Comparison Guide
Health Coverage Options for Self-Employed and 1099 Workers
Self-employment changes everything about how you access health coverage. Here are the four paths JHA most often helps 1099 workers, freelancers, and small business owners navigate.
| Option | Cost shape | Tax treatment | Network | Best for |
|---|---|---|---|---|
| ACA Marketplace plan | Subsidized for many self-employed; income-based | Premium deductible as self-employed health insurance deduction | Carrier networks vary | Subsidy-qualifying, pre-existing conditions, regulatory peace of mind |
| Health share program | Generally lower than insurance | Not deductible as health insurance; not pre-tax | No network — direct-pay providers | Healthy individuals/families, faith-aligned, comfortable with non-insurance arrangement |
| DPC + catastrophic | Often the lowest total monthly | DPC fee deductibility varies; catastrophic premium deductible | DPC: any direct-pay provider; catastrophic: carrier network | Self-employed wanting same-day primary care + financial protection for major events |
| Spouse's group plan | Whatever spouse's employer charges | Pre-tax through spouse's payroll | Carrier network | When a spouse has affordable employer coverage |
Important: Health share programs are not insurance and have varying state availability — verify before enrolling. DPC is not insurance. Tax deduction eligibility for self-employed health expenses depends on your specific situation; consult your tax advisor.
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