Health insurance for solopreneurs
How self-employed people in the US get health insurance: Marketplace plans, COBRA, a spouse's plan, and the self-employed health insurance deduction.
Losing employer coverage is one of the biggest hurdles to going solo in the US. Your main options:
| Option | How it works | Watch out |
|---|---|---|
| Marketplace (ACA) | Buy a plan on HealthCare.gov or your state exchange; premium tax credits depend on estimated income. | You must update your income estimate if it changes. |
| COBRA | Keep your former employer plan for a limited time. | You usually pay the full premium. |
| Spouse's or partner's plan | Join a family member's employer plan. | Check whether adding you is cheaper than a Marketplace plan. |
| Medicaid | Coverage for low incomes, depending on your state. | Eligibility depends on income and state rules. |
The tax deduction
If you're self-employed with a net profit, you may be able to deduct health insurance premiums for yourself and your family. See the IRS self-employed health insurance deduction guidance and talk to a tax professional.
Timing
Losing job-based coverage usually opens a Special Enrollment Period, so apply quickly; otherwise you wait for Open Enrollment.
General information, not insurance or tax advice.
Sources
- HealthCare.gov healthcare.gov
- IRS self-employed health insurance deduction guidance irs.gov
Checked 21 Oct 2026. Spotted an error? Tell us.
Update history
- : first published; figures checked against the sources listed.