The solopreneur’s guide to getting insured | Oscar Rx | hioscar Blog | Oscar
Solopreneur? Freelancer? Here's your guide to getting insured.
Work for yourself? Have no employees? Here’s what you need to know about getting health insurance.
How Insurance Works Oscar Health Insurance
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There are a lot of perks to being a freelancer or solopreneur. You set your own hours. You are your own boss. You collaborate with anyone you want. You follow your vision. You embody your own brand.
The downside of working for yourself is that you’ve got extra stuff on your checklist of to-dos that an employer would typically cover: health insurance, retirement fund, life insurance... Even though you live for the thrill of creative problem solving, figuring out how and where you can get these benefits can be overwhelming.
When you’re busy juggling a client list or landing your next big deal, there’s not a lot of time for stuff like researching and buying a health insurance plan. We’ve assembled this guide so you can find a good health plan fast and get back to hustling.
Why is getting health insurance important?
A health insurance premium (opens in new tab) is a pretty hefty sum to add to your monthly expenses. In the past, many freelancers have chosen to go uninsured to save a penny. But thanks to the Affordable Care Act (ACA), which was created to help provide affordable health care to all Americans, there are now more options when it comes to getting insured. Those options can actually save you money in the long run.
Even if you’re healthy, there’s good reason to invest in insurance. All health plans now come with free essential health benefits, which help you stay healthy and spot issues before they become a problem. With free screenings, , labs, and annual checkups with your , you’ll save money and get sick less.
If you have a chronic condition, get routine care, or take medications regularly, then health insurance will help you keep your costs down so you aren’t paying out-of-pocket for these types of expenses.
Lastly, emergency medical bills are a leading cause of debt (opens in new tab) in the U.S., and health insurance plans can help protect you and your pocketbook.
Where to get health insurance.
As a solopreneur, there are several ways you can get health insurance:
Through an insurance Marketplace (opens in new tab) (also known as an Exchange), either HealthCare.gov (opens in new tab) or your state’s health insurance marketplace. Based on your financial information, you may be eligible for financial aid (opens in new tab), which may significantly lower the cost of your monthly premium and other health care expenses. You can also determine if you’re eligible for government-assisted insurance like Medicaid or Medicare when you sign up through a marketplace.
Through your former employer.COBRA (opens in new tab) is a health insurance extension available for people who were formerly covered on an employer-sponsored plan. After your employment is terminated, you may elect to continue your coverage via COBRA. You’ll have 60 days after you’ve left your job to sign up. Talk to the HR department before you leave your current job to understand their COBRA process. When you elect COBRA, you may remain covered up to 18 months after you have left your job as long as you pay your monthly premium on time. This option is often a more expensive one, however allows you to continue care with doctors you may have been seeing while you were at your job.
Through a client. Are you an artist affiliated with a gallery? Are you a writer who’s regularly staffed for a certain paper? If so, then it’s worth it to ask your client if they offer health benefits to their employees. Just because you aren’t 9-5 doesn’t mean you aren’t eligible. Many states have minimum hourly requirements, where employers are required by law to offer employees health benefits if they work a certain number of hours a week. Even if you work fewer hours, this still may be an option. It never hurts to ask.
Through your union. If you’re a member of a union like Freelancers Union (opens in new tab) or Actors' Equity (opens in new tab), check to see if they offer health insurance. In order to be eligible for coverage through your union, you may be required to log a certain number of hours per week, quarter, month, or year. Contact your union representative for more information about your options.
In the market for individual health insurance? We’ve got you covered. Check out our plan options (opens in new tab) in your state.
What type of plan should I buy?
You shouldn’t pay for a plan with all the bells and whistles if you aren’t going to use them. The best way to avoid buying a plan with unnecessary features is to understand the cost-sharing components (opens in new tab) of a health care plan.
If you’re under 30 and healthy, now’s the time to consider a catastrophic plan (opens in new tab), which has a considerably lower premium and high deductible. This means that you’ll pay a high cost share when you get care, but you’ll still have access to free preventive (opens in new tab) benefits so you can stay healthy throughout the year.
If you see a doctor regularly or have a number of year-round prescriptions, you may want to opt for a Gold or Platinum plan. If you don’t need much care and don’t qualify for a subsidy, it may be cheaper to go with a Bronze or Silver plan.
Know your deal breakers.
Before you buy insurance, it’s important to identify your deal breakers so you can make sure you are purchasing the right plan. Here are a few of the questions you should ask yourself:
Who are my doctors? Will my new plan still pay for my care with them?
What medications do I take? Will my health insurance pay for them? If not, what other similar types of drugs do they cover?
Does this insurance company allow me to access my health and plan information online (cause waiting on hold is such a drag!)?
Can I get affordable coverage for my whole family?
Set up an HSA.
When you’re shopping for a plan, consider buying one that’s HSA-compatible. Health Savings Accounts (HSAs) (opens in new tab) are pre-tax accounts that are linked to high-deductible health insurance plans. You can use the fund to pay for any medical expenses throughout the year.
No matter how long the money remains in the account, you’ll never lose it. The funds will roll over year to year and will continue to accrue interest until you use it all to pay for your medical expenses. With an HSA, you can save you 20-30% on your medical expenses. Any interest earned is tax-deferred, and withdrawals are tax-free. The only rule is that you must spend these funds on qualified medical expenses - sorry, no European vacations.
Deduct your premiums.
As a freelancer or solopreneur, end-of-year tax deductions can save you a lot of money. Health, dental, and long-term care expenses all qualify as tax-deductible business expenses. In order to deduct your health care premiums, you must do the following:
Show that your business has a profit. If you’re self-employed and earn nothing or incur a loss, then you can’t deduct this as an expense. The deduction can only amount to as much you earn from your business. Don’t combine income from multiple businesses, otherwise you won’t be eligible for reimbursement. Don’t sign up for other health coverage. This means if you’re on COBRA from your last employer, or have health insurance through another means (like your union) you can’t deduct premiums as a business expense.
Ways to save once you’re covered.
Once you have health insurance, you’ll want to get the most out of your plan. Here’s how you can reduce your health care expenses during the year.
Use telemedicine services (opens in new tab) instead of going to the doctor. Many health plans offer free or inexpensive telemedicine services, which can help treat minor conditions like skin issues, colds, sinus infections, or get refills on routine prescriptions like birth control.
See doctors who take your insurance. Many health plans now require that you stay in-network (opens in new tab) in order for your care to be covered by your health insurance plan. Check with your health insurance company before you get care to make sure that your doctors take your plan.
Sign up for mail-order Rx delivery. Insurance companies are now offering mail-order Rx programs so you can save making the trip to the pharmacy. This is a great options for maintenance drugs.
Opt for generic drugs when you get your Rx filled. Insurance companies cover most generic prescriptions (opens in new tab) for the cost of a low copayment. Brand names tend to be more expensive and aren’t always covered by insurance companies.
Take advantage of your free essential health benefits (opens in new tab). All insurance plans now cover annual physicals, well-woman exams (opens in new tab), preventive vaccines and lab work, certain types of birth control, and routine screenings like colonoscopies and mammograms. As long as you stay in-network, your health insurance company will pick up the tab.
If you need care immediately but it’s not an emergency, try an urgent care clinic (opens in new tab) before making a trip to the ER. Hospital visits are generally more expensive.
Establish a relationship with a primary care doctor. Some plans require referrals (opens in new tab) from a primary care doctor when you need to see a specialist. Some don’t. Either way, it’s a good idea to build a relationship with a primary care doctor to avoid the expense of unnecessary doctor’s visits or medical tests.
