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Health Insurance for Freelancers

Robert Janelle

So you’re sick of the cubicle, middle management and 9-5 hours. You dream of quitting and freelancing full time but there’s one thing holding you back: the company health plan. This is by the far the most common reason I hear from Americans on why they won’t quit the full-time job.

However, there are options available. In this article, we’ll look at several solutions to keep yourself covered without the backing of a full-time employer.

COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985)

In 1986, COBRA was passed into law. It allows employees to keep their company health benefits should they, among other events that would end health coverage, resign or be terminated (for reasons other than gross misconduct.)

Of course, it’s not a free ride. If your health plan was being subsidized by your employer, you have to pay their portion as well as the amount that was being deducted off your pay-cheque. This can get pricey if your employer was providing a high-end plan but there is an option to change to a basic plan with no extras like dental coverage.

COBRA will generally cover an employee for a maximum of 18 months after being invoked, though that period will be cut off if premiums aren’t paid in a timely fashion, or if your (now former) employer discontinues the plan. The period can also be extended under certain circumstances, like long-term disability.

For more information, see the U.S. Department of Labor’s COBRA FAQ.

Chamber of Commerce

One of the most common ways freelancers get health insurance is from their local Chamber of Commerce. Your Chamber of Commerce exists to promote and support local business and that includes locally operating freelancers.

Most offer small business group packages for companies consisting of two or more employees along with individual plans for those who are self-employed.

Some even offer multiple packages to choose from, so it’s possible to shop around within the Chamber’s network. Contact your local group for more details.

Groups Rates Without the Rat Race

Make no mistake. When you’re employed, you’re still paying for your health insurance. It’s just a deduction off your pay-cheque and it’s cheaper since the company gets a group rate where the employees who don’t get sick subsidize the ones who do. It’s still possible to get a group rate even when your organization consists of yourself through various associations.

Freelancers Union offers group rates for freelancers in New York, New Jersey and Connecticut along with providing individual market plans for 30 other states.

Meanwhile, the National Association for the Self-Employed (NASE) provides a number of discount cards through their benefits plan along with an Association 105 Health Reimbursement Arrangement, which makes health insurance premiums and non-insured medical expenses 100 per cent tax deductible. According to their web site, it’s provided to members at no additional charge for the first year then at a discount for renewing members.

Besides organizations encompassing all freelancers, there are often niche specific associations that will also set members up with health plans.

For example, media freelancers can get insured through MediaBistro (they used to only offer coverage to New Yorkers, but now have plans for freelancers across the United States.) Freelance writers can also obtain coverage through the National Writers Union.

High Deductible Insurance

If it comes down to it, it’s possible to get low monthly premiums at the expense of a higher deductible, which can mean having to pay the first $5,000-$10,000 of medical bills before the insurance company picks up the tab.

It does sound scary, but it’s also important to shop around. Some plans, despite being high deductible, do cover preventative visits and other expenses. Plus, some coverage is always better than none. Consider what’s worse: getting into a sudden car accident and having to pay a $5,000 deductible or being stuck with a full $40,000 in medical bills?

Health Saving Account

For those who opt to go with a High Deductible Insurance Plan, as of 2003 you can open what’s called a Health Savings Account from a bank or credit union. You contribute money to be used towards paying the deductible portion of your insurance policy or any other qualified medical expense.

Contributions to the HSA can also be claimed as an “above the line” deduction to lower their taxable income.

Maximum contributions to an HSA as of 2007 are $2,850 for an individual policy and $5,650 for a family plan. The numbers are adjusted for inflation according to the United States Department of Treasury website.

Go Through An Insurance Broker

Aside from all these options, you can also go through an insurance broker who’ll deal with the insurance companies on your behalf and is supposed to find the best deal for your situation.

As with everything else mentioned in this article, it’s best to shop around and ask for references to find the most reputable broker in your area. This would also be the best option for someone whose situation might be more complicated due to something like a pre-existing medical condition that makes it difficult to get approved for health insurance.

Conclusion

As you can see, a multitude of options exist for finding health insurance outside of being a slave to a company. Of course, it’s important to remember that this is merely a list of options and you should do your own research before settling on a plan — especially if you’re looking for coverage for your whole family.

Also, one last important note: before agreeing to a plan, make absolutely certain to go over it to make sure everything you think is covered is in fact covered. There are too many horror stories out there about people who’ve endured catastrophic medical expenses over something they thought they were covered for but were not.


Robert Janelle

Click here to view a bio plus other posts


Leave a Comment
  1. Nice article, insurance is often overlooked until it is too late.

  2. You should also mention health care sharing organizations, like Samaritan Ministries, Christian Care Medi-Share and Christian Care Newsletter. They’re all Christian faith-based programs, but offer a great service and the monthly amounts are very affordable.

