When you work for yourself, there is no employer plan to sign up for. Finding coverage is up to you, and your income may change from month to month. The good news is that self-employed people have solid options, plus a tax break that many overlook. Here is how to cover yourself and your family.

Your main coverage options

A marketplace plan. You can buy a plan through HealthCare.gov or your state's marketplace during open enrollment, which runs from November 1, 2026 to January 15, 2027 in most states.
A spouse's or partner's job-based plan. This is often cheaper than buying your own, so compare the costs.
A parent's plan if you are under 26.
Medicaid if your income is low enough. You can apply at any time of year.

Getting marketplace savings when your income varies

Premium tax credits are based on your expected household income for the year. For self-employed people, that means estimating your net self-employment income, after business expenses.

Make your best estimate when you apply, based on last year and your current work.
Update it during the year if your income changes a lot. That helps you avoid owing money back at tax time.
Know the limit. For 2027, households above 400% of the federal poverty level do not qualify for premium tax credits.

The self-employed health insurance deduction

If you have a net profit from self-employment, you may be able to deduct your health insurance premiums on your federal tax return. The deduction can include:

Medical, dental and vision insurance premiums
Coverage for your spouse and dependents
Coverage for a child under 27, even if they are not your dependent
Qualified long-term care insurance, up to age-based limits

There are some limits. You cannot take the deduction for any month you were eligible for a subsidized employer plan, including through a spouse's job, even if you did not enroll. The deduction also cannot be more than your net self-employment earnings. It is claimed on Schedule 1 of Form 1040, sometimes with Form 7206.

Consider pairing a Bronze plan with an HSA

Starting in 2026, Bronze and catastrophic plans are eligible for a Health Savings Account. An HSA lets you save for medical costs tax-free, which can be a smart move if your income is good but uneven. For 2027, you can contribute up to $4,500 for yourself or $9,000 for a family.

Be careful with cheap alternatives

Short-term plans and health care sharing ministries can look cheap, but they often exclude pre-existing conditions and may not cover essential care. They are also not covered by federal surprise-billing protections. Read the details carefully before you choose one.

The bottom line

Being your own boss means managing your own coverage, but it also comes with real savings. Estimate your income carefully, compare marketplace plans, and talk to a tax professional about the self-employed health insurance deduction.