Private Health Insurance Direct Questions

What are the health insurance options for the self-employed?

The self-employed typically buy an individual ACA-compliant private health plan off-exchange or on-exchange, and if they have net self-employment income they can deduct the premium above the line under the self-employed health insurance deduction (IRS Publication 535).

Reviewed by Jason Burns, Editor & Steward · Last verified 2026-07-19

What it means

  • Self-employed workers are treated as individual buyers, not group buyers.
  • They can choose a PPO, HMO, EPO, POS, or HSA-eligible HDHP directly from a carrier.
  • The self-employed health insurance deduction reduces adjusted gross income for the premium paid for you, your spouse, and dependents.

Action steps

  1. Confirm you have net self-employment profit for the year the premium is paid.
  2. Keep monthly premium statements and 1095-B/1095-A forms for your tax preparer.
  3. Consider an HSA-eligible HDHP if you want to shelter income and pay medical costs with pre-tax dollars.

Risks & deadlines

  • The deduction cannot exceed your net self-employment earnings.
  • You cannot take the deduction for any month you were eligible for employer-subsidized coverage through a spouse.

Sources

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Phone consultations only — 1-866-254-9580. Private Health Insurance Direct Questions is an educational question directory for full-price, off-exchange private health insurance buyers. It is not medical, legal, tax, or benefits advice.

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