Best Health Insurance for Self-Employed

While many people get health insurance through their employer, if you’re among the 44 million self-employed Americans it can be difficult to find quality, affordable health insurance.¹ You can sign up for a new health insurance plan during the open enrollment period, which happens every November 1 through January 15. You can also enroll if you have a qualifying life event like getting married, having a baby, or losing your previous health insurance coverage. 

The best health insurance plans for self-employed workers are affordable and offer decent coverage, with low premiums and deductibles and a wide provider network. You should also look for a health insurance company with a good reputation and a simple claims process.

Best Health Insurance for Self-Employed of 2022

•  Best Overall: Blue Cross Blue Shield
•  Best Network: UnitedHealthcare
•  Best for Preventative Care: Kaiser Permanente
•  Best for Convenience: Cigna
•  Best for Underserved Groups: Molina Healthcare
•  Best for Customer Service: Oscar

Best Health Insurance For Self-Employed

• Blue Cross Blue Shield
• UnitedHealthcare
• Kaiser Permanente
• Cigna
• Molina Healthcare
• Oscar
• Final Verdict
• Compare Providers
• How Should You Compare Providers?
• If Self-Employed Insurance Needed?
• How Do You Choose The Best Options?
• What Kind Of Policy Is This?
• Is Coverage A Business Expense?
• What Is The Average Cost?
• Methodology

BEST OVERALL: Blue Cross Blue Shield

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• No. Policy Types: 4
• No. States Available: 50
• Providers In Network: 1.7+ million

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Why We Chose It 

With a history of customer satisfaction and nationwide availability, Blue Cross Blue Shield is our top overall choice for a healthcare plan for the self-employed.Pros & ConsPros

• Strong company reputation
• Large provider network
• Data-driven to improve quality and affordability

Cons

• Member experience may vary by region
• Bad customer reviews in some states

Overview

Blue Cross Blue Shield (BCBS) is an association of 34 independent Blue Cross Blue Shield companies across the United States. Since 1929, the association has established a strong reputation, and most of its companies have high AM Best ratings, earning BCBS our top spot.² The companies have scored 2.5 to 4.5 on a scale of 1 to 5 from the National Committee for Quality Assurance (NCQA).³ Blue Cross Blue Shield companies also earned high rankings in many regions in the J.D. Power 2021 U.S. Commercial Member Health Plan Study.⁴ 

Blue Cross Blue Shield offers coverage to 110 million members in all 50 states, Washington, D.C., and Puerto Rico. The companies have an expansive network including 96% of the country’s hospitals and 95% of doctors and specialists. Expats may also have health coverage through the company’s global network. Depending on the state, Blue Cross Blue Shield companies may offer a variety of products. You may also have access to health and wellness discounts like gym memberships and fitness products through Blue365.

You may compare plan quotes and apply for health insurance through your local Blue Cross Blue Shield company’s website. You can also call or sign up through your state’s health insurance exchange or Healthcare.gov. With 34 different companies, prices may vary by location, plan type, age, tobacco use, and the size of your family.

After receiving healthcare, visiting a hospital, or getting a prescription, the provider submits a claim to Blue Cross Blue Shield. You may access a claim summary, including how much you owe, by logging into your online portal or by mail.  

Self-employed workers may like Blue Cross Blue Shield’s data-driven approach, like the company’s National Health Index, which maps health status by county. Blue Cross Blue Shield also uses nationwide data to address major issues like the rising cost of healthcare.

BEST NETWORK: UnitedHealthcare

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• No. Policy Types: 4
• No. States Available: 50
• Providers In Network: 1,300,000

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Why We Chose It

United Healthcare is our top pick for the best network, with over 1,300,000 providers in network and availability in every state.Pros & ConsPros

• Large network of 1,300,000 providers
• Availability in 50 states
• Customers can get a free quote online

Cons

• History of discriminating against mental health and substance abuse patients to save money
• Mostly poor customer satisfaction scores

Overview

UnitedHealthcare is a subsidiary of UnitedHealth Group, the biggest health insurance provider in the country.⁵ Founded in 1977, the provider has an A rating from AM Best.⁶ UnitedHealthcare didn’t earn a top spot in any region in the J.D. Power 2021 U.S. Commercial Member Health Plan Study.⁷ 

UnitedHealthcare Group offers broad health coverage in every state and 130 countries. The provider network included 1.3 million physicians and other healthcare professions and more than 6,500 hospitals. The company offers a range of products including health insurance, Medicare, Medicaid, short-term insurance, vision, dental, and supplemental coverage.

