Health Insurance for Freelancers

Freelance work is a common form of income generation, however, it can complicate things when it comes to health insurance. As a self-employed worker, it's important to understand your options when it comes to health insurance coverage.
By Peter K.
Updated Sep 4, 2022
Health Insurance for Freelancers
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In the last decade, there has been an exponential rise in the number of Americans opting for freelance work. In 2019, US freelancers earned almost $1 trillion. Upwork, a freelancing site, indicates that 59 million Americans are engaged as freelancers in 2020, up from 57 million in 2019. This number makes up 36% of the total American workforce. 

Some of the typical freelancing jobs include content writing for websites, graphic design, web design, project management, bookkeeping, independent contractor, proofreading, translation, and teaching.

Freelancing or working in the gig economy is now a common form of income generation in the job market. Freelancers are independent workers who perform jobs for clients, both individuals and companies, in return for payment. These individuals are self-employed and don’t work under a contract but rather agree on payment terms with the clients.

As self-employment surges in the country as a viable way to make a living, these workers are left to find their own health coverage. As a self-employed worker, it's important to understand your options when it comes to affordable health insurance coverage.

Why Is It Important for Freelancers to get Health Insurance?

One of the most critical benefits of being a salaried worker in the United States is that your employer caters to your health insurance. As a freelancer, however, you’re an independent worker under no contract, and this means you don’t have an employer's health insurance coverage. When choosing a career as a freelancer, you have to consider the fact that you have to pay for your own health insurance coverage.

With the escalating costs, you can’t take chances. Your sickness can devastate your family’s finances and this is a good reason to start comparing the best health coverage options.

Man working from home with dog that was able to save money while addressing health concerns by using PolicyScout to compare self employed health insurance plans

Source: Pexels

How Much Does Health Insurance for Freelancers Cost?

The annual cost of health insurance in the USA is $7,470 for individuals and $21,342 for families. Health insurance costs vary from person to person for various reasons such as age, geography, current health status, medical history, amount of coverage needed, and more.

When searching for a self-employed health insurance plan, there are many options to consider what's right for you. Speak to a PolicyScout agent or get a quote from our calculator to scout the best option for you.

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Viable Health Insurance Options for Freelancers

Below are some of the health insurance coverage options that would suit a self-employed worker:

The Affordable Care Act

The Affordable Care Act (ACA) or Obamacare is the best health insurance option for freelancers. Obamacare provides a health insurance marketplace that allows individuals to sign up for a health plan regardless of their employment status. 

There are two enrollment periods to sign up for a health insurance marketplace plan.

- Open Enrollment Period

The first is the Open Enrollment period running from 1st November to 15th December. Signing up during this window allows enrollees to get coverage for the next calendar year beginning the 1st of January.  

Freelancers can, therefore, take advantage of the window to sign up like everyone else in employment. The Open enrollment period has some variations from one State to another.

- Special Enrollment Period

Self-employed individuals unable to sign up during the open enrollment period may also get coverage if they qualify for Special Enrollment. The special enrollment period allows individuals who experience a significant life event to still qualify for coverage. Any event that necessitates special enrollment is referred to as a qualifying life event and includes marriage, divorce, childbirth, or a job loss.  

As per the Act, if you experience a qualifying life event, you qualify for Special Enrollment any time of the year. You do not have to wait for the Open enrollment period to get a new health insurance plan. However, you must enroll within 60 days of the event. Of note, Obamacare marketplace plans may have varying premiums depending on your State of residence. However, they all give the same essential health benefits.

 If you miss out on the Affordable Care Act (ACA) plans, you can opt for short-term or temporary insurance. This coverage helps avoid paying medical costs until you can get ACA-type coverage.

The Metal Tiers In Health Insurance

All marketplace plans fall into four categories: Bronze, Silver, Gold, and Platinum. The difference in tiers ranges from lowest to highest premiums.

With metal tiers, if you opt for low premiums, you will carry a higher deductible and vice versa. Once you met your out-of-pocket max, insurance kicks in to cover the remaining health care costs.

For more details, check out our article on The Metal Tiers In Health Insurance

Medicaid

Medicaid is a health insurance program available to low-income families and individuals in need of help to pay for health care. Freelance workers making up to 133% of the federal poverty level qualify for Medicaid.

To qualify for Medicaid in a particular year, your annual income in the preceding year must be within the federal poverty threshold.

Each state has its own Medicaid modalities, and therefore eligibility criteria will vary depending on the State of residence. To gauge your eligibility, visit healthcare.gov or your States Medicaid portal.

The good news is that you can enroll for Medicaid at any time of the year. This means you do not have to worry about health insurance if you opt for freelance work.

COBRA Health Insurance

Passed in 1986, the Consolidated Omnibus Budget Reconciliation Act (COBRA) included a rule that freelancers can use to enjoy health insurance. When you leave a job where you had an employer-based plan, the employer must offer you the right to extend your health insurance coverage (usually for up to 18 months) as you pay your own premium payments.

COBRA coverage converts a group insurance plan into an individual plan. It’s the perfect way for freelancers who have recently left employment to continue enjoying health coverage. 

The COBRA plan’s high cost including a 2% administrative fee on top of the premiums, makes it a short-term solution as you look for a more affordable plan in the marketplace.

