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How to Get Health Insurance as a Freelancer

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Female patient talking to male doctor about health care coverage

One of your biggest expenses as a freelancer — after income and other taxes — might be health care coverage and medical costs. However, when it comes to getting covered, a lot has changed over the past few years.

Are you aware of all the options available to cover your costs? Here’s a breakdown of the options and how to make them affordable.

Affordable Care Act (ACA)

You probably know the Affordable Care Act requires all individuals to have health insurance regardless of preexisting conditions. There are a few ways to avoid this individual mandate, but for the most part, you need coverage to dodge a tax penalty even as an independent contractor.

At first glance, your two basic options for health insurance under the ACA are:

  • Get coverage from an employer-sponsored insurance program, a private insurer, Medicare Part A, Medicaid, or a variety of other programs and providers listed on the IRS website;
  • Buy coverage through the Health Insurance Marketplace

As a freelancer, it’s important to review the options available through the Marketplace and sign up for coverage. If you go without health insurance and don’t meet the ACA coverage requirements, you may incur a penalty when you file your tax return. That penalty is called the Individual Shared Responsibility Payment.

Premium Tax Credits

If you buy coverage through the Health Insurance Marketplace, you could qualify for a tax credit to reduce the cost of your monthly insurance premiums.

To qualify for the credit, you must file an income tax return and meet a list of other requirements. The Internal Revenue Service (IRS) website has a tool to help you determine whether you’re eligible for a Premium Tax Credit.

Exemption from Health Insurance Coverage Requirement

The IRS website also has an online tool for individuals and families to help determine whether you qualify for a health insurance plan exemption.

To use the tool, you’ll need to have this information handy:

  • Tax filing status
  • Number of dependents, if any
  • Adjusted gross income
  • Adjusted gross income of your dependents

Reduced Cost Health Care Options

If you have self employment income but aren’t wildly successful, you might qualify for reduced price or even free health care. If you think you only qualify as impoverished if you’re homeless, that’s not always the case.

Michelle Katz, MSN, LPN and author of “Healthcare Made Easy: Answers to All of Your Healthcare Questions Under the Affordable Care Act”, suggests checking the poverty levels in your state or county. They might be based on the poverty guidelines issued by the U.S. Department of Health & Human Services. In that case, you can have a relatively high income but still qualify for free health care and other benefits.

Katz encourages people to think beyond health insurance plans and traditional medical providers when trying to cut costs. “Try outpatient community centers and surgical centers. There’s a bit more flexibility in pricing since they don’t have the overhead that hospitals do,” she said.

“Non-profit as well as some for-profit hospitals provide ‘charity care’ and other discounts for treatments for those who qualify in exchange for a tax credit for providing the discounted treatment,” she said.

“You might have to do a bit of digging, but you could get health care or even surgery for free. Go to a specific non-profit for your condition or ailment. Ask your doctor and other people with the same condition about resources,” said Katz.

Prescription Medications

Prescription medications can be quite costly. However, some major pharmaceutical companies give discounts to hospitals, which ultimately reduces the patient’s cost.

“Some hospitals participate in the 340B Discount Drug program created by the federal government,” said Katz. “That requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices.”

Katz suggests researching to see which providers benefit from this program and ask them for the discounts.

You can also check websites like for competitive searches of your local pharmacies to find coupons.

Negotiate with Doctors and Hospitals

In some cases, you can negotiate the anticipated expense of a health visit to avoid a huge medical bill. Whether or not you have insurance, try bargaining with your health care providers, suggested Katz.

Paying with cash is another way you can sometimes get a reduced rate for appointments and medical procedures. Plus paying up front might certainly help when negotiating costs for upcoming medical expenses.

Free Health Care Coverage Resources

Try the website. It’s a free, confidential referral and information service that strives to help you find local resources about medical, dental, mental health or in-home health care. It can also assist in locating other health and human services.

It’s important to take care of your health and ensure you’re financially prepared for unexpected events, but you’re not limited to costly medical insurance.

A wealth of discounted or free health care coverage and treatment options are available even if you are a moderately successful freelancer.

About Valerie Rind

Valerie Rind is the author of the award-winning book, “Gold Diggers and Deadbeat Dads: True Stories of Friends, Family, and Financial Ruin.” With expertise in a broad range of personal finance and lifestyle topics, her work has been featured online in Time, Forbes, Fortune, MSN, U.S. News & World Report, The Huffington Post, PBS Next Avenue, and her own website at

During a hiatus from a corporate career, Rind worked for a housing authority where she created its pilot personal finance program for low-income individuals. She was one of the founding volunteer moderators for the myFICO community forum. Her social media links include Twitter and LinkedIn.


  1. I thought the 3rd option is to buy your own insurance outside the Marketplace? That is what I do. It’s a good thing too, because my county in my state is down to one shaky provider. I have Blue Cross/Blue Shield through Farm Bureau. I pay currently $252 per month, includes dental. And yes, it covers everything I need. It is higher deductible- $3,500 and $5,500 out of pocket. I used it this year for an ACL surgery and paid the $5,500 out of pocket. For the same exact policy on the exchange, it would have cost me over $900 a month. I’m keeping my “grandmothered” policy as long as I can.

    • Valerie Rind says:

      Hi Kim, thanks for your response. We included “buy from a private insurer” in the first option. Looks like you’ve figured out a solution for your situation!

  2. Paul Franklin says:

    There is also excellent coverage available thru sharing ministries such as Samaritan Ministries and Christian Care Medishare. Low rates and then low out of pocket for expenses.
    These have been fantastic for my family. They are fully ACA compliant.

    • Valerie Rind says:

      Paul, thanks for your comment. I have heard of the sharing ministries and understand they share pools of resources but are not insurance providers. Glad you have been happy with the coverage.