Self-Employed
Self-Employed and Need Health Insurance? How the ACA Marketplace Works
When you work for yourself, choosing health insurance becomes one more responsibility that used to belong to an employer.
Freelancers, consultants, independent contractors, gig workers, and other self-employed people may be able to get health coverage through the Health Insurance Marketplace.
But shopping for coverage isn't only about finding the lowest monthly premium. Your expected household income, family size, doctors, prescriptions, and how you use healthcare can all affect what makes sense for you.
Can self-employed people get ACA Marketplace insurance?
Yes. HealthCare.gov says self-employed people can use the individual Health Insurance Marketplace to enroll in health coverage.
If you run a business that brings in income and don't have employees, you're generally considered self-employed for Marketplace purposes. That can include freelancers, consultants, independent contractors, and other people working for themselves.
If your business has employees, different small-business coverage rules may apply.
Can being self-employed qualify you for Marketplace savings?
Being self-employed doesn't automatically determine whether you qualify for financial assistance.
When you apply, the Marketplace looks at information including your expected household income and household size to determine whether you qualify for premium tax credits or other savings.
That distinction matters because two self-employed people running similar businesses can have very different household situations.
Which income matters when you're self-employed?
HealthCare.gov says self-employed applicants should estimate their net self-employment income for the year they're seeking coverage.
Marketplace savings are based on expected income for the coverage year — not simply what you earned last year.
That's useful when your business is growing, slowing down, seasonal, or relatively new. But it also means your income estimate deserves attention.
What if your business income changes during the year?
Variable income is normal for many self-employed people.
HealthCare.gov says to make your best estimate using your experience, realistic expectations, expenses, and other available information. If your expected annual income later changes, update your Marketplace application as soon as possible.
Keeping that estimate current matters because the amount of financial assistance you're eligible for can change along with your income.
Don't look at your business income by itself
The Marketplace generally considers expected household income, not just the income from the person applying for coverage.
Depending on your household, that can include income from a spouse and certain tax dependents even when those family members don't need Marketplace coverage themselves.
This is one reason a quick conversation about your household can be more useful than assuming your business revenue alone determines what you'll pay for health insurance.
When can a self-employed person enroll?
Self-employment doesn't create a year-round Marketplace enrollment period by itself.
HealthCare.gov currently lists the federal Marketplace Open Enrollment Period as November 1 through January 15. Outside Open Enrollment, you generally need a qualifying life event that gives you a Special Enrollment Period.
Medicaid and CHIP have different enrollment rules and can be available throughout the year for people who qualify.
What should you compare besides the monthly premium?
The monthly premium matters, but it doesn't tell you everything about how coverage will work when you actually need care.
Before enrolling, consider the doctors and healthcare facilities you use, your prescriptions, deductible, copayments or coinsurance, expected healthcare needs, and the total amount you could be responsible for during the year.
A plan that looks inexpensive at first glance may work differently once you start using healthcare.
What if your spouse has employer coverage?
Having access to coverage through a spouse's employer can affect Marketplace financial assistance, depending on the coverage being offered and your household circumstances.
Don't assume that being self-employed automatically means Marketplace savings are available. Include information about other health coverage available to your household when completing the application.
Health insurance shouldn't become another full-time job
Running your own business already means wearing enough hats. Health insurance doesn't need to become another one.
Golden Milestone Services is an independent insurance agency that helps individuals and families understand available ACA Marketplace coverage from the insurance companies we represent. Assistance is available in both English and Hmong.
If you're self-employed, the best starting point is understanding your household, expected income, healthcare needs, and enrollment timing. From there, you can look at the coverage options available to you.
Common questions
Can I get ACA Marketplace insurance if I'm self-employed?
Yes. HealthCare.gov says freelancers, consultants, independent contractors, and other self-employed people without employees can use the individual Health Insurance Marketplace.
What income do I report to the Marketplace if I'm self-employed?
HealthCare.gov says to estimate your net self-employment income for the year you're getting coverage. Marketplace savings are based on expected household income for the coverage year rather than simply using last year's income.
What if my self-employment income changes during the year?
Update your Marketplace application when your expected annual income changes. That helps the Marketplace determine the financial assistance you're currently eligible for.
Can I enroll in Marketplace coverage anytime because I'm self-employed?
No. Self-employment by itself doesn't create year-round enrollment. You generally enroll during annual Open Enrollment or during a Special Enrollment Period if you experience a qualifying life event.
Does the Marketplace look at gross business revenue?
HealthCare.gov instructs self-employed applicants to report estimated net self-employment income. Marketplace financial assistance is based on expected household income and other eligibility factors.