  3. There’s also the Freelancer’s Union (http://www.freelancersunion.org/), which offers affordable insurance in some states in the US.

  4. Try http://www.ehealthinsurance.com — I got a plan from BXBS for a very reasonable price. It’s a bare-bones plan, and I haven’t actually used it for anything, but it’s nice to know that I can still get _something_ even without a full-time job or a large organisation backing me up. The site works like Travelocity or one of those — worth a visit.

  5. yea, im on the “cross your fingers and be careful” plan - at least until i start bringing in some more moola.

  6. @liz - I’ve been on that plan too - be careful! The point this article makes about high deductibles is spot on. A five or even ten thousand dollar deductible might almost make having health insurance seem pointless, but it’s still better than nothing in the event of something tragic. I’ve seen plans as low as $40-50 that fall into this category (The same price as a cheap cell phone, really), so it’s definitely worth it.

  7. I hardly ever get sick enough to go to the doctor. So, I’m looking for affordable disaster insurance. I.E. I only need health insurance to help with car accidents, cancer, surgery ect, but not routine trips to the doctor for being sick (which I have not done in 10 years). Anyone know a good place for this kind of insurance?

  8. OR… you could move to Canada, where trips to the doc, major cancer treatment, broken bones and the very air you breath all cost the same: $0 :)

  9. We started down the road with NASE and found it to be a rip-off. The insurance they were selling was written up in a few magazines as being sued for intentionally denying large bills in situations where people died without getting the necessary health care. The 105A plan is something you can self-administer for free without having to pay someone else. The other offers they had turned into “fake” offers (”free” items that you had to pay for, stuff like that). We weren’t impressed and quickly cancelled our membership.

    Your experience may vary, but be aware that the marketing won’t always match the execution.

  10. Gravatar

    rotationbias

    Keep an eye on your mail for offers from health insurance companies, too. I had insurance through a small business consortium for more than ten years, and this year the monthly premium went up to $450. Needless to say, I started looking around. I contacted a few insurance brokers, who told me that because of my weight and current health issues, I would never find insurance for less than $400/month. Then I got a mailing from Independence Blue Cross, who set me up with a pretty decent plan for “only” $301/month. Yeah, it’s still expensive, but it’s much cheaper than what I was paying and it was nice to be able to thumb my nose at the brokers and their “Sorry you’re such a fat slob” attitude. :-D

  11. Great post - and timely. I just acquired new health insurance through Freelancer’s Union. It was easy, painless (mostly) and affordable. I’m lucky in that I don’t have health issues, but I wasn’t comfortable not having any insurance at all. Consider plans without co-pays and prescription coverage - they are cheaper in the long run, especially if you don’t have any health issues.

    Don’t overlook dental insurance, either. Many plans are in the teens per month in cost, depending upon the company.

  12. I’m fortunate enough to have a spouse with a great full-time gig and a really nice benefits package that covers me and my pre-existing conditions. Due to pre-existing conditions I am uninsurable if I were to go it alone though.

    For those of you who do not have insurance, I strongly advise you begin looking into options. I was perfectly healthy, young, seldom saw a doctor, fit, and ate right, when I received a devastating diagnosis in 2006. I believe within the year the bills racked up to well over $250,000, and current meds sit at $3200/monthly…luckily I have/had insurance and pay/paid only a small fraction of that out-of-pocket. I shudder when I think of what would have happened had I not been insured.

  13. I would strongly advise against the NASE insurance plans. Their plans do not offer good health coverage, and have been known to deny large medical claims. I would rather advise looking for either a large deductible or HSA health plan on line through an independant insurance broker.

  14. I’ve got to agree with tek79. Marrying well is also an option. My partner’s firm offers incredible spouse/domestic partner insurance benefits - medical, dental, vision, etc. Yes, we still pay for them - but the cost is about a quarter of what I would pay elsewhere. A $10,000 emergency room visit one night, with an ambulance ride, ended up costing me $300 out of pocket.

  15. I live in maine and have looked up health insurance before. Needless to say it is not cheap! Even insurance with catastrophic deductible of $5000-$10,000 starts at $350 a month. You can just forget about standard insurance as it could run as high as several thousand a month! Unfortunately, there aren’t really alternatives like the ones mentioned above in Maine. To put it bluntly you better be lucky and have a good genetics to freelance here.

  16. OR… you could move to Canada, where trips to the doc, major cancer treatment, broken bones and the very air you breath all cost the same: $0

    Do you *really* think the health insurance is free in Canada?

  17. It is truly insane the costs of health insurance in today’s world.

  18. “Do you *really* think the health insurance is free in Canada?”

