Self-employed coverage
Self-employed health insurance, without the marketplace runaround.
Three buying channels. 100% premium deduction via Form 7206. Year-round enrollment on private plans. We model after-tax cost both ways.
The short version
Self-employed workers in the U.S. — sole proprietors, partners, LLC members, and 2%+ S-corp shareholders — can buy health insurance through three main channels: the ACA marketplace (Healthcare.gov or a state exchange), private off-exchange plans through a broker like TMRW, or association group plans. Premiums are 100% deductible above-the-line on your federal return via IRS Form 7206, reducing AGI directly. Private off-exchange plans don't qualify for ACA premium tax credits, but they often offer broader networks, lower deductibles, and year-round enrollment.
Your three buying channels
Each has a real tradeoff. Subsidy eligibility usually decides.
Self-employed coverage channels · 2026 plan year
| ACA Marketplace | Private (off-exchange) | Association group | |
|---|---|---|---|
| Best for | Income under 400% FPL (subsidies kick in) | Income above subsidy cliff; need broader networks | Members of qualifying trade groups |
| Tradeoff | Limited to Healthcare.gov plans; OEP/SEP-locked | No subsidies; year-round enrollment | Limited carrier list; eligibility varies |
| Tax treatment | Deductible (Form 7206) — but cannot combine with PTC | Deductible (Form 7206) | Deductible (Form 7206) |
The decision usually comes down to subsidy eligibility. If your household income qualifies for ACA premium tax credits, the marketplace almost always wins. If you earn enough that you don't qualify for subsidies, off-exchange private plans typically win on price and network.
The self-employed health insurance deduction
One of the most underused tax breaks for the self-employed.
Deduct 100% of premiums for medical, dental, vision, and qualified long-term care insurance covering yourself, spouse, dependents, and children under 27. Above-the-line — reduces AGI on Schedule 1 (Form 1040), Line 17, calculated on IRS Form 7206.
TMRW Benefits is a benefits brokerage, not a tax advisor. Consult your CPA for situation-specific guidance.
Who this page is really for
Six business structures, one set of options.
Sole proprietors
Single-owner businesses with no formal entity.
Freelancers & 1099 contractors
Consultants, agency owners, real estate agents.
Partnerships
Multi-owner businesses without S-corp election.
LLC members
Single-member or multi-member LLCs.
S-corp shareholders (>2%)
W-2 reporting structure required for premium handling.
Pass-through entity owners
Various pass-through structures.
What private off-exchange plans typically offer
Five real differences from Healthcare.gov.
Broader networks
Many private plans use the carrier's full PPO network, not the narrow marketplace network.
Lower deductibles
Often at the same premium tier vs marketplace plans.
Year-round enrollment
Not bound by ACA's Open Enrollment Period (Nov 1 – Jan 15) or Special Enrollment Period rules.
Same essential benefits
Most off-exchange plans still cover the 10 ACA essential health benefits and don't impose pre-existing condition exclusions.
No subsidies
The tradeoff — you pay full price. If you qualify for ACA tax credits, marketplace usually wins.
What working with TMRW looks like
Five steps from situation to coverage.
15-minute call
Share situation, income range, current coverage, household.
Side-by-side quote
Marketplace plans + 5–8 private off-exchange options, both displayed.
Tax math
After-tax cost modeled with your self-employment deduction.
Enrollment
We handle paperwork; you sign electronically.
Year-round support
Claims questions, network changes, mid-year SEPs.
FAQ
Frequently asked questions
Can a self-employed person get health insurance?
Yes. Self-employed workers have three main options: ACA marketplace plans (Healthcare.gov), private (off-exchange) health plans through brokers like TMRW, or association group plans. Premiums are 100% deductible above-the-line via IRS Form 7206, reducing AGI directly.
How does the self-employed health insurance deduction work?
You deduct 100% of premiums for medical, dental, vision, and qualified long-term care insurance covering yourself, spouse, dependents, and children under 27. The deduction is above-the-line — it reduces AGI on Schedule 1 (Form 1040), Line 17, calculated on IRS Form 7206. Restriction: can't take it for any month you (or your spouse) were eligible for an employer-subsidized plan.
What about S-corp shareholders with greater than 2% ownership?
For >2% S-corp shareholders, premiums must be reported as W-2 wages — they're not deducted at the corporate level. The shareholder then claims the self-employed health insurance deduction on their personal return. Get this structure right with a CPA — it's non-trivial and easy to mess up.
Can I claim the deduction and ACA premium tax credit?
No. You can't double-dip — if you claim the ACA premium tax credit (PTC) on a marketplace plan, you can't also deduct the same premium dollars via the self-employed deduction. The IRS prevents claiming both subsidies on the same coverage.
Are private off-exchange plans ACA-compliant?
Most are. They cover the same 10 essential health benefits and follow the same pre-existing-condition rules as marketplace plans. A handful of plans (short-term medical, health-sharing ministries) are NOT ACA-compliant and shouldn't be confused with private off-exchange plans.
When can I enroll in a private plan?
Private health plans typically allow year-round enrollment, unlike marketplace plans which limit you to Open Enrollment (Nov 1 – Jan 15) or a Special Enrollment Period. Major advantage if you missed OEP, lost coverage mid-year, or are between jobs.
Get the real number
Tell us your situation. See the math.
Marketplace and private plans side-by-side, with after-tax-deduction cost factored in. Usually within 24 hours, no obligation.