When you work for yourself, health insurance is easy to push down the list. There’s no HR department reminding you, the paperwork looks confusing, and when money is tight, a monthly premium can feel optional.
You’re not alone. Self-employed workers have been more than twice as likely to be uninsured as people who work for private companies or the government. But going without coverage carries extra risk when you’re the one running the show.
When you can’t work, you don’t get paid
An employee who gets sick or hurt usually has paid time off, maybe disability coverage and a job waiting when they get back. When you’re independent, a health problem can stop your income completely. That’s hard enough without a large medical bill landing at the same time.
One emergency can mean years of debt
Medical costs add up fast, and they don’t wait for a good month. About 20 million adults in the U.S. owe medical debt, and people who were uninsured for part of the year are much more likely to carry it than people who were covered all year. For someone whose income already goes up and down, a single emergency room visit or hospital stay can take years to pay off.
You may skip care you need
Without insurance, it’s natural to put off checkups, skip a prescription or wait to see if a problem goes away. Small issues can turn into bigger, more expensive ones. With a Marketplace plan, many preventive services like checkups and screenings are covered at no extra cost.
Coverage has real protections
If you’ve been turned off by insurance in the past, a lot has changed. Marketplace plans:
- Can’t turn you down or charge you more because of a pre-existing condition
- Must cover essential health benefits, including emergency care, hospital stays, prescriptions and more
- May come with premium tax credits that lower your monthly cost, based on your income
You’re more common than you think
Millions of self-employed people and small business owners already buy their own coverage through the Marketplace. In 2023, they made up more than a quarter of Marketplace enrollees between ages 21 and 64. Buying your own plan is a normal part of working for yourself.
The bottom line
Being your own boss shouldn’t mean betting your health and your savings that nothing will go wrong. Open enrollment is the best time to get covered. If you’re not sure where to start, a quick conversation with a licensed advisor can show you your options and what you may qualify for.
Information current as of September 2026. Your advisor can confirm what applies in your state.