After leaving employment, contact your employer’s insurance company to establish the COBRA plan’s full cost. You will therefore be in a position to make an informed decision on whether to continue with the plan for the long haul.

You can also get expert advice from PolicyScout on COBRA’s implications for your health insurance plan and your pocket. 

Spouse

As a married freelancer, you can secure coverage by joining your employed spouse's insurance plan. Many employers will have no objection to their employees adding a spouse to the group cover. However, you should be ready to fork out a substantial amount of money in monthly premiums. 

Parents

If you are self-employed and under the age of 26, you may select to remain in your parent’s health insurance plan. The Obamacare plan has a provision allowing young adults to continue getting coverage under a family member plan. This is still possible even if the children do not live with their parents anymore, they are married, or the parents have not listed them as dependents. Once you reach 26, you will have to hit the health insurance marketplace to look for your own plan.

Get the Right Health Plan through the Freelancers Union

To help their members get health insurance, the Freelancers Union shops for insurance plans and invites freelancers to enroll in the plans. In most instances, a union will enter into a memorandum of understanding with private health insurance companies to enroll their members in their plans. 

Rather than providing nationwide coverage, the union lists plans available state by state, making it easy for freelancers to get coverage in their residence states. Health insurance plans also include dental, optical, and disability insurance.

Some of the Freelance Union plans include the Essential Plan for freelancers living and working in New York. This plan’s benefits include the option to buy dental/eye cover with some plan premiums ranging between $0-$20. The plan also offers telemedicine services besides the opportunity to join in at any time of the year.

For freelancers over the age of 65, the Freelancers Union has Medicare Advantage plans. Additionally, freelancers who have frequent travels or live abroad can get out-of-network and international health insurance coverage wherever they go. The Union encourages freelancers to join its ranks and purchase their handpicked plans.

Health Insurance Subsidies for Freelancers

Freelancers who do not qualify for Medicaid or any other health care plan may be eligible for insurance subsidies. The main subsidies in this category are the advanced premium tax credit and the cost-sharing reduction plan.

The advanced premium tax credit intervenes by bringing down the cost of premiums. The subsidy gives back a certain amount to the contributor when you file tax returns. If at year's end you have taken more premium tax credits than entitled, you pay back the excess as you file your tax returns. On the other hand, you are eligible for a refund if you have taken less. 

The cost-sharing subsidy brings down the amount you have to pay for co-payments, deductibles, and coinsurance. If you are a freelancer and qualify for a cost-sharing reduction, you will also enjoy a lower out-of-pocket maximum.

These subsidies’ net effect is to bring down the cost of care for individuals with low income. To qualify, freelancers and their households need to have an income of up to 400% of federal poverty levels. To see whether your freelancing income is within the range to qualify for APTC, check out this site on the healthcare.gov website. For CSR eligibility, head over here.

Health Savings Account

Regardless of your health insurance policy, some medical expenses are not catered for and have to be borne by you. These out-of-pocket expenses include co-pays, deductibles, and coinsurance. They also include any other services not explicitly covered by the insurance plan.

At this juncture, a health savings account becomes a vital safety net. A health insurance savings account is a savings plan operated to cater to qualified medical costs. Unlike the typical savings account, a health savings account is untaxed. By utilizing untaxed savings in a health savings account to pay for out-of-pocket, you will lower the overall health care expenses.

Over-the-counter meds, doctor consultations, and drug prescriptions can cost a substantial amount of money. This means that with an HSA, you will have a fall-back plan to pay for healthcare costs. However, you are only eligible to kick start an HSA if you have a High Deductible Health Plan (HDHP).

An HDHP is a health plan with lower monthly premiums and much higher deductibles than other insurance plans.

For instance, in 2020, the minimum deductible is $1400 and $2800 for an individual and a family, respectively. For out-of-pocket costs, the maximum for an individual is $6900 and $13800 for a family.

An HDHP might be a more affordable plan, but you will need to pay your annual deductible before the insurance pays its share. Freelancers with a high-deductible health plan may qualify for HSA. Find out whether HSA is right for you.

Self employed person working from home with their dog browsing the health insurance marketplace to ensure they have affordable health insurance plans

Source: Pexels

Freelancer Health Insurance Shopping Guide

Navigating the complex world of insurance for the best health plan is a daunting task for most self-employed workers. Here are a few guidelines to help you as you shop for the best insurance cover for freelancers today.

  1. Consider joining unions near you: A freelancer union or a freelancers’ professional group is an excellent strategy for getting the best health insurance deal.

  2. Check for riders in any health plan to avoid surprises

  3. Look for a well-rounded cover for the best protection

  4. Look for a health plan that suits your freelancing work and lifestyle

  5. Compare as many health plans as possible

  6. If possible, check out a family member's plan

  7. Check the insurance network of hospitals

  8. Get Expert Advice: Insurance companies have hundreds of health insurance plans, which might be overly confusing. Seek the advice of insurance experts to walk you through the various options.

Final Thoughts

Healthcare is a basic necessity and as a freelancer, you have to look for the best plan you can afford. Consider the consequences of falling sick without adequate coverage. For all your health insurance concerns, PolicyScout is the go-to resource for the most comprehensive information on health insurance plans for freelancers.