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Self-employed · 1099 · freelancers · solo owners · all 25 states

What Is the Best Health Insurance for Self-Employed People? It Depends on Three Things

Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published October 13, 2026 · Updated October 13, 2026

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There is no single best health insurance for self-employed people, and anyone who names a plan before asking you three questions is selling, not advising. The best plan for you depends on your income, your health, and your household. Under the premium tax credit line, the marketplace is the only door where that credit exists. Over the line and healthy, a private plan priced on your own health or a pre-established ERISA group plan usually costs less and buys a wider network. Living with a serious diagnosis, the marketplace plan is the right door for now, because it cannot turn you down. Below: the five doors, the 2026 prices, the 2026 and 2027 income lines, the tax write-off, the open enrollment dates, and a link to your state. I educate, you decide.

I'm Dick Tracy, a health insurance broker. My office is in Buffalo, New York, I hold licenses in 25 states, and I work with 80+ carriers, so I have no reason to push one door over another. Most of the people I sit down with work for themselves: contractors, consultants, realtors, truckers, therapists, designers, and freelancers of every kind. I spent years on the healthcare side before I left it, so I know how the bills get made and I can say so.

Benchmark: KFF (2026). Credit lines: 2025 HHS poverty guidelines and 2026 HHS poverty guidelines, 400% of the one-person figure. Dates: healthcare.gov.

What "best" actually means when you work for yourself

Employees get one plan handed to them. You get to choose, which is the good news and the bad news. Every plan a self-employed person can buy is "best" for somebody, and the same plan is a mistake for the person next to them. Before I look at a single carrier, I need three facts.

• Your income, measured the right way. Net profit after expenses, not gross receipts, decides whether a premium tax credit exists for you. For 2026 coverage the credit stops at 400% of the poverty line: $62,600 for one person, $128,600 for a household of four. For plans starting January 1, 2027 the lines move to $63,840 and $132,000. One dollar over and the whole credit is gone, and since the 2026 plan year there is no cap on paying back a credit you were not entitled to (the full knockout list is here). A 1099 income that swings makes this the hardest fact to pin down, and the MAGI calculator gets you the number the marketplace actually uses.
• Your health, over the last several years. Off the marketplace, in most of my 25 states, some carriers sell plans that are not marketplace-style plans at all: they ask health questions, price you on the answers, and can decline you or exclude a condition you already have. Clean answers usually mean a lower premium than the one-price marketplace charges a healthy person. A serious diagnosis in the last five years usually sends the answers the other way, and then the marketplace plan, which cannot say no, is the right answer for now. New York does not allow health questions on an individual plan at all, which changes the order of the doors there. Here is how old conditions are actually handled.
• Your household. Who goes on the plan, how old they are, and whether anyone in the house is offered a plan at work. An offer of affordable coverage from a spouse's employer can take the premium tax credit off the table, and it ends the self-employed deduction for every month the offer stands. A single freelancer at $130,000 and a family of four at $130,000 are in two different worlds: the first is well over the credit line, the second is under it for 2027 coverage.

The five doors a self-employed person can walk through

Every real option fits in one of five doors. I open them in a different order depending on the three facts above, so read all five before you decide which one is yours.

How much does health insurance cost when you're self-employed?

Here are the published averages, so you have an honest anchor before anyone quotes you. For a 40-year-old buying alone in 2026, before any subsidy, the marketplace looks like this nationally and in the five states where I get the most self-employed calls:

Source: KFF analysis of 2026 marketplace data, lowest-cost plan per tier and second-lowest-cost Silver, weighted by where people enrolled.

Read that table twice, because it hides as much as it shows. Those are marketplace prices, and a marketplace plan cannot ask about your health, so the $625 benchmark is the same for a 40-year-old marathoner and a 40-year-old with three prescriptions. Notice that the lowest Gold sits below the benchmark Silver in four of the six rows. Most of that is the Silver loading from Door 2, fine if a credit pays most of it, a trap if you pay full freight; the rest is the comparison itself, since the Silver column is the second-cheapest plan and the Gold column the cheapest, which flatters Gold a little. New York's $817 is the price of a market with no underwriting at all. Texas and Florida run above the national average even though underwriting is allowed there, so a healthy Texan or Floridian has the most to gain from pricing the underwritten door against it. Your own number moves on age, ZIP code, tobacco, network, and whether the plan is underwritten. Give me those five facts and you get real quotes, usually the same day. For a couple or a family, the monthly cost ballpark page walks the math.

