The Self-Employed Guide to Health Insurance

Without an employer group plan, self-employed professionals generally choose between an ACA Marketplace plan, a private PPO plan, or in some cases a health-sharing ministry (which is not insurance and carries real coverage gaps worth understanding before enrolling).

Income variability is the main planning challenge: Marketplace subsidies are based on estimated annual income, so a strong year can trigger a subsidy repayment at tax time. Private PPO premiums don't fluctuate with income, which some self-employed clients prefer for budgeting predictability.

If you also run a small team, an ICHRA or QSEHRA can let you reimburse employees (including yourself) for individually-purchased coverage tax-free — worth a dedicated conversation once you're ready to hire.