UnitedHealthcare hasn’t always offered robust mental health or substance abuse coverage, though. A federal judge ruled the company was discriminating against members who needed these services. Since then, the company has created one of the biggest virtual mental healthcare services via the purchase of a company in that field.

You may get a quote and apply for health insurance through the company’s website, by phone, through your state’s exchange, or Healthcare.gov. UnitedHealthcare plan pricing varies by state, your plan type, your age, whether you smoke, and your family size. 

The UnitedHealthcare claims process is simple: If you use the company’s provider network, you won’t need to submit a claim. But you may need to for your flexible spending account, upfront billing, or out-of-network providers. You may submit a claim through the online portal or by its claim by mail service.  

Forward-thinking entrepreneurs may appreciate UnitedHealth Group’s approach to technology and innovation. The company uses robust data to address healthcare inequality, expanding telehealth amid the pandemic, digital therapy for managing type 2 diabetes, or using artificial intelligence to improve member engagement.  

UnitedHealthcare, part of the country’s biggest health insurance company, offers the most robust network on our list. With coverage in every state, UnitedHealthcare may make it easier to find a health insurance plan with your preferred providers so that self-employed individuals don’t have to skimp on medical care.

BEST FOR PREVENTATIVE CARE: Kaiser Permanente

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• No. Policy Types: 3
• No. States Available: 8
• Providers In Network: 23,000+ doctors

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Why We Chose It

We included Kaiser Permanente on our list of top health insurance plans for the self-employed because of its notable emphasis on preventative care.Pros & ConsPros

• Emphasis on preventative care and overall health
• Strong customer satisfaction reviews
• HSA access

Cons

• Only available in 8 states
• History of skimping on behavioral healthcare

Overview

Kaiser Permanente is another health insurance company with a strong reputation. The company was founded in 1945 and it doesn’t have a rating with AM Best. Kaiser Permanente earned high scores of at least 3.5 and up to 5.0 from NCQA with a majority of plans scoring 4.5 or better.⁸ Additionally, Kaiser received standout rankings in the J.D. Power 2021 U.S. Commercial Member Health Plan Study, including first place in several regions.⁹

Kaiser Permanente has faced some scrutiny from the state of California, though. The company has been subject to several state sanctions and fines for skimping on behavioral healthcare. Some members were still struggling to get care at the end of 2019, according to the Los Angeles Times.¹⁰ More recently, the company has continued to face criticism of this nature.¹¹

Kaiser Permanente offers health insurance in Washington, D.C., and eight states—California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington—for 12.5 million members. The company’s network includes 39 hospitals, 734 medical offices, 23,656 physicians, and 65,005 nurses. 

You may have access to a variety of health plans that include Medicare, Medicaid, high-deductible health plans, health savings account-eligible plans, and catastrophic plans. Plan availability depends on where you live. 

You may get a quote or apply for coverage through Kaiser Permanente’s website. If you want financial assistance, you may apply through your state’s exchange or Healthcare.gov. Like the other providers, pricing may vary based on where you live, plan type, age, smoking status, and family size.

The claims process may depend on your health plan and must be within 12 months of the date of your service. There are some additional steps to submit a claim for an emergency or urgent care visit away from home. 

As a self-employed or gig economy worker, you may have limited funds for spending extra money on healthcare and may benefit from Kaiser Permanente’s emphasis on preventative care. The company’s record-keeping and system of reminders make it easier to catch the early stages of a disease. As a result, the company leads the nation in preventative cancer screenings and keeping a cap on high blood pressure, which is why it wins this category.

