Health insurance options for the self-employed, a doctor explains

It’s hard to figure out what to do for health insurance if you are self-employed. The standard employer sponsored plans end up being way too expensive for most people to pay for on their own. I’m self employed and I use a combination of Direct Primary Care (DPC), and a healthshare. I believe that this is the best option for most people.

What are the best options if you and your family are healthy?

If you and your family are healthy, pairing DPC with a healthshare is the best way to go. Direct Primary Care (DPC) is where you pay a monthly membership fee to a doctor who can then see you as many times as you like. It’s kind of like a gym membership. They can give you medications and labs at cost, and on the whole the care is relationship and much better than what is otherwise available with the standard 7 minute visits that you will get with using insurance. Good DPC will cover about 80% of your medical needs. For catastrophic care, a healthshare can often be much more affordable and better than standard insurance care. However, they aren’t regulated like heath insurance and you need to be careful you choose the right one. Healthshares do not function like insurance, you are essentially presenting yourself as uninsured to hospitals and then paying cash or getting a payment plan, for which the healthshare will reimburse you. Note that they don’t cover pre-existing conditions in most cases.

What are the best options if you and your family have large regular medical expenses?

If you and your family have large regular medical expenses and many pre-existing conditions, DPC care is still the way to go. A healthshare may not be as good as they generally do not cover pre-existing conditions. An option would be to get Medicaid if at all possible. As a self employed individual you may have some low income years that will qualify you. Otherwise, you can select an Obamacare plan. If your income is low enough they will give you a subsidy so it isn’t as expensive. However, the plans generally have very high deductibles and don’t cover much of anything until you hit them, so they should be reserved for truly catastrophic issues and you are better off paying cash for everything else.

Are there any insurance plans to avoid?

Short term health insurance are plans that are offered for up to one year. Oftentimes people will mistake these with regular insurance or Obamacare regulated plans. They are not regulated and unfortunately many will find that they cover next to nothing. You are almost better off going without any insurance than using these.

I hope we were able to answer some of your questions about health insurance options for the self employed. Feel free to contact us below with further questions!