Health Insurance When You Are Self-Employed: Your Options

Where self-employed people usually get coverage

The main route is the individual Marketplace. HealthCare.gov says self-employed people can use it to enroll in coverage, and that a business with no employees generally does not qualify for group coverage. Plans are sold in metal tiers, and you pick one based on monthly premium versus what you pay when you use care.

Other routes include a spouse or partner's employer plan, a parent's plan if you qualify as a dependent, and Medicaid if your household income is low enough in your state. Income limits and rules differ by state, so check the current rules for yours.

Estimating your income

Marketplace savings are based on your expected yearly income. When your income moves up and down, you estimate it for the year when you apply. Net profit after business expenses is what generally matters, not gross sales. If your income changes during the year, you can update your application so your savings match.

When you can enroll

Most people can enroll during the annual open enrollment period. Outside it, you generally need a qualifying life event, such as losing other coverage, moving, or a change in household size. Medicaid enrollment is open all year. See our guides on Marketplace open enrollment, how to apply for Medicaid and what to do after losing insurance.

Picking a plan if your income is unpredictable

A plan with a lower premium and a high deductible leaves you paying more of your own costs before coverage helps. A plan with a higher premium usually has lower costs when you use care. If you expect to need regular care or prescriptions, add up your likely yearly costs under each plan, not just the premium. Our guide on what a deductible is explains how the pieces fit.

If you are uninsured for now

Many routine needs can be paid in cash at a known price. Ask for the self-pay price before a visit, and see our guide on asking for a self-pay discount. Federally funded community health centers charge based on income, and our page on community health centers explains how to find one. For typical cash prices, browse medication prices, lab test prices and visit prices.

Pay for care with a health savings account

If you buy a high-deductible plan that qualifies, you may be able to open a health savings account. The IRS sets the 2026 limit at $4,400 for self-only coverage. Contributions and rules depend on your plan and tax situation, so read the IRS publication below or ask a tax professional. Our guide on HSA vs FSA covers the basics.