When you are self-employed, being unwell causes trouble for both you and your business. As a healthcare plan provider, we know that the loss of earnings, added to costs related to your care, can be crippling. That’s why, as a freelance worker, you need to take steps to protect yourself, your family and your business.
While private health insurance is a go-to for many, it often doesn’t suit freelancers and contractors. Obamacare, with its high deductibles, is not the right option either. That’s where health insurance alternatives come in, providing affordable solutions to fill the gaps left wide open by private health insurance and Obamacare.
Learn here how to create a personal shield by using health insurance alternatives. Discover your options and learn how to compare them, and finish by resting easy in the knowledge that you can improve your family’s financial stability and personal freedom without insurance or government interference.
Key Takeaways
- Private health insurance and the ACA Marketplace are not the only options for self-employed Americans.
- Not everyone wants the government to interfere with their healthcare choices.
- Health sharing plans offer value and community-based protection.
- Your choice will be guided by your evaluation of your needs, budget, and each product’s fit with your values.
Table of Contents
- Your Private Health Insurance Alternative Coverage Options
- Health Insurance vs. Alternatives
- How to Lower Your Healthcare Costs Without Insurance
- Health Insurance and Self-Employment FAQs
- Summary: What Are the Best Health Insurance Alternatives for Self-Employed People?
Your Private Health Insurance Alternative Coverage Options
Here are the core self-employed health insurance options explained.
Medicaid/Medicare
Medicaid provides free or low-cost healthcare for some self-employed individuals and their children. To meet the threshold to join Medicaid, your income must be very low. In 2025, the threshold income in many states was $21,597 for a single adult.
If you are over the age of 65 and have paid Medicare taxes, you will be eligible to join the Medicare scheme to get some free healthcare benefits, including hospitalization, but you will not get doctor visits without paying a premium.
ACA Marketplace
Under the Affordable Care Act (ACA), all US citizens and nationals are eligible to join ACA Marketplace, as long as they aren’t enrolled in Medicare. Through ACA Marketplace, you may qualify for savings on a health plan if your income is below $100,000.
All Marketplace plans cover 10 essential health benefits (EHBs), including hospitalization, prescription drugs and maternity cover, and there are no exclusions based on pre-existing conditions or lifetime limits. However, there is little to no choice over providers.
Self-employed workers may find it difficult to forecast their net income for enrollment purposes. Also, there’s only a six-week window for enrolment each winter, so this is not the most flexible option for the self-employed.
Short-Term Coverage
Short-term insurance coverage may be useful for some self-employed workers. For example, you may be waiting for the Marketplace enrollment window to open. Note that short-term insurance is likely to be an expensive option.
Often, short-term coverage is limited to three to four months. The coverage often precludes many typical benefits of private health insurance and is unlikely to cover pre-existing conditions.
Health Sharing Plans
Health sharing is a private health insurance alternative in which total medical expenses are shared among a like-minded group of patriots. Simply, pay into the group funds each month and access healthcare as and when you need it.
Ideal for Godfearing Americans, the primary benefit of a health sharing plan is that you are free to choose any medical provider that suits you and aligns with your values. If you wish, these plans enable you to legally opt out of government-mandated insurance in all 50 states through religious exemption.
With no limits on the healthcare you can receive through health-sharing plans, this option exceeds the coverage provided by both ACA Marketplace and Medicaid and provides a long-term solution for protecting your health and business. Most members find it a more affordable option than private health insurance.
Health Insurance vs. Alternatives
What health insurance should self-employed families choose? Use this handy overview.
| Eligibility | Cost | Exclusions | Benefits | |
| Private health insurance | Everyone | Medium to high. | Must cover EHBs to be ACA compliant, but coverage varies beyond this. | Broad choice of providers and extensive coverage options. |
| Medicaid | Low-income individuals and families only. | None to low. | Varies from state to state. | Comprehensive coverage and little to no cost. |
| Marketplace plans | US citizens and nationals | Low to high. | Must cover EHBs only. | Affordable standardized healthcare, including preventative medicine. |
| Health sharing plans | May require affiliation with a religious or lifestyle statement. | Low. | Exclusions vary. Opting for certain exclusions (e.g., maternity cover) means you will not pay for something you will not use. | Community-based support and direct reimbursement for any medical provider. |
How to Lower Your Healthcare Costs Without Insurance
If you’re looking to lower your healthcare costs, first check alternative private health insurance providers. Depending on your age, health status and benefits needed, you may qualify for lower premiums than ACA Marketplace can offer with some providers.
If you are a values-led person and don’t qualify for low-cost or free healthcare through Marketplace subsidies or Medicaid, then a health sharing plan could offer the savings you need. Our Health Sharing Plan at America First Healthcare enables conservative, God-loving patriots to save and support their community.
Health Insurance and Self-Employment FAQs
How do self-employed families compare monthly cost versus total risk?
Self-employed families should weigh the monthly cost of a plan against the potential out-of-pocket exposure if a serious health event occurs. A lower monthly contribution means higher financial risk if medical costs arise unexpectedly. The key is to calculate your realistic worst-case healthcare costs, not just your best-case monthly savings.
Is private coverage always better than Marketplace coverage for contractors?
Private health insurance is not always the better choice for contractors. The right choice depends on your income, health needs, and how much flexibility matters to you.
What should a 1099 worker look for besides the monthly premium?
Beyond the monthly premium, a 1099 worker should evaluate the deductible, out-of-pocket maximum, and whether the plan covers their preferred providers. Also consider whether the plan covers specialist visits, prescription drugs, and any conditions relevant to your health history.
Can self-employed people get nationwide PPO access?
Access to a nationwide PPO network depends on the type of coverage chosen. Many ACA Marketplace plans are tied to regional networks. Health sharing plans, such as the one offered by America First Healthcare, allow members to visit any medical provider of their choosing, giving self-employed workers flexible nationwide access.
Summary: What Are the Best Health Insurance Alternatives for Self-Employed People?
The best health insurance alternatives for self-employed people depend on income, health needs, and personal values. You are looking for a product that allows you to get on with enjoying the present without worrying about the future, whatever your current health or employment status.
Kick the government out of your healthcare choices and avoid sky-high premiums. Contact us at America First Healthcare for a free healthcare review to discover the right solution for you.
