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Lora Shinn is Investopedia's senior editor of insurance reviews, building on 15 years of experience covering insurance and other personal finance topics as a freelance writer and editor. Her articles have also been published by CNN Money, U.S. News & World Report, and Bankrate, among others.
Updated September 05, 2024 Fact checked by Fact checked by Maddy SimpsonMaddy Simpson is an experienced data journalist and fact-checker with a background in financial analytics.
Blue Cross Blue Shield is our pick for the best health insurance company for self-employed people because of its numerous advantages, including overall costs, widespread availability, huge provider network, and varied plan options. We also like Oscar for its low copays and Kaiser Permanente for its prices on Bronze and Silver plans.
Affordability and adequate coverage are essential when you’re a freelancer or otherwise self-employed. The Affordable Care Act (ACA) established a federal Health Insurance Marketplace and gave states the option to create their own marketplaces. These exchanges offer affordable plans for independent contractors, consultants, and gig workers. However, choosing the right insurance provider or plan can be challenging.
To identify the best health insurance companies for self-employed people, we evaluated nine major health insurance companies based on 40 criteria, including state availability, customer satisfaction, health management programs, tax incentives (the percentage of plan premiums eligible for premium tax credits), costs (copays, monthly premiums, and deductibles), dental coverage, and types of plans offered.
We used National Committee for Quality Assurance (NCQA) annual ratings to evaluate plan quality and customer satisfaction. The NCQA is a nonprofit organization that evaluates health plans for patient care quality, patient satisfaction, and health plans' efforts to improve.
Blue Cross Blue Shield (BCBS) is the best overall health insurance company for self-employed people for several reasons. It features the best overall cost scores of all providers we reviewed. The combined premiums, deductibles, and copays are more affordable than other providers on this list.
In addition, BCBS has the lowest-cost silver plans of all the insurers we reviewed. Older adults starting or winding down a business while waiting for Medicare to kick in will also find the best rates, according to our sampling of average costs for 60-year-olds.
BCBS is also our pick for the best overall health insurance company. With coverage in 36 states and a network of 1.7 million health care providers, you’re more likely to find available BCBS health care options. (For this analysis, we excluded Anthem from our BCBS evaluation because the two compete in some markets.)
Shoppers on the ACA exchange should find many choices, including plan types: health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), and point-of-sale (POS) plans, as well as six metal levels. BCBS also offers catastrophic plans, which may be a good fit for freelancers under 30 or those not yet earning much. Outside of traditional health insurance plans, BCBS offers short-term coverage and travel medical insurance for contractors headed overseas.
Third parties, including NCQA, generally give BCBS high ratings. However, since BCBS is a group of companies, member experience varies by region. For example, the J.D. Power 2024 U.S. Commercial Member Health Plan Study has BCBS in top positions in places like New York and Ohio but below average in other regions.
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Oscar is our top-ranked provider for copays, with the lowest physician-visit copays of the companies we researched. Copays are particularly affordable for silver plans.
Oscar’s solid app allows you to visit a primary-care physician for $0, providing a predictable charge for self-employed people with variable income. You can also use the app to message your care team or for prescription refills and virtual urgent care, even while traveling. The app rewards you for hitting daily step goals—between $25 and $100 per year, depending on your state.
Oscar offers a variety of plan types and every available type of medical management program we researched. These include programs for asthma, diabetes, depression, pain management, heart disease, high blood pressure and cholesterol, low back pain, and pregnancy. It’s also the only insurer we surveyed that offers a weight-loss program.
Oscar’s NCQA rating for member experience was 3 out of 5 stars, lower than most competitors. In addition, Oscar plans are only available in 18 states. And you can’t use the app to book a $0 primary-care doctor visit outside your home state, which could be a limitation if you’re a digital nomad.
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Kaiser offers affordable plans with excellent ratings. In many of the quotes we gathered, it had the lowest premiums available. However, that can mean higher out-of-pocket costs, so read the plan carefully.
Kaiser Permanente boasts the best average NCQA rating among all the providers we reviewed and is the only provider with a rating above 4 stars. Kaiser also dominates customer satisfaction rankings in many of the regions it’s offered, according to the 2024 J.D. Power Survey.
Self-employed people with limited schedules may like Kaiser because the company has its own hospitals and doctor’s offices. The provider-and-plan ecosystem may minimize paperwork and hassles.
However, Kaiser was the least-available plan we reviewed, only offering coverage in eight states and Washington, D.C. Some people may chafe at the plan’s HMO setup, which won’t cover out-of-network providers in most cases.
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Every Aetna plan sold on the federal marketplace is eligible for premium tax credits, which could reduce premiums to $0 for people who qualify for the maximum credit.
That doesn't mean they're entirely free. Some $0 bronze plans may have higher out-of-pocket costs (deductibles and copays) than higher-premium plans.
Even if you don’t qualify for tax credits, Aetna offers better-than-average rates across its plans. For example, Aetna has the second-lowest costs (premiums and deductibles) for bronze plans as well as for 45-year-olds and 60-year-olds.
Busy contractors who shop at CVS pharmacies will also appreciate the wide range of $0 MinuteClinic services included with Aetna’s plans. You can walk into a MinuteClinic (typically housed within a CVS) or book an appointment online. Aetna also throws in a quarterly $25 allowance to spend on CVS-branded wellness products and 20% off CVS Health brand products.
