When you work for yourself, nobody splits the premium with you. That changes which options make sense, and it changes the math on all of them.
Your four options, in the order worth checking
A spouse's employer plan if one exists. Medicaid if your income qualifies. A subsidized marketplace plan. A private PPO.
Most self-employed people jump straight to the marketplace, see the unsubsidized number, and stop. That is the expensive mistake.
The subsidy cliff is the whole game
ACA premium tax credits taper with income. Just below the threshold, the marketplace is excellent value. Just above it, you pay the full unsubsidized premium and it stings.
If you are near that line, estimate your year carefully — and check both paths rather than assuming.
The self-employed health insurance deduction
If you're self-employed and not eligible for an employer-subsidized plan, premiums are generally deductible above the line — which changes the effective cost of every option on this list.
This is a real tax matter with real conditions attached. Talk to your accountant rather than to a website about the specifics.
What to have ready when you talk to an advisor
It's a short list, and none of it is sensitive:
- Your state and household size.
- Whether anyone needs a pre-existing condition covered.
- Your current prescriptions, if any.
- The doctors you'd want to keep.
General information only. Not insurance, tax or legal advice about your situation, and not a price offer. Plan availability, pricing and underwriting rules vary by state and carrier.
