According to the most recent data from the Bureau of Labor Statistics, there are 9.6 million self-employed workers in the U.S. That number is projected to grow to 10.3 million in 2023. One big consideration for self-employed workers is finding health insurance.
As I’m sure you know, this is a big topic.
Since I’ve had to go through the process, I wanted to provide some information about your options to help you navigate finding affordable coverage. There are many different considerations that go into selecting health coverage.
Make sure you consider all different angles and consult with your spouse before making a decision.
If you are lucky enough to have a spouse with access to an employer plan, that is likely your cheapest option. Otherwise, you may want to consider COBRA, or buying private insurance via healthcare.gov. If that isn’t an option you can look into health sharing services such as Medishare.
Before we get started, I wanted to address some questions that I’ve seen pop up here and there regarding health insurance for the self-employed.
Table of Contents
Can I Get Health Insurance if I’m Self-Employed?
In short, yes. There are several different options for securing health insurance coverage when you’re self-employed. If you do decide to go the self-employed route, make sure you add healthcare spending as a budget line item.
Don’t go without coverage because you think it’s too expensive. Even if you’re young and healthy, you never know when something could go wrong. It takes just one medical emergency for the bills to start piling up.
While having coverage in place is essential, review all of your options first. It’s important to do your research and consider all the different ways you can get coverage before making a decision.
How Much Does it Cost for Health Insurance if I’m Self-Employed?
According to eHealthInsurance.com, an online health insurance marketplace, the average price for an individual policy in 2021 was $450. Premiums for family plans cost an average of $1,437 per month.
The final price tag for your health coverage will depend on a number of factors including the type of plan you select if you qualify for any subsidies, your annual income, and so on. Here’s Healthcare.gov’s online calculator to help you estimate your health insurance costs.
I personally use a health sharing ministry vs actual insurance and I pay $350 per month to cover my family of five. Be sure the alternatives section below for more info.
Group Health Insurance vs. Individual Health Insurance
One of the first things you need to understand when buying health insurance is the difference between group health insurance and the individual kind. This is something that I didn’t have a firm grasp of going in and I think it helps to understand how these differ so that you know what to expect.
Individual health insurance is what you purchase if you can’t participate in a group plan. You buy this on the open market at a place like eHealthInsurance.com or Healthcare.gov.
Just to clarify, you can purchase individual insurance for your entire family. “Individual” doesn’t mean one family member.
Group health insurance is cheaper (with the exact same coverage) than individual insurance. Why? Because with group insurance, the risk is spread across a large number of people. Also, typically with group plans, your employer is picking up some of the costs.
Health Insurance Options if You’re Self-Employed
If you’re self-employed and don’t have employees, you’re looking at “individual” health coverage options. However, if you run a business with one or more full-time employees, you may be able to sign up for group health insurance as a “one-man group.” See this list of one-man group states.
Also, there are faith-based medical-sharing ministries, like Medi-Share, that could be a good option depending on your health care coverage needs.
Below are some options to consider when looking for health insurance coverage as a self-employed individual.
1. Spouse’s Plan
If you’re married and your spouse has group health insurance available through the workplace, this should be your first stop. As mentioned previously, group health insurance plans are often significantly cheaper than what you’ll find on the open marketplace.
In addition, you’ll get better coverage to go with the lower monthly premium.
Even if you’re not married, you may qualify as a domestic partner. Have your spouse check with the Human Resources department on the cost of coverage and conditions for adding another person to the plan.
First, know that if you recently left your job and were covered by a group plan there, you can take advantage of COBRA continued coverage. This means you’ll convert your existing group plan into an individual plan and pay the full price tag.
In my case, to continue with my old group plan, COBRA ended up being very expensive. I think a lot of newly self-employed folks find the same thing. That’s why I’m writing this post. 🙂
However, in some cases, taking advantage of COBRA can be a good option as a newly self-employed individual. Make sure you weigh all of the pros and cons and decide on which way to go before your COBRA eligibility runs out.
Another option to find health insurance is through Healthcare.gov, the government health insurance marketplace. You can find coverage for either an individual policy or as a small business.
Most states use Healthcare.gov to purchase health care coverage. However, certain states have their own websites where you can compare options and enroll. Here’s a quick list:
- District of Columbia
- New Jersey
- New Mexico
- New York
- Rhode Island
Open enrollment usually starts in November and runs through mid-December. Coverage for plans purchased during open enrollment begins on Jan. 1 of the following year.