BEST FOR CONVENIENCE: Cigna

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• No. Policy Types: 4
• No. States Available: 13
• Providers In Network: 1,500,000+

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Why We Chose It

Cigna is our top pick for self-employed individuals looking for convenience because of its virtual care options and prescription home delivery.Pros & ConsPros

• Solid company reputation
• Virtual services and prescription delivery
• Expansive provider network

Cons

• Not available in all states
• Mixed customer satisfaction reviews

Overview

Cigna is the oldest health insurance company on our list, with a history dating back to 1792. The company has earned an A rating from AM Best and rankings of 2.5 to 4.0 from NCQA.¹²¹³ Cigna also earned high marks, including four regional first places, in the J.D. Power 2021 U.S. Commercial Member Health Plan Study. However, it did receive low scores in some other regions.¹⁴

Cigna offers global coverage to 180 million customers in 30 countries, which includes 1.5 million providers and facilities. In the United States, the company works with over 67,000 pharmacies, more than 500 hospitals, and over 175,000 mental and behavioral health providers, growing 70% since 2016. 

Cigna offers individual plans in 13 states: Arizona, Colorado, Florida, Georgia, Illinois, Kansas, Mississippi, Missouri, North Carolina, Pennsylvania, Tennessee, Utah, and Virginia. Depending on where you live, you may have access to Cigna’s other products like Medicare, Medicare supplemental plans, dental insurance, vision insurance, or international health insurance.

You may shop for quotes or buy coverage online or by phone. You may also purchase coverage through your state exchange or Healthcare.gov. The pricing may vary based on factors like where you live, the type of plan, your age, smoking status, and the size of your family.

Most providers will send a claim directly to Cigna and you can see your explanation of benefits through the company’s online portal. You may need to file a claim with out-of-network providers, though, which involves downloading a form, filling it out, and sending it by mail.

Cigna offers a number of options for busy self-employed workers. You may qualify for low-cost virtual care. Self-employed workers may also love the convenience of Cigna’s Express Scripts Pharmacy, which offers home delivery of a 90-day supply of prescriptions along with 24/7 access to licensed pharmacists. Cigna recently added Talkspace, a popular digital therapy service, to its behavioral health network. This provider has worked hard in these areas to make care as convenient as possible, thus winning this category.

BEST FOR UNDERSERVED GROUPS: Molina Healthcare

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• No. Policy Types: Varies by state
• No. States Available: 19
• Providers In Network: Not stated

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Why We Chose It

With an emphasis on serving individuals receiving government assistance, Molina Healthcare is our top choice for a healthcare company for underserved groups.Pros & ConsPros

• Affordable coverage
• Plan transparency on website
• New program to improve healthcare access

Cons

• Not available in all states
• History of regulatory issues including fines for not handling grievances
• Lower financial strength ratings

Overview

Molina Healthcare is a health insurance company focused on those receiving government assistance. Founded in 1980, the company’s individual state enterprises have separate ratings from AM Best. The ratings tend to be lower than those of other insurers featured here indicating some financial instability.¹⁵

Molina Healthcare has had some regulatory issues including fines for enrollee complaints in California and administrative issues in Texas.¹⁶¹⁷ But the company has been making efforts to improve its reputation.   

Molina Healthcare has 4.6 million members. The company offers Medicaid and Medicare plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Ohio, Nevada, New Mexico, New York, South Carolina, Texas, Utah, Virginia, Washington, and Wisconsin. Medicaid covers a broad range of services and access to care is generally comparable to private coverage.  

You may get quotes or apply through Molina Healthcare’s website, or by calling their support team. You may also apply through your state’s healthcare exchange or Healthcare.gov.

Many Molina plans are set up as an HMO which means you’ll have a copay due at the time of service for many services. If a provider doesn’t send a claim to Molina, you may have to submit it yourself for reimbursement.   

In August 2020, the company announced an initial $150 million in funding for the MolinaCares Accord, a project dedicated to filling health coverage gaps for disadvantaged populations. This further solidifies it as the best for underserved groups. Some of the key focuses are racial disparities in access to care, opioid use disorders, rural healthcare access, and other socioeconomic issues.

Molina Healthcare focuses on affordable healthcare for lower-income families. If you’re self-employed and struggling to make ends meet, you may qualify for Medicaid, which offers comprehensive benefits through Molina. Qualified Illinois residents may also enroll in the Molina Dual Options plan that coordinates the benefits of both Medicare and Medicaid.