    It’s probably cheaper in Canada. I moved to the US after marrying a US citizen and still can’t believe how much things cost here. Our medical bills in New Zealand were $10 for a doctors visit, and $5-10 for a prescription.

    For a nation that seems to pride itself of encouraging entrepreneurship and business it amazes me that the US continues to place the burden and expense of providing insurance upon business.

  19. First of all, thanks for explaining what COBRA stood for…i always wondered why they named that after a snake ;)

    Second, after reading this i checked my snail mail and had a premium update for my health insurance. It went up ANOTHER $45/month!!! it went up $45/month about 6 months ago! and that’s with a $2,000 deductible and only 4 allowed doctor visits a year. it’s insanity. i’m totally looking into some of the options you mentioned. Thanks for the great info!

  20. We had Mega-Life (often associated with NASE) but luckily we got off of it a couple of years ago after working with an excellent health insurance broker.

    On Easter, I broke my leg while snowboarding. Emergency room, doctor visits, operation, rehab - it’s looking like it’ll total out to around $40k. Expensive recreation:(

    The good news is that we’ve been paying $375/month (me and two kids) for high-deductible ($5K) insurance and have an HSA ($5K) for the tax deduction. I didn’t remember until this accident but, when we signed onto this policy, we also have a $5000 accident policy which will cover my deductible in this case. I’ve yet to receive all the billing but I am pleased to see that the policy is paying 100% over the deductible. Plus the network discounted the $29K surgery bill down to $7000. Of course, I’m sure my monthly premium will now go up (again.)

    One tip my doctor gave me was to ask up front about costs and discounts. I had an MRI last year (another stupid snowboarding injury) and offered to pay half that day and half the following month. Low and behold, the imaging clinic bill dropped from $1500 (if submitted through insurance) down to $500. Of course, I paid via my HSA account. Often, the doctor/medical office will not be able to tell you costs but will at least direct you to their billing department. I’ve learned to be insistent about offering to pay up front (if I’m able to.)

    We also take advantage of public health fairs for discounted blood tests and health screenings. There are other obvious things like quitting smoking, improving diet, exercising more, and quitting snowboarding.

  21. Thanks so much for this great information Robert! I am in the process of writing a book (Escape from Cubicle Nation) and one of the chapters is on this very subject, since it is such a stickler for people wanting to leave corporate life.

    I really appreciate the research and organization. I will be in touch if I use stuff in the chapter, and make sure you get attribution!

    All the best,

    -Pam

  22. It’s probably cheaper in Canada. I moved to the US after marrying a US citizen and still can’t believe how much things cost here. Our medical bills in New Zealand were $10 for a doctors visit, and $5-10 for a prescription.

    Who do you think pays for the health insurance in Canada? Who bears the cost? I would ask the same question for New Zealand?

    Simply because the health costs are rolled into a tax structure doesn’t mean they are “free”. It just means they are paid for by the “gun in the room” i.e. the Government.

    Make no mistake that in each country the end user is ultimately paying for the health care costs. How else could it possibly be?

  23. I found that it was much cheaper to purchase a “disaster” and then just set money aside for visits to the doctor. It also doesn’t hurt to ask the doctor for some money off when paying cash. They’ll sometimes knock some off because they know you’re save them some administrative costs.

    I’m lucky now that my wife works for a large corporation that has awesome benefits. Completely and fully covered with anything medical related for $80/month. So marry for benefits, not for money :).

  24. Gravatar

    Jeff Keyser

    For those talking about “disaster” insurance, you may want to consider a “high deductable” insurance plan instead, since that’s basiclaly what it is. For my plan, I have a $5000 annual deductible and 100% coverage after that. So if I get into a car accident or something, my HSA would pretty much be drained, but the insurance would cover the rest. (Not that I do that much driving anymore, anyway.)

    The much lower rate has already paid for itself over the COBRA plan I was first on when I first quit or what we would pay to get me on my wife’s plan, even after having paid for some doctor’s visits myself. I get the added bonus of paying the insurance company’s “negotiated” rate with the doctor instead of the full rate. Plus, I fund my HSA based on the money I’m not paying for a more expensive plan, which I will keep (barring some disaster) and from which I pay my medical bills tax free!

  25. Who do you think pays for the health insurance in Canada? Who bears the cost? I would ask the same question for New Zealand?

    People think of it as being free because you pay the same amount of tax and don’t see thousands of dollars a year leaving your bank account/pay cheque for insurance or medical costs.

    Health care IS cheaper over there though. I showed my GP in New Zealand an itemised medical bill and he couldn’t believe how much they charged for each item. He said that it was 30-50% more than what they can charge in New Zealand. I’ve also heard multiple media stories about how much more the administration costs are in the US because of the complicated billing and insurance situation (http://www.pnhp.org/publications/nejmadmin.pdf is one example).

