Health insurance for the self-employed

Who this is for

If you work for yourself, you’re responsible for your own health coverage — and you have plenty of company. Freelancers, gig and contract workers, sole proprietors, single-member LLCs, partners, and S-corp owners all fall into this group. The good news is that the Health Insurance Marketplace was built largely for exactly this situation: people who don’t get coverage through an employer.

The Marketplace is your main option

For most self-employed people, a Marketplace plan is the right home base. It’s ACA-compliant, so it covers pre-existing conditions and the essential health benefits, it can’t turn you down, and it may come with a premium tax credit based on your income. It’s a far more reliable foundation than a short-term plan, which can exclude pre-existing conditions and skip benefits — a trade-off our comparison lays out.

Two tax breaks worth knowing

Working for yourself comes with a double benefit at tax time. The self-employed health insurance deduction lowers your taxable income, and the premium tax credit lowers your premium based on income — and the two can stack. If you choose an HSA-eligible plan, which as of 2026 includes Bronze plans, you can add a Health Savings Account for a third tax advantage. Few other groups get to layer benefits this way.

The income question

Subsidies hinge on your net profit, projected for the year, and self-employment income is famously hard to predict. Estimating it well is the difference between a smooth year and a surprise at tax time — especially now that the cap on repaying excess credits is gone. Our guide to estimating your income covers how to project it and adjust as you go.

If you’ve incorporated

Once you’ve set up an S-corporation, the rules for deducting your premiums change — they have to run through your W-2 in a specific way, which our guide for S-corp owners walks through. And if you’ve grown to the point of covering employees rather than just yourself, that’s a different framework again, with arrangements like an ICHRA or QSEHRA.