Self-Employed Health Insurance

The two problems that make this different

An employee's coverage is chosen for them, subsidized by payroll, and renewed automatically. None of that is true for you, and two specific things follow from it.

• Your income moves. A good quarter and a slow quarter can look like two different households on paper. Exchange subsidies are calculated against projected annual income, so guessing high or low has consequences at tax time. Medically underwritten private premiums do not depend on your income at all — they are set by age, household, state and health.
• You carry the whole premium. There is no employer contribution, so the difference between a $359 plan and a $509 plan is entirely yours. That makes plan structure worth real study rather than a five-minute decision.

What self-employed households actually end up buying

Across the plans we place, self-employed buyers cluster into four patterns. Which one fits depends far more on your health history and your state than on your business, and availability varies by state, carrier and plan.

"Private health insurance" is an umbrella term for several different structures: medically underwritten major medical style plans, fixed indemnity, ERISA and association coverage, short-term medical and supplemental products. They are not all ACA-compliant major medical, so it matters which one you are actually buying.

1. A medically underwritten major medical style plan on a national PPO. LifeX is the common one here. You answer health questions, and if you are healthy the price reflects that. It is the closest thing to what an employer plan feels like.
2. A layered design. Medical Mutual Protect is a fixed-indemnity plan that pays set amounts for day-to-day care, usually paired with Medical Mutual Protect Catastrophic — $1,000,000 per person per year after a $5,000 deductible. Two premiums, one package. Indemnity is not major medical on its own, and we will not pretend otherwise.
3. A guaranteed-issue fallback. If health history rules out the underwritten plans, Enrollment First SelectMed Bronze Pro is membership-style coverage nobody is declined for. It is not major medical, and availability varies by state. It is the floor, not the goal.

What it costs: published 2026 rates

Two of our plans publish rates. Everything else is quote-required, and we will not estimate it. These are real carrier rate sheets and brochures, not averages.

Source: Bright Life carrier brochures, rates effective 9/1/2026, at the $3,500 deductible — the lowest-premium of three levels. Bright Life is not available in AK, HI, MD, MN, NH, OR, VT, WA or DE. LifeX publishes rates on the PHCS PPO network in 43 states plus DC.

The other published option

LifeX on the PHCS PPO at the $1,500/$3,000 deductible, effective 1/1/2026, runs $369 to $509 a month for a single adult depending on age band (45–54 single is quote required), and $999 to $1,129 for a family. It is not available in AK, HI, MD, MN, NH, OR, VT or WA.

A fuller breakdown of both plans, including couple and child-only rates, is on private health insurance cost.

Why underwritten coverage often prices well for a healthy self-employed household

ACA exchange plans are community rated. Everybody in your area and age band pays the same premium whatever their health, because the plan must accept everyone. That protection is valuable and it is the right choice for a lot of people.

Medically underwritten plans price your household on its own risk instead. If you and your spouse are in good health, you are not paying into the cost of anyone else's claims, and it often costs less than an unsubsidized exchange plan, though this depends on health, household, location and subsidy eligibility.

The honest caveat: if your household qualifies for a large premium tax credit or a cost-sharing reduction, that subsidy is very hard to beat and the exchange is usually your better financial deal. Private coverage tends to win for households getting little or no subsidy. A licensed agent will tell you which side you are on rather than selling past it.

Underwriting: what the health questions really do

This is the part people are most anxious about, so here is how it behaves in practice.

• A clean history usually means a standard offer at the published rate.
• A managed, stable condition may still be accepted, sometimes with a higher rate or a rider excluding that specific condition.
• A significant or recent history can be declined. Underwritten plans can decline, and no honest agent will promise acceptance.
• If you are declined, guaranteed-issue coverage still exists, so there is always a floor — membership-style rather than major medical, and available in most but not all states.
• Nothing is final until the carrier confirms it at application. Benefits, exclusions, limitations, rates and availability all vary by state.

You do not have to wait for open enrollment

Exchange plans require open enrollment or a qualifying life event. Private medically underwritten coverage generally has no annual enrollment window — you can apply in any month, subject to underwriting.

For self-employed people that matters, because the moment you decide to fix your coverage is rarely November. If you are between contracts or starting one mid-year, 1099 health insurance walks through timing in more detail.

The self-employed health insurance deduction

There is a federal deduction for self-employed health insurance premiums, and it can change the real cost of your coverage meaningfully. Whether you qualify, which premiums count, and how it interacts with the rest of your return are questions for a tax professional.

We are insurance agents, not tax advisers, so we will not tell you what to claim. Ask your tax advisor before you factor a deduction into your budget.

Keeping your own doctors

Most of our plans run on national PPO networks — PHCS PPO, PHCS Extended, MultiPlan PHCS, First Health PPO, Aetna PPO, Aetna Open Choice PPO, Cigna PPO and Blue Cross Blue Shield's BlueCard. In many areas that reaches more providers than a narrow exchange HMO, though network size and access depend on the plan and where you live.

Broad is not the same as universal, and we cannot promise any specific doctor is in network. Many providers participate, and you can check your own doctor and hospital in the plan's provider directory before you apply, not after. An agent will do that with you.

If your plan is an EPO rather than a PPO, out-of-network exposure is much larger. See private PPO vs ACA networks for the practical difference.

How to work through it in an afternoon

A sensible order of operations, whether or not you buy from us.

1. Check whether your household is likely to qualify for a large exchange subsidy. If it is, start there.
2. List the doctors and prescriptions you are not willing to lose.
3. Look at what is actually filed in your state. The cheaper plan is often simply unavailable where you live, and that is the single biggest swing in price.
4. Compare structures, not just premiums — a low premium with a weak structure can cost more over a year.
5. Have a licensed agent confirm underwriting and network before you sign. A licensed agent always writes the application; you do not enroll yourself online.