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Best Health Insurance Companies for the Self-Employed

Blue Cross Blue Shield is our pick for the best overall health provider for the self-employed because of its numerous advantages, including overall costs, widespread availability, huge provider network, and varied plan options.

Affordability and adequate coverage are essential when you’re a freelancer or otherwise self-employed. The Affordable Care Act (ACA) established a federal Health Insurance Marketplace and offered states the option to create their own marketplaces. These exchanges offer affordable plans for independent contractors, consultants, and gig workers. However, choosing the right insurance provider or plan can be challenging.

To identify the best health insurance companies for self-employed people, we evaluated nine major health insurance companies for 40 criteria that encompass state availability, customer satisfaction, health management programs, tax incentives (the percentage of plan premiums eligible for premium tax credits), costs (copays, monthly premiums, and deductibles), dental coverage, and types of plans offered.

We used National Committee for Quality Assurance (NCQA) annual ratings to evaluate plan quality and customer satisfaction. The NCQA is a nonprofit organization that evaluates health plans for patient care quality, patient satisfaction, and health plans' efforts to improve.

Best Health Insurance Companies for the Self-Employed

Best Health Insurance Companies for the Self-Employed
Best Health Insurance Companies for the Self-Employed

Best Overall : Blue Cross Blue Shield


Blue Cross Blue Shield logo

Blue Cross Blue Shield

Pros & Cons
Pros
  • Offers the best overall cost scores of the insurers reviewed

  • Widely available nationwide

  • Wide variety of plan types and metal levels

  • Above-average third-party customer satisfaction ratings

Cons
  • Below-average J.D. Power ratings in some regions

Why We Chose It

Blue Cross Blue Shield (BCBS) is the best overall for self-employed people for several reasons. It features the best overall cost scores of all providers we reviewed. The combined premiums, deductibles, and copays are more affordable than those of other providers on this list.

In addition, BCBS’s plan costs are very good, with the lowest-cost silver plans of all the insurers we reviewed. Older adults starting or winding down a business while waiting for Medicare to kick in will also find the best rates, according to our sampling of average costs for 60-year-olds. 

BCBS is also our top-ranked provider for the best health insurance companies. With coverage in 36 states and a network of 1.7 million healthcare providers, you’re more likely to find available BCBS healthcare options. (For this analysis, we excluded Anthem from our BCBS evaluation because the two compete in some markets.)

Shoppers on the ACA exchange should find many choices, including plan types: health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), and point-of-sale (POS) plans, as well as six metal levels. BCBS also offers catastrophic plans, which may be a good fit for freelancers under 30 or those not yet earning much. Outside of traditional health insurance plans, BCBS offers short-term coverage and travel medical insurance for contractors headed overseas. 

Plans are generally very highly rated by third parties, with above-average NCQA ratings—the highest of all the providers on this list. However, since BCBS is a group of companies, member experience varies by region. For example, the J.D. Power 2023 U.S. Commercial Member Health Plan Study has BCBS in top positions in Kansas City, Missouri; Connecticut; Ohio; Florida; and Washington, D.C. But in a few regions, it ranks below average. 

Lowest Copays : Oscar


Oscar logo

Oscar

Pros & Cons
Pros
  • Best copays of all health insurance providers reviewed

  • Widest variety of health management programs

  • Convenient health app for refills, rewards, and more

  • $0 virtual primary and urgent care with most plans

Cons
  • Low third-party customer service ratings

  • Only available in 18 states

Why We Chose It

Oscar is our top-ranked provider for copays, with the lowest physician-visit copays of the companies we researched. Copays are particularly affordable for silver plans.

Oscar’s solid app allows you to visit a primary-care physician for $0, providing a predictable charge for self-employed people with variable income. You can also use the app to message your care team or for prescription refills and virtual urgent care, even while traveling. The app even rewards you for hitting your daily step goals—between $25 and $100 per year, depending on your state. 

Oscar offers a variety of plan types and every available type of medical management program we researched. These include programs for asthma, diabetes, depression, pain management, heart disease, high blood pressure and cholesterol, low back pain, and pregnancy. It’s also the only insurer among the ones we surveyed to offer a weight-loss program. 

That said, Oscar’s NCQA rating for member experience was 2.75 out of 5 stars, lower than most competitors. In addition, Oscar plans are only available in 18 states. And you can’t use the app to book a $0 primary-care doctor visit while outside your home state, which may cramp your style if you’re a digital nomad.

Best Bronze and Silver Pricing : Kaiser Permanente


Kaiser Permanente

 Kaiser Permanente

Pros & Cons
Pros
  • Lowest premiums in most of the quotes we gathered

  • Best quality rating of the companies we reviewed

  • Provider-and-plan ecosystem can be good for minimizing hassles and paperwork

Cons
  • Mostly available only as an HMO, which limits your physician and facility choice

  • Only available in nine locales

Why We Chose It

If you’re looking for an affordable plan with excellent ratings, Kaiser offers both features. In many of the quotes we gathered, it had the lowest premiums available. However, that can mean higher copays, so make sure you read the plan carefully. 

Kaiser Permanente boasts the best average NCQA rating among all the providers we reviewed and is the only provider with a rating above 4 stars. Kaiser also dominates customer satisfaction rankings in many of the regions it’s offered, according to the 2023 J.D. Power Survey.

Self-employed people with limited schedules may find Kaiser appealing because the company has its own hospitals and doctor’s offices. The provider-and-plan ecosystem may minimize paperwork and hassles. 

However, Kaiser was the least-available plan nationwide, with coverage only offered in eight states and Washington, D.C. And some people may chafe at the plan’s HMO setup, which won’t cover out-of-network providers in most cases. 

