Self-employed health insurance: What to know and where to start
Discover UPMC Health Plan’s individual and family plans tailored for self-employed professionals.
According to data from the Pew Research Center, roughly 15 million Americans are self-employed, accounting for approximately 10 percent of the U.S. workforce. If you’re part of this group, such as a freelancer or independent contractor, you won’t be able to access health coverage through an employer. Fortunately, there are plenty of alternative options for self-employed medical insurance—including family, individual, private, and public plans. In this guide to health insurance for self-employed workers, we’ll answer some FAQs about selecting coverage, helping you find the best plan for your unique health care needs.
Who is considered self-employed?
Self-employment is a broad category that includes many different types of workers. Here are a few examples of workers considered to be self-employed:
- Consultants
- Gig workers
- Freelancers
- Independent contractors
- Online content creators
- Single-member LLCs
- Small business owners
- Social media influencers
Why you should have health insurance if you’re self-employed
We understand that having health insurance can feel like an added expense when you are self-employed. Not to mention that with so many responsibilities to keep track of, you may not have time to shop for a health insurance plan. However, the truth is that your health is your most valuable asset and should be a top priority. Insurance will give you access to services that help you get and stay healthy, like annual check-ups and preventive screenings—but the perks of having coverage don’t end there.
No matter where you live, having coverage will help keep your medical costs down while expanding your access to care, making independent contractor health insurance a smart investment for any self-employed worker. Just remember that you’ll need to enroll yourself, since you won’t have access to employer-sponsored coverage.
Five benefits of having health insurance when you are self-employed
1 – Potential tax deduction and financial aid
On the fence about health insurance? It is more affordable than you might think. There are two types of financial assistance for health insurance that you might qualify for. One is an Advance Premium Tax Credit (APTC), which helps with the monthly premium cost. The other is a Cost Share Reduction (CSR), which lowers the cost at the point of service. For example, it can lower your copay when you see the doctor. Learn if you qualify for either of these using our tax calculator.
2 – Essential health benefits
Affordable Care Act (ACA) compliant plans will provide coverage for 10 essential health benefits. These services may include vaccinations and screenings, among other things.* Being in the know can help you understand the actions you should take to maintain your health and well-being.
3 – Free wellness programs
Some health insurance providers, such as UPMC Health Plan, offer wellness programs at no additional cost. These can help you quit smoking, lose weight, eat healthy, reduce stress, and more. Improving your health can help you have more energy and better focus. It can even help you be more productive during the day and sleep better at night.
4 – Telemedicine and digital tools
Your access to health care should keep up with your fast-paced world. When you shop for health insurance, ask about plans that include telemedicine services and apps, like UPMC VirtualCare. Services like this are flexible and convenient, regardless of where life takes you.
5 – Direct access to an outstanding network of doctors and hospitals
To be your best at work, you need to be at your best health. Unfortunately, there may be times when you need urgent or emergency care. If you don’t have health insurance, receiving care can be extremely costly. That’s why it’s critical to have coverage through a plan with a robust network. That way, you can get the care you need, no matter where you work, live, or travel.
How much do self-employed health plans cost?
The answer to this question is different for everyone, because there are numerous factors that can affect the cost of a self-employed health plan. Here are just some of them:
- Your age
- Your income
- Which U.S. state you live in
- How many people need coverage
- Your monthly premium
- Copays and coinsurance
- The cost of your deductible
Depending on factors like your income, location, and what type of coverage you’re seeking, you may be eligible for a subsidy or cost-sharing reduction (CSR). This can help make coverage more affordable. For example, you may qualify for financial assistance through Pennie®, which is Pennsylvania’s health insurance marketplace.
Explore your plan options with UPMC Health Plan
From free counseling sessions and preventive care to 24/7 virtual urgent care from top-rated doctors and hospitals, UPMC Health Plan offers flexible coverage for self-employed workers. Find the health insurance plan that’s right for you and your family, or contact us for one-on-one support from a representative.
[Disclaimers]
*Not all preventive services are recommended for every patient every year. Talk to your doctor about the preventive services that are recommended for you. For a list of preventive services and guidelines, visit upmchp.us/prevent.
**UPMC Health Plan members who are in Pennsylvania at the time of a virtual visit may select a UPMC-employed provider, subject to availability and discretion of the provider. Members located outside of Pennsylvania at the time of service or those who select Talk Therapy or Psychiatry services will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans who have opted out of coverage. Providers are not available to treat members who are in Puerto Rico.
*** Only the virtual visit with the provider will be covered at 100 percent. Prescription drug and other costs related to the visit or recommended by the provider will not be included in the virtual visit coverage and will be your responsibility. If you are enrolled in the UPMC Advantage Silver HSA $4,000/$0, UPMC Advantage Gold HSA $2,500/10%, or UPMC Advantage Catastrophic $9,200/$0 plan, UPMC AnywhereCare virtual visits will be covered at 100 percent after you meet your deductible. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.