    Look how many people want to freelance or start a small business and worry about medical insurance. That shouldn’t be something you need to worry about when you are trying to start a business…

  26. This is the wildest thing I have ever read — first off, a few days ago I posted on Wickedfire that I was interested in starting a health insurance provider that meets the needs of freelancers, then this article appears.

    Large companies like eHealth are a “convenient” solution for people like us — but I think that a more rounded benefit package tailored BY freelancers FOR freelancers would be a better fit. If you guys are interested in getting in on something like this - I would love to hear ideas on this…

    I would love to talk to someone at freelanceswitch about advertising and becoming an exclusive health insurance resource for freelancers in our profession. Obviously, a niche needs to be filled as nothing I’ve seen looks like a total package for us. I think HDHPs coupled with an HSA are the way to go!

  27. btw, a few web 2.0 sites are out there trying to promote price transparency in the healthcare market. Doctorpricing.com is one. Those sites will eventually help consumers make decisions on how to spend money in accounts like an HSA or FSA.

  28. Gravatar

    Michelle

    Being in good health and having not had any doctors visits in almost two years, I let a few days lapse between the end of my old policy and the signing of a new policy. The paperwork was sitting on my desk, just waiting to be signed. I’m sure you can see where I’m going with this… Yes, I developed intense stomach pain late at night and had to go to the ER. Luckily, it was not appendicitis. But just sitting in an ER examining room for 45 minutes, having 2 doctors press on my stomach and having blood drawn set me back $1400. I can’t imagine what that bill would’ve been if I’d let them do the CAT scan they wanted to do or if it had been appendicitis. So I don’t fool around anymore or put too much faith in the fact that my general good health will preclude emergencies from happening.

    Anyway, I bought a high-deductible ($2500) HSA through Anthem and I pay $220/month. My goal is to be protected in case of another emergency or major illness so I made sure that I have between 80-100% coverage once I go beyond my deductible. Peace of mind rocks :)

  29. I’m surprised that health insurance through the AIGA hasn’t been mentioned. I’m a young, healthy, non-smoking male and I was quoted at $190/month for their middle-of-the-road offering (not minimum coverage, but not the supreme burrito coverage either).

  30. The same reason I now do freelance work is the same reason I can’t get health insurance worth having; disability. I have chronic health conditions that I would not be able to get individual insurance to cover so instead my husband works a normal job and we use his health insurance. He wants to open a small business of his own but until we can determine how we could cover the high cost of the pre-existing conditions on our own or the government forces the insurance companies to cover them and we can afford their rates on our then we’re out of luck. Thing is I couldn’t do any work if I didn’t have insurance somehow.

  31. Also chiming in to steer people away from NASE and MegaLife. We had them — husband got appendicitis, we found out that his ER visits weren’t covered, and neither were a bunch of other things. Ended up costing us seven grand, out of pocket. And he was only in the hospital for a couple of days. Watch out when you do high-deductible programs (get a set dollar amount rather than having to pay a certain percent of the total) and make sure you have the cash on hand for a worst-case scenario. Life is unpredictible.

  32. About Canada…

    I have lived in Canada all my life. I realize that health care is not “FREE”, that we pay for it with our taxes. Rightly so!!! I’m willing to be that the amount of taxes coming out of my bank account which cover everything (schools, roads, fire/police protection, even military), are less per month than the amount most Americans pay for health coverage, ON TOP of their taxes.

    In Canada, if we need to go to the hospital in the middle of the night, we don’t have to worry about our Insurance coverage, how much it will cost out of pocket, co-pays, or any of it. We need only worry about getting the care we need. It’s a great system, it WORKS.

    We should pay for it with our taxes, this way everyone is treated equally, and gets the care they need regardless of income, or class. People with pre-existing conditions SHOULD be taken care of, they have every right to health care. But in a privatized system, sick people are turned away from getting the care they need because they are sick.

    That in itself, is sick.

  33. 100% agree with dinsky!

  34. I work for a small business that does not provide health insurance. I went online to find help with the cost of my meds. At http://www.rxdrugcard.com I found a prescription discount card that costs me only $4.50 a month. They have their drug prices posted to check before you enroll. Anyone can have this card. They don’t ask about age or income or pre-existing conditions. All the major drugstore chains accept RxDrugCard. Wouldn’t it be great if small business owners bought this plan for their employees?

  35. Dental insurance helps you in providing with the required dental care and that too at an affordable coast without causing harm to your financial position.

    Dental insurance helps you in providing with the require dental care and that too at an affordable
    coast without causing harm to your financial position.I will have to think about this myself and see
    where else I may like to visit. Great post!

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