Aetna offers HMO, PPO, and EPO plans, and various medical management programs for different conditions. The company’s average NCQA rating is 3.46 out of 5 stars, which is better than average. Aetna was top-ranked for customer service in the 2024 J.D. Power Survey in several large U.S. regions, including the Northwest and Southwest.
Aetna is only available in 12 states. If you don’t live near a CVS, many of the plan’s best advantages may not be available. Aetna offers only three metal-level plans—the fewest among the providers we surveyed—and no catastrophic plans.
Research Insights"The Health Insurance Marketplace offers premium tax credits to help eligible people afford coverage. The amount of the credit is based on income level and household size, and can come either in the form of lowered premiums, or a lump sum when you file your taxes." –Shanker Narayan, Investopedia Research Analyst
Self-employed people must factor in the affordability of health insurance plans and available tax write-offs when shopping on the ACA exchange. Each insurer operates differently due to state regulations. The Blue Cross Blue Shield provider in your area may be best for balancing overall cost and quality. But if it operates in your state, Kaiser Permanente could be a good alternative if you want an HMO.
If you’re in good health, don’t need much beyond the essential health benefits (which are fairly expansive), and aren’t making much money with your business yet, an Aetna plan could be a good fit. Other contractors and freelancers may want the stability of $0 copays for routine physician visits, which you can get with Oscar. Research the plans available in your area and weigh all costs beyond premiums, including deductibles, copays, and coinsurance.
The Biden administration finalized a rule, effective June 2024, that lets people with a projected household income at or below 150% of the federal poverty level get a special enrollment period for health insurance through the Marketplace. Most people with these income levels qualify for help paying for premiums. The rule could be helpful for self-employed people facing tight margins after tax season.
The cost of health insurance for self-employed people can vary depending on your plan, location, and age. The average monthly premium for a Marketplace plan is $477. But more comprehensive plans can cost more, while subsidies can help you save. It's important for self-employed people to carefully compare plans and consider both their up-front premium costs and potential out-of-pocket expenses.
If you have a net profit for the year, you may be eligible for a tax deduction for premiums you pay on a health insurance policy for yourself, as well as your spouse and dependents.
"Another consideration alongside plan type is metal tier. The tiers–Bronze, Silver, Gold, and Platinum–don’t refer to the quality of a plan, but rather the relationship between monthly premiums and out-of-pocket costs, like deductibles, coinsurance, and copays. Typically, the higher the metal tier, the lower your maximum out-of-pocket contribution. Once you meet this limit, you will be fully covered for any additional care you receive. If you have ongoing health issues and need frequent care, or expect to undergo prolonged treatment, a Gold or Platinum plan could better suit your needs." –Shanker Narayan, Investopedia Research Analyst
Investopedia collected and analyzed hundreds of key data points from nine companies to identify the most important factors for readers choosing a health insurance company for the self-employed. We used this data to review each company for state availability, customer satisfaction, costs, and other features to provide unbiased, comprehensive reviews to ensure our readers make the right decision for their needs. Investopedia launched in 1999, and has been helping readers find the best health insurance companies for the self-employed since 2020.
The Health Insurance Marketplace considers you “self-employed” if you make money from your business but don’t have any employees to report on a W-2 form at year’s end. Business owners with employees must use a different small business insurance marketplace—the SHOP Marketplace—to find insurance for staff. However, you’re still considered “self-employed” if you hire independent contractors.
Your Marketplace application relies on estimating your upcoming year’s self-employment net income or profit after expenses. Estimate this amount based on your past net income history, expectations, and industry standards. If your income changes dramatically over the year, you must update this estimate in the Marketplace. The Marketplace can ask you to prove your self-employment income with a spreadsheet or accounting software program.
If you’re self-employed and have a net profit for the year, you can take an income tax deduction for your health insurance costs—specifically, the premiums you pay. This deduction is an adjustment to your income rather than an itemized deduction. Form 1040 or 1040-SR and Schedule SE offer instructions on calculating and claiming the deduction.
Marketplace plans may offer a premium tax credit based on your income if you earn between 100% and 400% of the federal poverty level (FPL). You can use any or all of the tax credit to help pay your premiums. However, determining how your premium tax credit interacts with self-employment deductions can be complicated. Consult a tax professional or use the IRS’s Publication 974 for helpful worksheets.
Blue Cross Blue Shield is our pick for the best health insurance company in Texas. It offers plans in every metal tier, including catastrophic, and many include dental coverage. Its gold plans have relatively low deductibles, but premiums are high for bronze and silver plans.
To identify which health insurance companies to review, we analyzed business and market insight databases, considered health insurance company market share, and researched user-generated data from Google to determine public interest and trends in health insurance companies and plans.
We collected data from the National Committee for Quality Assurance (NCQA), an independent organization that rates health care plans on quality and patient satisfaction. We also gathered data from state and federal government health insurance marketplace websites and databases, and directly from companies via websites, media contacts, and existing partnerships. The data collection process took place between Sept. 29 and Oct. 23, 2023.
We then developed a quantitative model that scores each health insurance provider based on 27 criteria that fall into four major categories and are crucial in evaluating the company’s offerings and benefits. We weighted the four categories as follows for this article:
Read our full methodology for reviewing health insurance companies.
