Self-Employed

The Self-Employed Guide to Health Insurance

Freelancers and entrepreneurs face unique challenges. Here is every option explained clearly.

8 min read Updated 2026 Kohler Health Advisors

Being self-employed comes with freedom — but health insurance is not usually one of the perks. Without an employer picking up most of the tab, figuring out coverage can feel overwhelming. Here is the full picture, simplified.

Your Main Options

1. Private Marketplace Plans — My specialty and usually the best option. Off-exchange private plans offer broad PPO access, flexible plan design, and competitive pricing. Premiums are often fully tax-deductible as a business expense.

2. ACA Marketplace Plans — If your net self-employment income puts you in the right range, you may qualify for a premium tax credit that significantly reduces your cost. Without a subsidy, ACA plans are often expensive.

3. Health Sharing Plans — Not insurance, but cost-sharing between members. Much cheaper monthly contributions, but limited protections. Only suitable for very healthy individuals.

Tax Tip:

As a self-employed person, you can typically deduct 100% of your health insurance premiums from your federal taxes as an adjustment to gross income. A $400/month premium might effectively cost $280–$320/month after the deduction.

When to Review Your Coverage

Your income fluctuates as a self-employed person — which means your eligibility for subsidies can change year to year. Review your coverage options every fall before open enrollment to make sure you are not overpaying.

Let's Find the Right Plan for Your Business

We work with self-employed individuals every day. We'll compare private and ACA options for your income level and get you covered — usually within a week.

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