The Ultimate 2025 Guide to Freelance Health Insurance

Here are some things to consider before you commit to a plan for 2025.

1. Understand Freelance Health Insurance 101

Since healthcare is often tied to employer-sponsored benefits in the United States, freelancers and independent workers are left to find Individual Health plans for themselves. If you’re already familiar with the way freelance health insurance works, SKIP AHEAD to your options. If you’re new to the individual healthcare world, read on!

There are two ways to enroll in health insurance as a freelancer: on the government marketplace, or with private healthcare. For some independent workers, enrolling on the government marketplace can be less costly, though plans may not be as comprehensive. For other workers, enrolling with an insurer like Solo Health may make more sense cost-wise and be a better plan. For some individuals (especially those with S-Corps), getting insured through a full-benefits platform like Opolis can help them get premium coverage while saving thousands of dollars. 

Before we learn more about each option available to you, let’s take a minute to learn about some of the terminology associated with health insurance.

2. Learn some of the terminology associated with freelance health insurance plans

There are several different types of costs associated with insurance plans:

• Premium: This is the monthly fee you pay to have insurance coverage.
• Copay: A fixed dollar amount that you pay out of pocket for a medical expense until you have reached your out-of-pocket maximum. Insurance companies normally charge either copays for most services other than specific preventive health ones.
• Deductible: The annual amount you are responsible for paying toward medical expenses before your insurance coverage “kicks in” to pay the rest. Although copays apply towards your deductible, you will still be charged copays after you have reached your deductible.
• Maximum out-of-pocket: This is the maximum amount you will be responsible for paying toward medical expenses covered on your plan. Once you have reached this amount, you will not be charged for additional eligible medical expenses.
• Marketplace: The Health Insurance Marketplace, also known as the exchange, is a platform established under the Affordable Care Act (ACA) that enables individuals and families to compare and purchase health insurance plans.
• Open enrollment: This is the crucial time of year when you can enroll in or make changes to healthcare plans on the federal and state marketplace. Beginning November 1st, 2024 and running until January 15th, this is your opportunity to secure the coverage you need for the upcoming year.

To help understand your health insurance plan, read our glossary of health insurance terms.

The overall cost of your freelance health insurance plan is typically a combination of the various pricing factors listed above. For example, plans with higher premiums (monthly payments) will frequently have lower copays and deductibles. If you expect to have high medical expenses in the next year, you may want to sign up for a plan with a higher premium and lower copays.

3. Make a list of things that are vital to your healthcare plan

Be sure to consider your medical and financial needs. For example, if you are relatively young and healthy, you might want to select a high-deductible or catastrophic plan. If you have a chronic medical condition, a plan with a more expensive premium but lower out-of-pocket costs might work better for you. 

You can take our custom Health Insurance Survey to find out what the best health insurance plans are for you (survey will be available beginning 10/28). Additionally, you can sign up to get a free one-on-one consultation from Solo Health or benefits platform Opolis to discuss your needs with a live representative.

4. Understand your options for low cost care

You might be eligible for a free or heavily subsidized freelance health insurance plan based on a number of factors. Read on our blog to find out if you’re eligible.

There are several government programs that may offer free or extremely low-cost coverage. These include:

• Veterans Health Administration (VA): If you or your spouse is a veteran, you may be eligible for free VA health care.
• Medicare: If you are 65 or older, have end stage renal disease, or qualify for social security disability payments, you are eligible for Medicare.
• Medicaid: If your modified adjusted gross income is below 100 or 138 percent of the Federal Poverty Level (depending on your state of residence) for your size of household, you are eligible for Medicaid and ineligible for ACA subsidies.
• Children’s Health Insurance Program (CHIP): If you do not qualify for Medicaid, your child may still be eligible for the low-cost CHIP program. Prices and eligibility vary by state.
• Premium Tax Credits (ACA Subsidies): Before you shop for plans on exchanges, find out if your income qualifies you for subsidies in the form of premium tax credits: https://blog.freelancersunion.org/2024/10/15/free-or-subsidized-plans-for-freelance-health-insurance/

If you don’t qualify for any of the above options, it is still important to get covered. At Freelancers Union, we have over 25 years of experience connecting freelancers to the right health insurance plans. You can take our survey to get a custom list of options tailored for your needs, or browse all of our health options to decide what works for you (beginning 10/28).

5. Important Dates to Know

Open Enrollment for Medicare begins on October 15th, 2024. For other plans, the Open Enrollment period runs from November 1 to January 15 in most states. For coverage starting on January 1, most people need to apply by December 15. Make sure to check your state’s details below!

Open Enrollment from Nov 1st to Jan 15th:

Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Open Enrollment from Nov 1st to Jan 31st:

California, District of Columbia, New Jersey, New York, Rhode Island

Open Enrollment from Nov 1st to Jan 23rd:

Massachusetts

Most states require you to enroll by December 15 if you need coverage starting January 1, 2024 and enrollment by January 15 for February 1 coverage.

6. What options are available?

Browse the Health Marketplace: (Beginning 10/28) Catch simplifies government websites and allows you to easily compare plans on the federal and state marketplaces. Find the best plan at the best price, and ensure you’re getting any health insurance-related tax credits you might be qualified for.

Explore Affordable PPO Plans: Solo Health Collective’s innovative PPO plans offer affordable monthly premiums, full coverage after your deductible is met, and year round signups – no open enrollment period required.

Get the Benefits of a W2 Employee: Opolis is a freelance employment and benefits platform providing affordable, premium group benefits, payroll, tax compliance, and more.

When you buy health insurance through Freelancers Union, you’re investing in our community. At no additional cost to you, a portion of your purchase of freelance health insurance goes right back to our organization and the resources that we offer to our members (including FREE membership, educational resources, legal assistance, and more).

El lugar donde contrata su seguro es importante. Invierta en su salud y en un futuro mejor.