If you miss open enrollment, you may still be able to purchase insurance if you qualify. Special enrollment such as life changes or circumstances can make it possible to purchase insurance at other times of the year.
4. Professional Associations
As I mentioned previously, there are certain professional organizations that offer health insurance plans. Becoming a member of an independent worker association or a professional organization can give you access to group insurance at discounted rates.
Do a quick search to find out what professional organizations are available in your line of work. If you’re looking for a more general option, check out the National Association for the Self-Employed, which offers help with purchasing health insurance coverage.
5. Short-Term or Temporary Coverage
While getting short-term or temporary coverage is not a great long-term strategy, it can tie you over while you find something more permanent. Short-term insurance plans provide individual healthcare coverage for a defined period of time, up to 364 days.
These plans come with a renewal option so you can extend your coverage beyond the initial period. Many of these plans offer limited benefits and may not cover certain conditions such as pregnancy. Make sure you read the fine print before signing up for a temporary plan.
With that said, these can be a good option to help offset some of the medical risks until you can find a permanent health coverage solution.
Health insurance is so expensive! Here’s how to get health insurance when you are self-employed.Click to tweet
Alternatives to Traditional Health Insurance Coverage
There are other options for obtaining coverage beyond the standard health insurance options for the self-employed. One such alternative is to go with a health care sharing ministry rather than a big health insurance carrier such as Aetna.
While health care sharing ministries are not insurance, they can provide a coverage safety net for medical expenses. They could be a viable and often cheaper alternative to traditional insurance so I wanted to share more information.
What are Health Care Sharing Ministries?
At its core, a health care sharing ministry facilitates the distribution of health care costs among members who have common ethical and religious beliefs. It’s important to note that health care sharing ministries do not accept the risk or make guarantees that they will pay for medical bills.
Most health care sharing ministries are oriented toward practicing Christians and aligned with the ideas and principles found in the Bible. They use it as the basis for the idea that members have a responsibility to help with each other’s medical needs.
The majority of health care sharing ministries require its members to be actively practicing Christians in the U.S. Some even require a signed affidavit from the members’ pastors as a condition of joining.
With all that said, there are a few that are more lenient and inclusive, even to people who are not practicing Christians. Below you can find information on some of the largest ministries to help you decide if this could be a viable option for you and your family.
Medi-Share started in 1993 with the idea of following a biblical model of health care–Christians helping Christians. Members share each other’s eligible medical bills and are also encouraged to pray for other members in need.
Your monthly share (similar to an insurance premium) is based on the age of the oldest applicant and how many family members are participating. The annual household portion (AHP) is similar to an annual deductible and ranges between $3,000 and $12,000.
The AHP you select at enrollment will determine how much you have to pay out-of-pocket before your bills are covered by the health share. Each month, your monthly share will be matched with another member’s eligible medical bills. You’ll actually get information on whose bills your share is helping pay each month.
Medi-Share does offer limited coverage for pre-existing conditions. Members can receive up to $100,000 per year once they’ve been faithfully sharing for 36 consecutive months. And once a member has been sharing for 60 consecutive months, he or she can receive up to $500,000 per year.
Medi-Share does not cover dental, vision, or hearing expenses. However, they do give members savings cards which can provide discounts of up to 30% for these expenses.
Christian Healthcare Ministries
Christian Healthcare Ministries (CHM) claims to be the first and longest-serving health cost-sharing ministry. They’ve shared more than $3.5 billion in members’ medical bills. It’s available in all 50 states as well as countries outside of the U.S.
There are three program options to choose from – Gold, Silver, or Bronze. Your monthly premium and maximum out-of-pocket costs will depend on which option you select. There’s also an optional Brother’s Keeper program to protect against catastrophic medical bills.
Limitations do apply for pre-existing conditions so keep that in mind when looking at this as an option. The ministry does have a pre-existing condition program but there are certain conditions that need to be met before you’re accepted and your bills are shared.
CHM does not cover dental, vision, hearing, or chiropractic care. For dental and vision discounts, CHM recommends that members join the Careington LivingWell Plan, but this will be an additional monthly expense.
