA	Comprehensive	$600-$2,000+	Short-term transition
Health sharing ministry	Alternative	$200-$500	Faith-based, healthy
Short-term health	Limited	$100-$300	Very short gaps only
Private insurance	Comprehensive	$500-$1,200+	High earners

ACA Marketplace (Healthcare.gov)

How It Works

Feature	Details
Open enrollment	Nov 1 - Jan 15 (most states)
Special enrollment	60 days after qualifying event
Subsidy eligibility	100-400% FPL (higher with ARP extension)
Plan levels	Bronze, Silver, Gold, Platinum
Income calculation	Modified Adjusted Gross Income (MAGI)

2025 Federal Poverty Level (FPL)

Household Size	100% FPL	150% FPL	250% FPL	400% FPL
1 person	$15,060	$22,590	$37,650	$60,240
2 people	$20,440	$30,660	$51,100	$81,760
3 people	$25,820	$38,730	$64,550	$103,280
4 people	$31,200	$46,800	$78,000	$124,800

Premium Subsidies (Premium Tax Credits)

Your Income (% FPL)	Max % of Income for Premiums
100-150%	0-4%
150-200%	4-6.3%
200-250%	6.3-8.5%
250-300%	8.5%
300-400%	8.5%
Above 400%	8.5% (enhanced through 2025)

Subsidy Example: Single, $50,000 Income

Calculation	Amount
Income	$50,000
% of FPL	~332%
Max premium contribution	8.5% = $4,250/year
Full-price Silver plan	$7,800/year
Subsidy	$3,550/year
Your cost	$354/month

Income Level	Available On	Benefit
100-150% FPL	Silver plans	Significant deductible/copay reduction
150-200% FPL	Silver plans	Moderate reduction
200-250% FPL	Silver plans	Some reduction

Tip: If income is under 250% FPL, Silver plan with CSR often beats Bronze on total cost.

Plan Level Comparison

ACA Metal Tiers

Level	Actuarial Value	Monthly Premium	Deductible	Best For
Bronze	60%	Lowest	$6,000-$8,000	Healthy, low utilization
Silver	70%	Moderate	$3,000-$5,000	Moderate utilization, CSR eligible
Gold	80%	Higher	$1,000-$2,000	Regular healthcare needs
Platinum	90%	Highest	$0-$500	High utilization

Example Costs (Individual, 40 years old)

Plan	Monthly Premium*	Deductible	Max Out-of-Pocket
Bronze	$350	$7,500	$9,200
Silver	$450	$4,500	$9,200
Gold	$550	$1,500	$8,700
Platinum	$650	$250	$4,000

*Before subsidies; varies significantly by location and insurer

Which Plan Level to Choose

Your Situation	Best Level
Rarely see doctors, want catastrophic protection	Bronze
Income 100-250% FPL	Silver (get CSR!)
Regular prescriptions or conditions	Gold
High healthcare needs, prefer predictability	Platinum
Planning pregnancy	Gold or Platinum

Self-Employed Health Insurance Deduction

How the Deduction Works

Feature	Details
Type	Above-the-line (don’t need to itemize)
Amount	100% of premiums
Covers	You, spouse, dependents
Limitation	Can’t exceed self-employment income
Where to claim	Form 1040, Schedule 1

Tax Savings Example

Your Tax Bracket	Annual Premium	Tax Savings
22%	$8,000	$1,760
24%	$8,000	$1,920
32%	$8,000	$2,560

Note: This deduction does NOT reduce self-employment tax, only income tax.

Interaction with Premium Tax Credit

Situation	What to Do
Taking marketplace subsidy	Deduct only the premium YOU pay
Premium paid pre-tax from S-corp	No deduction (already tax-advantaged)
High income, no subsidy	Deduct full premium

Spouse’s Employer Plan

Often the Best Option

Advantage	Details
Group rates	Usually lower than individual
Employer contribution	Employer pays 50-80% of premium
Easier enrollment	No marketplace navigation
Comprehensive coverage	Usually broad networks

Cost Comparison

Option	Your Monthly Cost
Marketplace (with subsidy)	$350
Spouse employer (add spouse)	$300
Spouse employer (family)	$500

Ask spouse’s HR: What does it cost to add you to their plan?

