Self-employment and gig economy work is on the rise. In fact, self-employment activity has reached the highest levels since 1957. If you’re among the 44 million self-employed Americans, you may worry about finding quality, affordable health insurance.
Typically, you may qualify to sign up for a new health insurance plan during the open enrollment period, which happens every November 1 through December 15. If you have had a qualifying life event you can also enroll. Qualifying events include getting married, having a baby, or losing your previous health insurance.
We created our list of the best health insurance for self-employed workers by comparing 15 of the top providers, including each company’s history, reputation, convenience, nationwide availability, claims process, and more. Our list covers why each company made the cut.
Best Overall : Blue Cross Blue Shield
Blue Cross Blue Shield earns our top spot because of the company’s longevity and strong customer satisfaction. Blue Cross Blue Shield also offers nationwide health insurance, along with coverage outside of the United States, and the company’s provider network is one of the largest.
Strong company reputation
Large provider network
Data-driven to improve quality and affordability
Member experience may vary by region
Bad ConsumerAffairs reviews in many states
Blue Cross Blue Shield (BCBS) is an association of 36 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. The companies have scored 2.5 to 4.5 on a scale of 1 to 5 from the National Committee for Quality Assurance (NCQA). Blue Cross Blue Shield companies also earned high rankings in the J.D. Power 2020 U.S. Commercial Member Health Plan Study.
Blue Cross Blue Shield offers coverage to 107 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 36 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
UnitedHealthcare earns a spot on our list because it offers coverage in all 50 states and has the best network of healthcare providers. The company also stands out with technology, which may make their providers more efficient and affordable.
Large network of providers
Easy to get an online quote
Robust healthcare technology
Recent legal issues for discriminating against mental health and substance abuse patients to save money
Mixed reviews on ConsumerAffairs
UnitedHealthcare is a subsidiary of UnitedHealth Group, the biggest health insurance provider in the country. Founded in 1977, the provider has an A rating from AM Best. UnitedHealthcare didn’t earn a top spot in any region in the J.D. Power 2020 U.S. Commercial Member Health Plan Study.
UnitedHealthcare Group offers broad health coverage with benefits in all 50 states and 130 countries. In 2020, 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. Last year, 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
Kaiser Permanente’s solid reputation and commitment to prevention make it the best on our list for preventive care. By focusing on prevention, you may stay healthier and save money over time. The company’s high levels of customer satisfaction also stand out, making it less likely you will waste time switching providers every year.
Strong company reputation
Emphasis on preventative care
Health savings account access
Coverage in only nine states
Recent regulatory issues and customer complaints for skimping on behavioral healthcare
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 4.0 and up to 5.0 with NCQA along with standout rankings from the J.D. Power 2020 U.S. Commercial Member Health Plan Study.
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.
Kaiser Permanente offers health insurance in Washington, D.C., and eight states—California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington—for 12.4 million members. The company’s network includes 39 hospitals, 719 medical officers, 23,271 physicians, and 63,306 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
Cigna edged out the competition as best for convenience because of the company’s options for time-strapped, self-employed workers. The company’s options for $0 virtual care may save you from hours in the waiting room. There are also plenty of options for virtual behavioral and mental healthcare. You may also like prescription benefits if you’re working from home, including Express Scripts delivery, the country’s largest pharmacy benefit manager.
Solid company reputation
Virtual services and prescription delivery
Expansive provider network
Not available in all states
Limited transparency on company’s website
Low ConsumerAffairs reviews
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. Cigna also earned high marks, including one regional first place, in the J.D. Power 2020 U.S. Commercial Member Health Plan Study.
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 10 states: Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, 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 $0 virtual care (except for Arizona and Colorado). Self-employed workers may also love the convenience of Cigna’s Express Scripts Pharmacy—which offers home delivery for 90-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
Molina Healthcare made our list because the company specializes in providing affordable healthcare for folks receiving government assistance. You may apply for a robust Molina plan for Medicaid, Medicare, or Integrated Medicaid/Medicare. You may also qualify for subsidies with a Marketplace Molina plan. The company pledges to keep out-of-pocket expenses down, and the MolinaCares Accord renews its commitment to improving access to quality care for all, making it our top choice for underserved groups.
Plan transparency on website
New program to improve healthcare access
Not available in all states
History of regulatory issues including fines for not handling grievances
Lower credit rankings
Molina Healthcare is a health insurance company focused on those receiving government assistance. Founded in 1980, the company doesn’t have an AM Best rating. Although the company’s Moody’s credit rating isn’t high (B2), the latest report shows signs of improvement.
Molina Healthcare has had some regulatory issues including fines for enrollee complaints in California and administrative issues in Texas. But the company has been making efforts to improve its reputation.
Molina Healthcare had 3.6 million members as of June 30, 2020. The company offers Medicaid and Medicare plans in California, Florida, Illinois, Michigan, Mississippi, Ohio, Puerto Rico, New Mexico, New York, South Carolina, Texas, Utah, Washington, and Wisconsin. Medicaid covers a broad range of services, and research shows access to care is 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.
You may need to make a partial payment for the service when you check-in and the provider will bill you for the remaining balance. 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
Oscar earned a place on our list because of the company’s expansive customer service. You have access to unique features through the company’s mobile app (like Doctor on Call and Concierge) which makes it easy to talk with a doctor 24/7 or refill a prescription. For those who prefer phone support, you may also contact their support team by phone, Monday through Friday from 9:00 a.m. to 8:00 p.m. EST.
Doctor on Call
Not available in all states
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.
Although the company has limited availability—Arizona, California, Colorado, Florida, Georgia, Iowa, Kansas, Michigan, Missouri, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, and pending regulatory approval, North Carolina—they have plans to expand in 2021. The company currently offers health insurance and Medicare plans to 420,000 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 mostly offers HMO plans.
Oscar has a few unique features that may be handy for self-employed or gig economy workers. The company’s Doctor on Call feature offers free, unlimited, 27/4 access to a provider. The Concierge 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 Doctor on Call or Concierge 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.
What Is Health Insurance for 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.
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. 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.
How We Chose the Best Health Insurance for Self-Employed
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.