There are many benefits to being a self-employed freelancer or contractor - flexible work hours, self-management…. But what about healthcare benefits? 35% of full-time and part-time independent workers say they’re without health insurance. The top reason is because of the high cost. Are all options as expensive and complex as we may believe?
Without insurance, the price for an urgent care visit can vary as much as three times. We put together the ultimate guide to finding self-employed health insurance in NYC- whether you’re a contractor, self-employed, or freelancer, this guide will help you find the right option specifically for you.
A major benefit of the ACA is that it requires all insurances to cover 10 essential health benefits (including mental health, chronic diseases, addiction, etc.). The ACA also allows children to stay on their parent’s health insurance plans until they’re 26.
Similar to an employed-sponsored PPO or HMO health plan, there is a designated enrollment period for the ACA so you are not guaranteed to be able to enroll at any given time. It usually begins in November and ends in December.
Individual monthly premium: $435-$671
All pre-existing conditions and essential health benefits are always covered
Qualified medical expenses are tax-deductible (up to 10% of income)
Free preventative care including vaccination and health screenings
Insurance premiums are not tax-deductible if you buy it on your own (the case for most freelancers)
Can only enroll in November - December, there are exceptions but only for special situations
Could be very costly, the average monthly premium for 2020 is $400-$500
Very high deductible, averaging >$3000, this means you will have to pay 100% full price before hitting your deductible
Join a Spouse’s or Domestic Partner’s Plan
If you have a spouse or domestic partner, you may be eligible to join their group health insurance through their employer. Employer-based plans actually may save you money due to the fact they most likely charge a lower premium for dependents, saving you money on alternative plans.
However, this option may have potential complications of one spouse or partner has significant health problems. The healthy spouse or partner may decide to choose a lower-cost plan with a more restrictive provider network and higher out-of-pocket exposure, while the spouse with medical conditions may want to choose a higher-cost plan with a larger provider network and lower out-of-pocket costs.
Individual monthly premium: current premium + $100-$200 increase
Companies usually pick up 70-80% of the cost so you pay less
Cheaper than buying it through the exchange
You need to be in a legal union to qualify as a dependent
If you have a chronic condition, it could increase the premiums up to 100%
Get On COBRA (Consolidated Omnibus Budget Reconciliation Act)
COBRA is a program that allows employees to keep their employer-sponsored health insurance plan when they leave their job in the United States, whether voluntary or not.
This is a great option for those who may have had great health care coverage at their previous job, and would not want to get rid of it. However, it’s important to know that COBRA coverage is expensive.
When employed, your employer would typically subsidize health coverage for you, in which the cost you would pay isn’t the full cost of a plan. When choosing COBRA, you will be required to pay the full price of the plan, as well as a 2% administrative fee.
It would then cost hundreds of dollars more a month- making it a short-term option for many. But be sure to track your finances as a freelancer, or contractor, for you could be making enough money to make COBRA worth your while.
Costly, paying 100% of a health plan could be more than a month of rent
Sometime it could cost for more than individual exchange products
Join A Union
If you’re a freelancer, you may want to consider freelancers union insurance. Freelancers Union is a large organization representing the 56.7 million independent workers across the country.
They provide their members with a powerful voice through policy advocacy, benefits, and community. Becoming a member is free- and they offer a variety of insurance options including dental, disability, and accident.
Inidivudal monthly premium: $400-$500+
Vetted plans with a small discount
The product is the same as ones available on the individual exchange
Very costly, $400-$500 a month
Very high deductible, >$3000
Medical Sharing Plan
Medical sharing plans are religious affilifated non-insurance alternative that pool monthly contributions from thousands of members and pay out for medical claims. This is one of the fastest growing health benefits product with over 1M+ members nationally.
There are various medical sharing plans like Christian Ministry Health, Liberty, KnewHealth. Some of require you to have a religious notary from a pastor while most just ask for a self-attestation that you under the requirements.
Though medical sharing plans are relatively lower cost compared to insurance plans, they have strict coverage benefits that sometimes exclude pre-existing condition and diagnoses like cancer and autoimmune diseases.
Instead of paying for your care upfront, most sharing plans require you to pay out-of-pocket and submit the claims to the reimbursed.
Individual monthly premium: $150-$300
No enrollment period
May not cover existing conditions and benefits are not clear what's covered what's not
Members have to bear the cost upfront and submit claims to be reimbused
Reimbursement can take up to 90 days
If You Just Need Occasional Care, Mira May Be A Good Fit
Mira is a membership-based for non-hospital medical services. For less than $1 a day, you’ll get affordable copays for unlimited preventative and urgent care. The company was named among Accenture Health 11 top innovation finalists nationally.
Mira partners with urgent care centers all over NYC so you can go to a center near you. You can make an appointment on their web app in under 30 seconds. Signing up for an account is FREE with Mira and you can activate benefits whenever you need care.