Telemedicine: 24/7 Access to Online Doctors and Therapy
Telemedicine is another alternative to traditional health insurance that you may want to consider. Even if you have health insurance, telemedicine gives you access to a doctor or a therapist for a low fee. So it could still save money.
Telemedicine is the future of healthcare and so many new companies are trying to lead the way. With most of the companies, you can schedule a consultation with a doctor at any time and from anywhere.
When you want to schedule a consultation, simply call the helpline or log on to your member portal. A coordinator will then update your Electronic Health Record (EHR) with your symptoms.
Next, you choose from 100s or 1,000s of board-certified physicians through a web portal. Members can typically communicate with doctors via live video, phone, or email.
If you need a prescription, the doctor will send it to the pharmacy of your choice. Once your consultation is complete, the telemedicine company will update your EHR. Any doctors that you consult with in the future can see your full medical history via your EHR.
See this list of the best telemedicine companies from Healthline.
The Bottom Line
There are a number of different options for getting health insurance for self-employed individuals. Don’t let the fear of the unknown stop you from starting your own business. Make sure to compare all the different options before making a decision.
In addition to traditional insurance, check out health care sharing ministries as an alternative. They could be a good and affordable option for you in some circumstances. Do your research and make sure you’re comfortable with the risks before finalizing your decision.
Whatever you do, make sure you get medical coverage. Don’t let high costs be the reason you go unprotected or don’t get the necessary treatment. Your health is one of the most important things so make sure you’re covered.
Health Insurance Terminology You Need to Know
(this section contributed by Emily Guy Birken)
I recently decided that I needed to actually familiarize myself with what it is that our insurance covers and why we keep getting checks. Below is the cheat sheet for your health insurance terms.
Once you understand these, you’ll be in a better position to know your benefits and dispute problems—and keep your budget healthy!
Anyone who has ever carried car insurance knows that the deductible is the minimum amount that you must pay before you can get any benefits from the insurance company. The deductible is generally a yearly amount, so it resets every year.
The deductible can get to be hairy if you have several family members on the plan, as we do. We each have an individual deductible of $300, and then there is a cumulative deductible of $900. So if anyone of us incurs $900 or more in medical expenses, the benefits kick in for all three of us for the rest of the year.
Just to make things more complicated, we have a non-comprehensive deductible, meaning not all procedures will apply toward the deductible. For many policies, a regular checkup will not apply to the deductible, but a visit to the ER or surgery would.
This is the part that so confused me about the hospital stay for the birth of my son. I knew that we had met the deductible prior to my son’s birth, so I was confused as to why we still owed the hospital money.
That was because we had co-insurance, meaning that our policy will pay for 80% of a procedure or visit, while we are responsible for the remaining 20%. We had gone into the hospital thinking that we were completely covered, and came out with a somewhat hefty bill.
Luckily, most doctors and hospitals know that co-insurance can take anyone by surprise and will happily set up an interest-free payment plan for the remainder of the bill.
Make sure you avail yourself of this service because it really will help you to keep medical bills from eating up the rest of your budget.
This is the fixed amount that you will pay at the time of service or when filling a prescription. The one benefit to our new insurance plan is that it has no co-payments, so each doctor visit is simply a quick trip without having to take out the checkbook.
However, at least in our case, by trading out co-payments, we got a much more confusing policy.
4. Annual Out-of-Pocket
Most insurance policies set an annual cap at how much you will pay yourself, including deductibles, co-insurance, and co-payments. This will be a boon if you are ever plagued with a bad year, health-wise.
5. Lifetime Maximum
Your insurance company has decided ahead of time how much it can pay for the health of an individual or a family. This lifetime maximum is an important figure to know because if it is too low it could leave you with a very high bill at a time of great family stress, and it will leave you scrambling to find another insurer for the other members of the family.
Do make sure you know the difference between the individual and family lifetime maximum, as the numbers will often be different.
It’s important to understand your health insurance policy so that you will not be surprised by bills (or checks!) after you have had medical care.
It’s also important to make sure you’re getting the best care for your money, and you can only do that if you understand what options are available to you, both within your insurance policy and among other possible policies you may buy into.
No one wants to think about health insurance, but both your family’s health and finances are depending on it.
If you’re self-employed, what do you do for health coverage? How do you like it? Share in the comments.