Best Health Insurance Options if You're Self-Employed or Retired
Published Sep 22, 2019
— Last updated Sep 23, 2019
Most people have no idea that there are some lesser known alternative options for health insurance in the US for people who can't get insurance through an employer.
In the US, most people look to their employer to provide their health insurance. But more than ever, many people don't have a traditional full time job that provides that coverage. This includes retired people, contract workers, part-time workers, digital nomads, and the self-employed. Finding health insurance without a job is also a major concern of people pursuing the growing trend of early retirement (financial independence / retire early — "FIRE").
The available options look somewhat bleak. The Health Insurance Marketplace (HealthCare.gov) is the only available option that most people are aware of when it comes to getting health insurance independently. But the prices have skyrocketed, and the choices for Marketplace plans have dwindled.
But there are some great alternative options that most people aren't aware of.
Consider Using the Marketplace
The HealthCare.gov Marketplace was established by the government to provide a place where people can buy insurance without getting it through an employer. But the insurance companies have been having difficulties in providing reasonably priced plans on the Marketplace without losing a lot of money. The problem is that it's not just healthy self employed people who are buying plans there, but also most people who are too sick to work end up buying through the Marketplace. And providing for the healthcare for all those sick people drives up the cost of providing Marketplace plans.
So health insurance companies have had to raise their Marketplace prices, and they've also been providing fewer "PPO" plans that allow more choice in doctors and hospitals, and instead mostly only offer "HMO" plans that require that you use providers in a limited network to help them reduce costs by negotiating lower healthcare prices.
But it still may be your best option if your yearly income is low enough to qualify for a "premium tax credit". You can apply the tax credit automatically to your monthly premium, so the credit effectively lowers your monthly payment. The income limits change each year, but you can find out here if your income level will qualify you for a premium discount.
Health Insurance Plans Outside of the Marketplace
If you don't qualify for a tax credit from the Marketplace, your best options for insurance may be looking outside of the Marketplace. And even if you do qualify for a discount, in some cases you may still be able to get better or cheaper coverage from other options.
To go that route, you can buy directly from an insurance company or through an insurance agent or broker (including insurance websites). Because of the wider variety of options, this can involve spending significantly more time doing research and comparing prices and options.
Faith-Based Health Coverage
When the Affordable Care Act ("ObamaCare") was crafted they added a special exception to the insurance mandate for people who get coverage through approved religious organizations. This can be a way to get health coverage at a much lower cost and with a less restrictive range of options than many health insurance plans. There are some catches to be aware of, but this can be a great alternative for many people.
The first catch to be aware of is that the coverage they offer isn't technically health insurance and it isn't subject to the same strict regulations as health insurance companies. These groups can choose what types of treatments they will and won't cover. Because of their religious basis, many won't cover procedures such as contraception or genetic testing. They also may have the right to deny coverage based on any criteria, including their views on the cost or necessity. So read the fine print carefully. Also, each organization has its own guidelines as to what they expect in terms of your adherence to the faith they represent. They may have guidelines that ask you to adhere to certain types of lifestyles, church membership, etc.
You may be able to qualify for a discount group rate from "Membership or Association Health Plans". These are usually through groups that are associated with your line of work or some other affiliation. Before the Affordable Care Act, these membership-based plans were often low quality plans with little real coverage. But after the restrictions enforced by the ACA, insurance plans still must provide the same broad coverage as any other health insurance plans.
Some of the groups have stricter membership requirements than others, and in general you'll find that the better rates are from groups that have more stringent membership requirements. Search for groups that fit your particular line of work or situation, but some of the larger ones include the National Association of Female Executives, Small Business Service Bureau, Writers Guild of America, and the Freelancers Union. You may also want to check with your local Chamber of Commerce to see if they offer group rate health insurance for members.
Become a Student
Universities often offer discount rate health insurance to their students. If you have free time because you're retired (or early retired), this could be a sensible option if taking college classes was already something you were considering anyway. The schools will typically require that you're accepted as an actual degree-seeking student, not just taking a class or two. So this option probably doesn't make financial sense to sign up for classes if health insurance is your only goal. But if you were considering attending anyway, this is definitely an option worth looking into.
Become a Business
This isn't an option for everyone, but it might be if you're running a business, even if it's just a side business. Many health insurance companies offer health insurance plans for companies as small as two people. So if you're already working on a business with a partner, you may be able to get better health insurance for a better rate than you can as an individual.
In case you're wondering, in most cases you won't be able to qualify if your spouse is the other half of your business partnership. But even then, it may be worth looking around to see if there are any plans you can qualify for with a spouse as your employee or partner. Otherwise you may want to consider whether it could make sense to bring in an outside partner (or employee) for your business.
The specific requirements will vary depending on the company and plan, but they'll typically want to see some kind of proof of your business arrangement. Some may require that you have formed an LLC for example. And they may also need to see documents showing that you have a partnership (such as Schedule K-1 tax forms), or an employee arrangement where you have filed the various tax forms that are required of employers for the previous quarter.
The health care situation in the US is complicated for people who aren't able to get health insurance through their employer. But with a little research, and maybe some creativity, you may be able to find some good deals to get the coverage you need.
This blog post contains no paid content, no affiliate links, and no compensation was paid for any products or services mentioned in this post. The information in this blog post may contain opinions or incorrect information, and we always encourage you to do your own research before making any financial decision.