Self-employed workers and freelancers mainly choose between ACA Marketplace coverage and private off-exchange plans. All ACA plans must include essential health benefits such as preventive care, mental health, maternity, prescription drugs, and pediatric dental and vision. Premiums are higher than in prior years, but there is also a major policy improvement: all Bronze and Catastrophic ACA plans are now HSA eligible, giving independent workers more flexibility to save on taxes while paying for care.
Understanding ACA Marketplace Plans
ACA plans are grouped into metal tiers that determine how costs are shared between you and the insurer. The medical benefits are identical across tiers, but monthly premiums, deductibles, and out-of-pocket costs differ.
Bronze Plans
Bronze plans have the lowest monthly premiums and the highest deductibles. A typical Bronze plan carries a deductible around $7,500, meaning most medical services are paid out of pocket until that amount is reached. Preventive services are still covered at no charge. These plans now qualify for HSAs, making them attractive for healthy self-employed people who want to keep premiums low and save on taxes.
- Lowest monthly premiums
- Very high deductibles
- Preventive care covered before the deductible
- HSA eligible
Silver Plans
Silver plans strike a middle ground between premium and cost sharing. They cover about 70 percent of healthcare costs on average and are the only tier that qualifies for cost-sharing reductions for lower-income households. These subsidies can reduce deductibles and copays to extremely low levels, making Silver plans especially valuable for families and moderate users of care.
- Moderate premiums and deductibles
- Only tier with cost-sharing reductions
- Includes maternity and mental health
- Good value for subsidy-eligible households
Gold Plans
Gold plans are built for people who expect frequent medical use. Monthly premiums are higher, but deductibles and copays are much lower, which reduces total spending for those with chronic conditions or ongoing prescriptions.
- Higher premiums
- Low deductibles, often $500 to $1,000
- Small copays for most services
- Best for heavy users of healthcare
Platinum Plans
Platinum plans pay about 90 percent of medical costs and offer very low deductibles. They are rare in the individual market and come with very high monthly premiums.
- Very high premiums
- Minimal cost sharing
- Near full coverage
Catastrophic Plans
Catastrophic plans are limited to people under 30 or those with hardship exemptions. They have very low premiums and extremely high deductibles. These plans now qualify for HSAs and mainly serve as protection against major medical emergencies.
- Lowest premiums
- Very high deductible
- HSA eligible
- Restricted by age or hardship status
What All ACA Plans Include
Every ACA plan must cover a comprehensive set of essential health benefits. This ensures self-employed workers are protected against major financial and medical risks.
- Preventive services at no cost
- Mental and behavioral health treatment
- Maternity and newborn care
- Prescription drugs
- Pediatric dental and vision
Although coverage is broad, out-of-pocket costs remain significant. Deductibles often range from $7,500 to $9,000, and maximum out-of-pocket limits can exceed $10,000. Federal tax credits continue to lower premiums for those who qualify.
Major Insurer Options
Kaiser Permanente
Kaiser operates an integrated HMO system in states such as California, Colorado, Georgia, Hawaii, Oregon, Washington, and the DC area. Members receive care through Kaiser’s own hospitals and doctors, which allows strong coordination and predictable costs. Bronze plans qualify for HSAs, while Silver and Gold tiers reduce cost sharing significantly.
This is a strong option for self-employed people who value simplicity and are comfortable staying within one medical system.
Blue Cross Blue Shield
Blue Cross Blue Shield affiliates operate nationwide and offer the widest range of plan designs, including HMOs, PPOs, and EPOs. Networks are generally large, making it easier to keep your doctors when you move or travel.
This carrier suits freelancers who want flexibility and broad provider access.
UnitedHealthcare Choice Plus PPO
UnitedHealthcare’s Choice Plus PPO plans provide nationwide access to doctors and hospitals. These plans often feature lower deductibles than typical marketplace options and include first-dollar coverage for many office visits. Many also bundle in accident coverage and telemedicine.
These plans are sold off-exchange, so subsidies do not apply, but they can be cost-effective for higher-income self-employed professionals.
Oscar Health
Oscar offers ACA-compliant plans in 18 states with a strong focus on digital tools. Members get free telehealth, app-based messaging with clinicians, and coordinated care teams. Deductibles are similar to other marketplace plans, but the technology experience is much smoother.
This insurer is well suited for freelancers who prefer managing healthcare through their phone.
Molina Healthcare
Molina specializes in low-cost HMO plans in about 15 states. Premiums and deductibles are often lower than average, making it attractive for subsidy-eligible self-employed households.
It works best for cost-conscious families willing to use a more limited provider network.
Ambetter by Centene
Ambetter operates in 29 states and is known for some of the lowest premiums in the marketplace. Bronze HDHP plans qualify for HSAs and often cost far less per month than competing carriers, though deductibles are high. Wellness rewards and telehealth services add extra value.
Ambetter fits freelancers who want the lowest possible monthly premium.
Other Notable Options
Some self-employed workers may also consider alternatives depending on income and business structure.
- Anthem Blue Cross for strong regional ACA coverage
- Cigna for international or travel-friendly benefits
- Solo Health Collective for high-income solo entrepreneurs seeking PPO coverage
- Short-term or sharing plans only for temporary gaps
Short-term and medical sharing plans do not include essential health benefits and exclude pre-existing conditions, so they are not suitable for long-term protection.
Comparing Standout Plans
Self-employed buyers should compare premiums, deductibles, and network access rather than focusing on one feature alone.
- Kaiser Bronze HMO offers low premiums with a $7,500 deductible and integrated care
- Blue Shield Silver 73 in California provides no deductible for subsidy-eligible households
- UnitedHealthcare Gold PPO delivers nationwide access with moderate deductibles
- Oscar Silver emphasizes telehealth and digital care
- Ambetter Bronze offers the lowest premiums with high deductibles and HSA eligibility
All of these plans include essential health benefits, but they differ in how costs are shared and how flexible the provider network is.
Choosing the Right Plan
The best health plan for a self-employed person depends on income, health needs, and tolerance for financial risk. Lower-income freelancers usually benefit most from Silver plans with cost-sharing reductions. Healthy individuals with stable cash flow often do well with Bronze HSA-eligible plans. Higher-income professionals who need flexibility tend to favor private PPOs.
The right choice balances monthly premiums, deductible exposure, and access to doctors in a way that protects both your health and your business.