BEST FOR CUSTOMER SERVICE: Oscar

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• No. Policy Types: Varies by location
• No. States Available: 22
• Providers In Network: Not stated

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Why We Chose It

If you’re looking for a health insurance provider with excellent customer service, then Oscar is a good option. Oscar features a dedicated team of guides and nurses to answer your questions and help you save money.Pros & ConsPros

• Free virtual primary care and free 24/7 access to virtual urgent care
• Dedicated team of guides and nurses to answer your questions
• Easy to use mobile app

Cons

• Only available in 22 states
• Less established than competitors

Overview

Oscar is a technology-driven health insurance startup and is the youngest company on our list. Established in 2012, Oscar has been making waves with its unique approach to customer service. The company doesn’t currently have a rating with AM Best and has earned rankings of 2.5 to 3.0 from NCQA.¹⁸   

Although the company has limited availability—Arizona, Arkansas, California, Colorado, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, and Virginia. The company currently offers health insurance and Medicare plans to over 1 million members. 

You may get quotes or sign up for a plan through Oscar’s website or by phone. You may also shop through your state’s exchange or Healthcare.gov. The pricing will vary based on where you live, type of plan, your age, tobacco usage, and family size.

The claims process is similar to other companies. Your provider will submit a claim to Oscar and the provider will share an explanation of benefits covering how much you owe. The company typically doesn’t cover out-of-network claims because it is an EPO. 

Oscar has a few unique features that may be handy for self-employed or gig economy workers. The company offers free virtual primary care as well as virtual urgent care which gives free 24/7 access to a provider. The Care Team is also a standout feature, with a dedicated team of guides and nurses to answer your questions and help you save money. This level of customer service is unsurpassed among the providers reviewed.

If you’re tired of mediocre customer service, Oscar may be worth a look. As a member, you may use virtual care or the Care Team through the company’s mobile app along with easy access to your records, lab results, deductibles, and more. The company’s white-glove service may be particularly appealing to self-employed folks navigating health insurance on their own for the first time.

Final Verdict

There are lots of options when it comes to health insurance for the self-employed. While you may not be able to access employer-based health insurance, you can still purchase health insurance plans on the marketplace or through a private provider. Overall, our top pick for a health insurance company for a self-employed individual is Blue Cross Blue Shield.

Blue Cross Blue Shield has widespread availability in all 50 states. They also have a strong company reputation and a history of customer satisfaction. They use a data-driven approach to improve the quality and affordability of their care.

Compare The Best Health Insurance for Self-Employed

Company	Plan Types	Providers In-Network (#)	No. States Available
Blue Cross Blue Shield Best Overall	4	1,700,000	50
UnitedHealthcare Best Network	4	1,300,000	50
Kaiser Permanente Best for Preventative Care	3	23,000+ doctors	8
Cigna Best for Convenience	4	1,500,000	13
Molina Healthcare Best for Underserved Groups	Varies by state	Not stated	19
Oscar Best for Customer Service	Varies by state	Not stated	22

How Should You Compare Health Insurance Companies for the Self-Employed?

There are a few things that you should keep in mind when shopping for health insurance as a self-employed person. These include:

• Premium: Your premium is the amount you’ll have to pay each month for your health insurance policy. You should look for a plan with a premium that fits your budget.
• Deductible: Your deductible is the amount you have to pay out of pocket before insurance begins to cover the cost. Plans with higher deductibles typically have lower premiums, and vice versa.
• Copays: Copays are the amount you have to pay out of pocket for a given service, like seeing a primary care physician. Look for policies with low copays when possible.
• Prescription coverage: If you have any prescription medications, look for a plan that covers them.
• In-network physicians: If you already have a doctor or physician you’re happy with, you should make sure to see whether or not they’re in-network for your new health insurance policy.
• Customer satisfaction: Look for insurance companies with high customer satisfaction ratings and good customer reviews.
• Company reputation: It’s a good idea to research the insurance company’s reputation, including whether or not they’ve had past scandals or issues.