How They Work

Feature	Details
Not insurance	Members share each other’s costs
Monthly share	$200-$500 individual, $500-$1,200 family
Large medical bills	Shared among members
Pre-existing conditions	Often excluded or limited
Preventive care	Usually not covered

Program	Monthly (Individual)	Monthly (Family)	Notes
Medi-Share	$180-$450	$450-$800	Christian values required
CHM	$95-$300	$500-$700	Lower cost option
Samaritan	$250-$400	$500-$700	Prayer requirement
Sedera	$200-$400	$500-$800	Non-religious option

Pros and Cons

Pros	Cons
Lower monthly cost	Not regulated as insurance
Sharing community	Pre-existing conditions excluded
No mandate penalty	Limited coverage for some conditions
Can combine with HSA plans	No guarantee of payment

Good Fit	Not Good Fit
Healthy, few medical needs	Chronic conditions
Align with faith requirements	Need guaranteed coverage
Want lower monthly costs	Pregnancy planned soon
Comfortable with uncertainty	Want comprehensive care

Short-Term Health Insurance

Overview

Feature	Details
Duration	1-12 months (varies by state)
Coverage	Limited (often excludes pre-existing)
Cost	$100-$400/month
ACA compliant	No
Network	Often narrow

When It Makes Sense

Situation	Use Short-Term?
Between jobs (< 3 months)	Maybe
Waiting for employer coverage	Maybe
Long-term coverage	No
Has pre-existing conditions	No

HSA Eligibility

Health Savings Account Rules

Requirement	To Qualify
Insurance type	High-deductible health plan (HDHP)
2025 minimum deductible	$1,650 (individual), $3,300 (family)
2025 max out-of-pocket	$8,300 (individual), $16,600 (family)
Other coverage	Cannot have non-HDHP coverage

2025 HSA Contribution Limits

Coverage	Limit	Catch-up (55+)
Self-only	$4,300	+$1,000
Family	$8,550	+$1,000

HSA Tax Benefits

Benefit	Details
Contributions	Tax-deductible
Growth	Tax-free
Withdrawals (medical)	Tax-free
Triple tax advantage	Most powerful savings vehicle

Decision Guide

Choosing Your Best Option

If You…	Consider
Qualify for subsidies	ACA Marketplace
Have spouse with employer plan	Add to spouse’s plan
Earn over $60K single	Compare marketplace vs private
Are very healthy, want low cost	Bronze HDHP + HSA or Health sharing
Have chronic conditions	Silver/Gold marketplace plan
Want maximum flexibility	ACA marketplace

Annual Cost Comparison Example

40-year-old single, $60,000 income, rarely uses healthcare:

Option	Annual Premium	Typical Utilization	Total Cost
Marketplace Bronze	$4,200 (after subsidy)	$500	$4,700
Health sharing	$3,000	$500	$3,500
Spouse’s plan	$3,600	$500	$4,100

40-year-old single, $60,000 income, regular healthcare needs:

Option	Annual Premium	Typical Utilization	Total Cost
Marketplace Silver	$5,400	$2,000	$7,400
Marketplace Gold	$6,600	$500	$7,100
Health sharing	$3,000	$5,000+ (not all covered)	$8,000+

Key Takeaways

ACA Marketplace works for most self-employed — Subsidies make it affordable
Spouse’s employer plan may be cheapest — Always compare
100% of premiums are tax-deductible — Significant tax savings
Silver plans with CSR are valuable — If income qualifies
Health sharing isn’t insurance — Understand the risks
Pair HDHP with HSA — Triple tax advantage for savers

Self-employed individuals can shop the ACA marketplace — see health insurance marketplace guide for plan selection guidance. For the HSA that works well with a high-deductible self-employed plan, see HSA vs. FSA. For the health insurance hub, see health insurance hub.

Written by WealthVieu

WealthVieu researches and writes data-driven personal finance guides using primary sources including the IRS, Bureau of Labor Statistics, Federal Reserve, and Census Bureau.

The content on Wealthvieu is for informational purposes only and should not be considered financial, tax, or investment advice. Consult a qualified professional before making financial decisions. Full disclaimer · Editorial policy