The income lines for 2026 and 2027 coverage

The premium tax credit is figured on the poverty guidelines in force when the plan year begins, so 2026 plans use the 2025 guidelines and 2027 plans use the 2026 guidelines. Here is where the credit ends, by household size, and where Medicaid for adults begins in the states that expanded it. A slow first year of self-employment can land you below the Medicaid line, and that is real coverage, not a consolation prize.

Sources: 2025 HHS poverty guidelines ($15,650 for one person, add $5,500 per additional person; 2026 coverage); 2026 HHS poverty guidelines ($15,960 for one person, add $5,680 per additional person; 2027 coverage and 2026 Medicaid). Add $22,000 at the 2026 cliff and $22,720 at the 2027 cliff for each additional person. Alaska and Hawaii use higher guidelines. Medicaid applies only in states that expanded it; your state page says whether yours did. The 400% and 138% columns are my multiplication of the published guidelines.

The enhanced credits that erased the 400% line expired at the end of 2025, and KFF reports the average marketplace enrollee paid 58% more for premiums in 2026 as a result, and that is after many people moved to cheaper plans with higher deductibles (114% more for those who kept the same plan). The line is back, and it is a cliff, not a slope. If you are under it, a subsidized marketplace plan, or Medicaid if you are under that line, may honestly be the best deal you can get, and I will tell you so. Here is the cliff explained in full.

Don't forget the write-off

Whichever door you walk through, the premiums are usually deductible on your federal return through the self-employed health insurance deduction, figured on IRS Form 7206. The IRS instructions set the terms: you qualify with a net profit on Schedule C or F, partnership earnings reported on your K-1, or wages as a more-than-2% S corporation shareholder; the plan has to be established under the business; the deduction covers medical, dental, vision, and qualified long-term care premiums for you, your spouse, your dependents, and a child under 27 at year end; it is capped at the net earnings of that business; and it comes off on Schedule 1 of Form 1040, so you don't have to itemize. The knockout is the one people miss: you cannot take it for any month you were eligible for an employer-subsidized plan, including your spouse's, even if you never joined it. Some states follow the federal deduction and some do not, so check your state page. Run your figure on the free self-employed deduction calculator, confirm it with your tax professional, and remember the plan is the bigger lever. A cheaper plan saves you money twelve months a year. The deduction only gives some of it back in April.

2027 premiums are going up, and here is when you can act

Insurers filed for a median increase of about 15% on 2027 marketplace plans, per KFF's October 6, 2026 fact sheet, citing a sicker risk pool after effectuated enrollment fell from 21.8 million to 19.2 million in 2026, and, in KFF's July 2026 review of the filings, rising medical and prescription drug costs. State regulators then approve their own numbers: New York 6.0%, Colorado 10.0%, Connecticut 11.3%, Maryland 14.6%, Pennsylvania 15.97%, and the list grows weekly on the 2027 premium tracker. Those are individual-market averages before any credit, per each state's insurance regulator. A privately underwritten plan or a pre-established ERISA group plan is priced on a different pool, which is the whole point of shopping more than one door.

In most states, open enrollment for 2027 marketplace plans runs November 1, 2026 through January 15, 2027, and enrolling by December 15, 2026 is the expected deadline for a January 1 start (a federal judge vacated the nationwide December 15 end-date rule in June 2026, and the appeal is pending). States that run their own exchanges set their own calendars: California takes applications through January 31, 2027, and New York and New Jersey are expected to do the same once they post their 2027 calendars. Connecticut and Massachusetts open early on October 23, 2026, and their closing dates differ from the federal calendar, so check the open enrollment 2027 page for yours; every state's window is there. Doors 3, 4, and 5 aren't tied to the window, so a healthy self-employed person can buy those any month of the year. Miss the marketplace window and you'll need a qualifying life event, like losing other coverage or moving, to get in before next fall.

Which door is for me?

Common questions from self-employed people