If You Are Self-Employed, Do You Need Health Insurance?

If you’re self-employed, odds are you may not have access to health insurance from an employer. While health insurance can seem like an unnecessary monthly expense if you’re young and healthy, it can help to protect you against significant medical expenses in the event of an emergency or if you become ill. This means that it’s still important to purchase adequate health insurance coverage as a self-employed person or entrepreneur.

It’s a good idea to explore your options before settling on a plan. During the open enrollment period (November 1st through January 15th), you can shop for plans on the Health Insurance Marketplace. Even if the open enrollment period has ended, you may still be able to secure health insurance through the marketplace if you’ve experienced a qualifying life event. This can include events like losing your previous insurance, having a baby, or getting married.

How Do You Select a Health Insurance Policy That Works for You?

When deciding between multiple health insurance plans, it’s a good idea to compare quotes from different providers to ensure you’re getting the best deal. The Health Insurance Marketplace allows you to quickly and easily compare quotes from providers and compare information like premiums, deductibles, copays, and covered services.

Once you’ve decided on a plan, the next step is to enroll in a policy. You’ll have to select your chosen policy on the Marketplace and pay your first premium before coverage goes into effect. To pay your premium, you’ll typically be redirected to the health insurance company’s website. Customers will receive their health insurance card within a few weeks after signing up for a policy. Once your coverage has gone into effect, you can begin to take advantage of your health insurance coverage by making appointments to address any medical issues or concerns. Some plans even have other perks to take advantage of, like free gym memberships.

What Is Health Insurance for the Self-Employed?

Health insurance for the self-employed is any insurance plan purchased as an independent contractor or self-employed individual where you are required to cover the cost of your own employee benefits, including health insurance. You may have a couple of options for buying coverage, such as purchasing health insurance directly from a provider or through your state’s exchange or Heathcare.gov. You may apply during open enrollment which happens once per year every fall or after a qualifying life event. 

Depending on your income, you may qualify for a discount through cost-sharing reductions, which may lower the cost of your deductible, co-payments, or co-insurance. To qualify, you must sign up for one of the Marketplace plans. 

If your income is low, you may also see if you qualify for Medicaid, which could offer free or inexpensive health insurance. You may apply for Medicaid through the Marketplace or through your state’s Medicaid agency.

Is Self-Employed Health Insurance a Business Expense?

As a self-employed or gig economy worker, paying for health insurance premiums on your own may be one of the most daunting expenses. Luckily, the government makes it easier with a tax break. When you file your tax return, you may deduct your annual health insurance and dental insurance premiums. This means you may subtract the total annual expense from your adjusted gross income, which may reduce your bill or increase your refund. 

Because this deduction is considered “above-the-line,” you may still take it whether you choose to itemize deductions or take the standard deduction. There is one caveat, though: You can’t deduct more than your net profit for the year, so if your business lost money, you won’t benefit from this tax deduction.¹⁹

What Is the Average Cost of Self-Employed Health Insurance?

There are five factors that may impact the cost of self-employed health insurance for Affordable Care Act-compliant plans: age, location, tobacco use, individual vs. family plans, and plan category. Some states have rules about how much these factors may impact your monthly premiums. 

Premiums may be up to three times higher for older workers, and tobacco users may pay up to 50% more.²⁰²¹ You may also pay more in a state with less competition among providers. The good news is companies can’t charge more based on your gender, your current health status, or medical history.    

Using Healthcare.gov, we ran a few quotes and saw that geography can have a huge impact on your premiums. The plans available in your area and level of competition are a very important factor in determining your prices. All other things being equal, we saw someone’s premiums change by hundreds per month depending on where they live.

Methodology

As a self-employed or gig economy worker, you may face many tough decisions on your own including choices about health insurance, retirement plans, taking time off, and more. Hopefully, these rankings make the process of picking the best health insurance a little less daunting. To create our list, we reviewed 15 of the top health insurance providers before choosing the best. We compared each company’s history, reputation, other product offerings, the application process, nationwide coverage, the size of the provider network, and claims process. 

SOURCE https://www.investopedia.com/best-health-insurance-for-self-employed-5078989