Benefitra Video
Independent Health Plans for Freelancers & Self-Employed
A one-minute video for the self-employed choosing an individual plan, with a written guide to network types, deductibles and out-of-pocket limits.
What this video covers
Independent Health Plans for Freelancers and the Self-Employed is a one-minute Benefitra video, published on the Benefitra YouTube channel in November 2024. It is the third Benefitra page that uses this video, and it concentrates on one job: comparing individual health plans once you have decided to buy your own.
Going by its title and YouTube description, the video presents Benefitra as a source of help for independent workers, freelancers and contractors who want coverage that fits their work and budget. This page does not give prices or plan details. The sections below explain how individual plans differ, using HealthCare.gov and IRS material, so you can compare options on the right things.
What to take from it
Understand the network type
HealthCare.gov lists the common types. An HMO usually limits coverage to its own doctors and generally covers out-of-network care only in an emergency. An EPO covers services only from in-network doctors, specialists and hospitals, except in an emergency. A POS plan pays less out of network and requires a referral to see a specialist. A PPO lets you use out-of-network providers without a referral, for an additional cost.
Weigh premium against deductible
HealthCare.gov says plans with lower monthly premiums generally have higher deductibles and plans with higher premiums usually have lower ones, across the Bronze, Silver, Gold and Platinum levels. The better choice depends on how much care you expect to use and how much of a surprise bill you could absorb.
Look at the out-of-pocket limit
Marketplace plans cap what you pay for covered in-network care each year. HealthCare.gov lists no more than $10,600 for an individual and $21,200 for a family in 2026, and $12,000 and $24,000 in 2027. Premiums and out-of-network costs do not count toward that cap, so it is a ceiling for worst-case planning, not a typical bill.
Consider a catastrophic or HSA-compatible plan
HealthCare.gov says catastrophic plans have low premiums and very high deductibles, are open to people under 30 or those with a hardship or affordability exemption, and still cover preventive services and at least three primary care visits before the deductible. All Bronze and Catastrophic plans work with Health Savings Accounts, which have their own IRS rules.
Watch family deductibles
HealthCare.gov notes that family plans often have both an individual deductible, which applies to each person, and a family deductible, which applies to everyone together. If you cover a spouse or children, check how the two interact before you assume the family will share one number.
Check savings before you pick a tier
A premium tax credit or cost-sharing reduction can change which tier is the better value, and HealthCare.gov says a Bronze or Silver plan may be better value if you qualify for either. Run your own expected income through the Marketplace before you decide, and compare plans after savings, not before.
Who this independent plans video is for
Freelancers, consultants, contractors and other self-employed people who already know they need their own coverage and are choosing between plan types and metal levels. It also suits household members, such as a spouse who works for the business, who need to compare the family side.
It is not for people shopping for a group plan for employees, who should start with the small business pages, or for people eligible for Medicare or Medicaid.
What is the difference between an HMO and a PPO?
An HMO usually limits coverage to doctors who work for or contract with the plan and generally covers out-of-network care only in an emergency. A PPO charges less in network but lets you use out-of-network providers without a referral, for an additional cost.
Should I choose a lower premium or a lower deductible?
Generally, plans with lower monthly premiums have higher deductibles, so it is a tradeoff. If you rarely use care and can absorb a large bill, a higher deductible may work. If you use care regularly, a lower deductible can cost less overall.
What is an out-of-pocket maximum?
It is the most you pay for covered in-network care in a plan year. HealthCare.gov lists $10,600 for an individual and $21,200 for a family in 2026, and $12,000 and $24,000 in 2027, for Marketplace plans. Premiums and out-of-network care do not count toward it.
Who can buy a catastrophic plan?
HealthCare.gov says people under 30, and others who qualify for a hardship or affordability exemption, can buy one. It has low premiums and a very high deductible, covers preventive services and at least three primary care visits before the deductible, and may not be available in every area.
Do HSAs work with individual plans?
Some do. HealthCare.gov says all Bronze and Catastrophic plans work with Health Savings Accounts, and so do some plans in other categories, and it offers a plan filter for HSA eligibility. IRS Publication 969 explains how HSAs work.
Does this page recommend a particular plan?
No. It is a general guide and does not quote prices or name a plan. Your best plan depends on your location, income, health needs and budget, so compare options using the Summary of Benefits and Coverage.
Related guides and tools
- Individual health plans: coverage for people who buy their own
- Freelancer health plan: options for freelancers and gig workers
- Health insurance for freelancers: the Benefitra guide for self-employed buyers
- Health insurance calculator: estimate what coverage could cost
Sources
- HealthCare.gov: health insurance plan and network types
- HealthCare.gov glossary: Deductible
- HealthCare.gov glossary: Out-of-pocket maximum/limit
- HealthCare.gov: catastrophic health plans
- IRS Publication 969: HSAs and other tax-favored health plans
- HealthCare.gov: coverage if you are self-employed
- HealthCare.gov glossary: Summary of Benefits and Coverage (SBC)
General information, not insurance, tax or legal advice. Plan details and eligibility rules change; confirm with the plan documents, the official sources above and a licensed adviser.