Best for Premium Tax Credits : Aetna


Aetna logo

Aetna

Pros & Cons
Pros
  • All of its Marketplace plan premiums are eligible for a premium tax credit

  • Offers no- or low-cost MinuteClinic walk-in services

  • Strong consumer satisfaction rankings in several large regions

Cons
  • Limited metal levels available

  • Obamacare plans are only available in 12 states

Why We Chose It

Because Aetna's plans that are sold on the federal Marketplace only include the essential health benefits (EHBs) outlined by the Affordabe Care Act, all of your premiums with its plans you buy there are eligible for premium tax credits, essentially reducing the premium to $0 for people who qualify for the maximum credit. 

Be sure to review the plan—some $0 bronze plans may have higher consumer cost-sharing (deductibles and copays) than higher-premium plans. 

However, even if you don’t qualify, Aetna offers better-than-average rates across a wide spectrum of plans. For example, Aetna has the second-lowest costs (premiums and deductibles) for bronze plans and for 45-year-olds and 60-year-olds. 

Busy contractors who shop at CVS pharmacies will also appreciate the wide range of $0 MinuteClinic services included with Aetna’s plans. You can walk into a MinuteClinic (typically housed within a CVS) or book an appointment online. Aetna also throws in a quarterly $25 allowance to spend on CVS-branded wellness products, and 20% off CVS Health brand products. 

Aetna offers HMO, PPO, and EPO plans, and various medical management programs for different conditions. The company’s average NCQA rating is 3.46 out of 5 stars, which is better than average. What's more, Aetna was top-ranked for customer service in the 2023 J.D. Power Survey in several large U.S. regions, including the Northwest and Southwest. 

However, Aetna is only available in 12 states. If you don’t live near a CVS, many of the plan’s best advantages may not be readily available. Aetna offers only three metal-level plans—the fewest among the providers we surveyed—and no catastrophic plans.

The Bottom Line

Self-employed people must balance health insurance plan affordability with available tax write-offs when shopping the ACA exchange. However, each insurer tends to operate differently due to state regulations. The Blue Cross Blue Shield provider in your area may be the best option for balancing overall cost and quality. Still, Kaiser Permanente could be a good alternative if you want an HMO and Kaiser operates in your state. 

If you’re in good health, don’t need much beyond the essential health benefits—which are fairly expansive—and aren’t making much money with your business yet, an Aetna plan could be a good fit. Other contractors and freelancers may want the stability of $0 copays for routine physician visits, which you can get with Oscar. Research the plans available in your area and weigh all costs beyond premiums, including deductibles, copays, and coinsurance

Frequently Asked Questions

  • What Does “Self-Employed” Mean When Buying Health Insurance?

    The Health Insurance Marketplace considers you “self-employed” if you make money from your business but don’t have any employees you report on a W-2 form at year’s end. Business owners with employees must use a different small business insurance marketplace—the SHOP Marketplace—to find insurance for staff. However, you’re still considered “self-employed” if you hire independent contractors.

  • How Should I Estimate My Future Income When Buying Insurance on the Marketplace?

    Your Marketplace application relies on estimating your upcoming year’s self-employment net income or profit after expenses. Estimate this amount based on your past net income history, expectations, and industry standards. If your income changes dramatically over the year, you must update this estimate in the Marketplace. The Marketplace can ask you to prove your self-employment income with a spreadsheet or accounting software program.

  • Can I Write Off My Health Insurance If I’m Self-Employed?

    Yes, if you’re self-employed and have a net profit for the year, you can take an income tax deduction for your health insurance costs—specifically, the premiums you pay. This deduction is more of an adjustment on your income versus an itemized deduction. Form 1040 or 1040-SR and Schedule SE offer instructions on calculating and claiming the deduction.

  • What Is the Premium Tax Credit?

    Marketplace plans may offer a premium tax credit based on your income if you earn between 100% and 400% of the federal poverty level (FPL). You can use any or all of the tax credit to help pay your premiums. However, determining how your premium tax credit interacts with self-employment deductions can be complicated. Consult a tax professional or use the IRS’s Publication 974 for helpful worksheets.

How We Chose the Best Health Insurance Companies for the Self-Employed

To identify which health insurance companies to review, we analyzed business and market insight databases, considered health insurance company market share, and researched user-generated data from Google to determine public interest and trends in health insurance companies and plans. 

We collected data from the National Committee for Quality Assurance (NCQA), an independent organization that rates health care plans on quality and patient satisfaction. We also gathered data from state and federal government health care marketplace websites and databases, and directly from companies via websites, media contacts, and existing partnerships. The data collection process took place between Sept. 29 and Oct. 23, 2023.

We then developed a quantitative model that scores each health insurance provider based on 27 criteria that fall into four major categories and are crucial in evaluating the company’s offerings and benefits. We weighted the four categories as follows for this article:

  • Plan Quality & Customer Satisfaction: 15%
  • Plan Features: 40%
  • Cost: 30%
  • Availability: 15%

Read our full methodology for reviewing health insurance companies.

Health Insurance for Self-Employed
Article Sources
Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in our editorial policy.
  1. National Committee for Quality Assurance. "Report Cards/Health Plans."

  2. J.D. Power. “Commercial Health Plan Member Satisfaction Declines in Key Areas, J.D. Power Finds.”

  3. Healthcare.gov. "SHOP Marketplace Basics for Employers."

  4. Healthcare.gov. "Reporting Self-Employment Income to the Marketplace."

  5. Internal Revenue Service. “Topic No. 502, Medical and Dental Expenses."