Self-Employed Health Insurance: Coverage Guide
Author: Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2009/02/05 - Updated: 2026/01/19
Publication Type: Informative
Category Topic: Insurance - Related Publications
Page Content: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This information provides practical guidance for self-employed individuals, independent contractors, and small business owners seeking affordable health insurance coverage. Written by the founder of a disability resource platform and drawing on established insurance frameworks like COBRA and health savings accounts, the article addresses a critical gap affecting over half of self-employed Americans who lack coverage. The resource walks readers through viable pathways including continuation of employer coverage, spousal plan enrollment, professional association group policies, and strategic use of high-deductible plans paired with tax-advantaged savings accounts. People with disabilities who work independently will find particular value in the disability insurance section, which explains how to secure income protection when employer-provided plans aren't available - Disabled World (DW).
Introduction
As increasingly more Americans are going to work for themselves, starting small businesses or working as independent contractors, the need for self-employed health insurance is on the rise.
Unfortunately, health insurance for the self-employed tends to be more expensive than employee-offered group insurance plans. This may be why well over half of all self-employed Americans don't carry an insurance policy. While this saves them money in the short-term, it can be financially disastrous when they find they need to go see a doctor.
Main Content
Getting Group Insurance
Group insurance is cheaper because everyone in the group increases the group's purchasing power. Most people get group insurance from their employers, but it's not the only way. Those who are self-employed do have some group insurance options. You can get group insurance plans from some trade or professional groups, civic organizations and churches.
For those who are just becoming self-employed, you can keep your group insurance plan for up to 18 months with a program called COBRA. COBRA simply extends your employee-offered insurance policy until you can get on your feet and find your own. It can also help you make the transition to a new insurance plan. For more information, and to see if you are eligible for COBRA, have a look at their website at www.cobrainsurance.com.
One way to save money on your insurance is to use your working spouse's group insurance plan. If you spouse works for a large company whose insurance plan extends benefits for families and spouses, you may be able to get on their insurance. This is a good option for those who are just starting out with their own business. It's not individually tailored to you, but it will save you money that you can spend on your start-up costs.
Getting Your Own Individual Plan
While looking for a good individual health insurance plan, remember that you are in control. Shop around and interview the insurance agents. There are lots of options available to you, and many companies to choose from, so don't go with the first good one that comes along.
You also have to read the fine print and understand every detail of the health plan they offer you. When you are looking at different companies, check with your state's insurance commission office to see if any complaints have been made against the company. This is a good way for you to find out if a certain insurance company is reputable or not.
Low Premiums, High Deductibles And Big Savings
Many self-employed people choose an insurance plan with low premiums and high deductibles. This means that what you pay each month is very low, but you end up having to pay more when you go to the doctor. Most people are eligible to start a health savings account. This is a tax free account that you can use when you need medical attention.
By saving money on your premiums but instead putting that money into a tax-free health savings account, you save money in the long run on your health insurance. When you have to pay those big doctor's bills, you can roll over the money from you health savings account.
Disability
You'll also have to make sure you get disability insurance. This is in case you are injured on the job and unable to work. Companies usually provide this, so self-employed workers have to take out a plan for themselves.
These work pretty much the same as insurance plans. You can choose between group and insurance plans. Usually, there are trade or profession specific disability insurance programs, where the risk of the entire profession is factored into the rates. These usually offer the best deal to self-employed workers.
When your business starts taking off and you hire employees to work for you, you can take out a group insurance plan for them, and cover yourself too. This is what small business owners usually do, and it saves them money.
Insights, Analysis, and Developments
Editorial Note: The landscape of self-employment continues to expand, yet access to affordable health coverage remains one of the most significant barriers facing independent workers. For people with disabilities who choose or need flexible work arrangements, the stakes are even higher - medical care isn't optional, and gaps in coverage can quickly become catastrophic. While the strategies outlined here offer tangible starting points, they also highlight a persistent structural problem: our healthcare system still largely assumes traditional employment as the norm. Until policy catches up with the reality of modern work, self-employed individuals must become their own advocates, carefully weighing premiums against deductibles, researching every provider, and building financial safety nets that salaried workers receive automatically. The irony isn't lost that those who take entrepreneurial risks often face the greatest personal liability when seeking basic health security - Disabled World (DW).
Author Credentials: Ian is the founder and Editor-in-Chief of Disabled World, a leading resource for news and information on disability issues. With a global perspective shaped by years of travel and lived experience, Ian is a committed proponent of the Social Model of Disability-a transformative framework developed by disabled activists in the 1970s that emphasizes dismantling societal barriers rather than focusing solely on individual impairments. His work reflects a deep commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.