So You’re Self-Employed in Texas… Now What About Health Insurance?
Let’s be real — being your own boss is a vibe. You make your own schedule, pick your clients, maybe even work in your pajamas (no judgment). But there’s this not-so-fun elephant in the room: health insurance.
Unlike traditional jobs where HR just hands you a benefits package, when you’re self-employed in Texas, you’re on your own. And dang, that can feel like a wild west of confusing terms, skyrocketing premiums, and endless options. HMO? PPO? Marketplace? What even is catastrophic coverage?
Take a deep breath. You’re not alone in this, and it’s not as scary as it looks once someone walks you through it like a friend. That’s what this guide is for.
Meet Jake: Our Imaginary (But Totally Realistic) Freelancer in Austin
Let’s take a sec to talk about Jake.
Jake’s a 33-year-old graphic designer in Austin who ditched his 9-to-5 last year to go full-time freelance. He’s loving it. More time with his dog, morning jogs by Lady Bird Lake, and no more awkward watercooler convos.
But now it’s open enrollment, and he’s got questions. Big ones. Like:
- “Can I even afford health insurance?”
- “Is there something just for self-employed folks?”
- “What happens if I get sick or injured?”
Jake’s not lazy. He just doesn’t want to spend hours on government websites trying to translate insurance-ese. Sound familiar?
First Things First: What Kind of Health Insurance Can You Get?
If you’re self-employed in Texas, your options actually aren’t bad — if you know where to look. Here’s a breakdown of your main choices:
1. Health Insurance Marketplace (Obamacare Plans)
You’ve probably heard of this one. If you’re not getting insurance through an employer or a spouse, the Marketplace is where most self-employed folks end up.
The good part? You may qualify for subsidies based on your income, which can seriously lower your monthly premiums.
Pro Tip: Even if you made more money this year, don’t assume you won’t get a subsidy. There are income brackets that still qualify. Jake ended up getting a $200/month plan with low copays because his net income after business expenses was lower than expected.
Plans come in tiers: Bronze, Silver, Gold, Platinum.
Bronze = lower premiums, higher deductibles.
Platinum = higher premiums, lower out-of-pocket.
Choose based on how often you go to the doctor or take prescriptions.
2. Private Health Insurance Plans
These are plans you buy directly from insurance companies (like Blue Cross Blue Shield of Texas, Aetna, UnitedHealthcare, etc.), not through the Marketplace.
You won’t get a subsidy here — so they can be pricier — but the networks may be broader, or coverage more flexible.
This works well if:
- You don’t qualify for a subsidy
- You want specific doctors/hospitals in your network
- You want more customized options
Still, read the fine print. Some cheaper plans have super limited networks or weird rules about prescriptions.
3. Health Sharing Ministries
Now, this one’s a bit… unconventional.
These are faith-based programs where members “share” medical costs. They aren’t technically insurance, so they’re not regulated the same way.
Pros:
- Often cheaper monthly contributions
- Sense of community
Cons: - They don’t cover everything
- They can deny certain claims
- You usually have to agree to a statement of faith
Not for everyone — but some people swear by them.
4. Short-Term Health Plans
These are like the “Band-Aid” of insurance. Temporary coverage, typically lasting a few months to a year.
Use these only if you’re in between coverage — like you just quit your job and haven’t gotten Marketplace insurance yet.
Why? Because short-term plans often:
- Don’t cover pre-existing conditions
- Don’t include mental health, maternity, or prescriptions
- Have super high deductibles
5. COBRA (If You Recently Left a Job with Insurance)
This lets you keep your old job’s insurance for up to 18 months — but you pay the full premium plus a small fee.
It’s convenient but expensive. Jake looked at COBRA for his old tech job, but it was over $600/month, so he passed.
What About Costs? Let’s Talk Real Numbers
Here’s a quick look at what self-employed folks in Texas typically pay:
| Plan Type | Avg. Monthly Premium | Deductible |
|---|---|---|
| Marketplace (with subsidy) | $100–$300 | $0–$5,000 |
| Private Plans | $400–$800 | $1,000–$8,000 |
| Health Sharing | $150–$400 | Varies (non-guaranteed) |
| Short-Term | $100–$250 | $5,000+ |
Remember, cheaper premiums usually mean higher deductibles — which is fine if you’re mostly healthy and just want coverage for emergencies.
Jake’s Choice: What Worked for Him?
After doing his research (okay, after talking to a friend who did the research), Jake signed up for a Silver plan on the Marketplace.
Why? Because:
- He qualified for subsidies
- The plan included his preferred clinic in-network
- His asthma medication was covered
He pays $225/month, has a $1,000 deductible, and feels way less stressed knowing he’s covered.
What Should YOU Think About Before Picking a Plan?
Here’s a little checklist. Be honest with yourself — there’s no perfect plan, but there is a smart one for your life.
- Do you have pre-existing conditions?
Go for plans that cover those without exceptions. - How often do you go to the doctor?
If you only go once or twice a year, a higher deductible plan might save you money. - Do you take medications?
Double-check the prescription coverage. - Do you want to keep your current doctor?
Make sure they’re in-network. - What’s your risk tolerance?
Some people want max protection. Others just want peace of mind in case something bad happens.
Bonus Tips to Make Life Easier
- Track your medical expenses as a business write-off.
Yup, you can potentially deduct premiums and some out-of-pocket costs. - Consider an HSA (Health Savings Account).
If you go with a high-deductible plan, HSAs let you stash away tax-free money for health expenses. - Use a broker or navigator.
They can help you pick a plan for free. Seriously. Find a local one through Healthcare.gov or insurance providers.
Final Thoughts: You’ve Got This
Choosing health insurance when you’re self-employed in Texas can feel like trying to order at a restaurant with a 30-page menu in a language you barely understand. But you don’t need to be an expert — you just need the right info (and a little patience).
Remember, it’s not just about having a card in your wallet. It’s about protecting your health, your hustle, and your peace of mind. Whether you go with a Marketplace plan like Jake, try a private option, or explore a health sharing group, just take the first step.
Because nothing derails your business dreams faster than an unexpected hospital bill.
FAQ: Self-Employed Health Insurance in Texas (Real Questions, Real Answers)
1. Do I have to get health insurance if I’m self-employed?
No one’s gonna force you (there’s no longer a federal penalty), but skipping it is risky. One accident or ER visit could cost thousands.
2. What if I only work part-time for myself?
As long as you don’t get insurance through a job or spouse, you’re eligible for Marketplace plans — even if your income’s part-time.
3. Can I get coverage even if I have a health condition?
Yes! Under the Affordable Care Act, pre-existing conditions can’t be used to deny you or raise your premium.
4. Are dental and vision included?
Usually not in basic plans — you’ll need to add them or buy separate coverage. Some plans bundle them for convenience.
5. What if I miss the open enrollment period?
If you have a “qualifying event” (like losing other coverage, moving, having a baby), you can still enroll. Otherwise, look into short-term plans until the next window.
