When you leave a job, you find out how much of your health insurance someone else was paying. Buying your own is not a fringe situation: it is the standard arrangement for freelancers, contractors, single-member LLCs and anyone whose income arrives on a 1099. The price is public, it is set by rules rather than by negotiation, and it moved sharply this year.
This guide uses published 2026 plan year marketplace data, the IRS revenue procedures that set the subsidy math, and HealthCare.gov’s own rating rules. Everything below was verified against those sources on September 5, 2026. Nothing here is tax advice for your specific return, and where the numbers get personal the honest answer is to run them with a tax professional.
What Self-Employed Health Insurance Costs
The figures below are KFF’s national average marketplace premiums for the 2026 plan year, before any premium tax credit is applied. They are what an individual pays with no subsidy at all, which is exactly the situation of a self-employed buyer above the income cutoff.
| Metal tier, 2026 plan year | 40-year-old, per month | 60-year-old, per month | 60-year-old, per year |
|---|---|---|---|
| Lowest-cost bronze plan | $456 | $969 | $11,625 |
| Benchmark silver plan (second-lowest silver) | $625 | $1,326 | $15,914 |
| Lowest-cost gold plan | $615 | $1,306 | $15,672 |
The 40-year-old column comes from KFF’s state-by-state average marketplace premium tables, which price every county for a 40-year-old and then weight by plan selections. The 60-year-old column comes from KFF’s February 2026 analysis of how the loss of enhanced credits hits older adults, which reports national annual averages of $11,625 for the lowest-cost bronze plan, $15,914 for the benchmark silver plan and $15,672 for the lowest-cost gold plan.
Two things in that table surprise people. First, the lowest-cost gold plan ($615 for a 40-year-old) is cheaper than the benchmark silver plan ($625). That inversion is real and common in 2026, because silver premiums carry loaded cost-sharing-reduction pricing in most states. If you are not getting a cost-sharing reduction, gold is often the better buy. Second, the lowest-cost silver plan averages $611 for a 40-year-old, below the benchmark. The benchmark is the second-lowest silver plan, and it matters only because the subsidy formula is built on it.
Add a spouse or children and the price stacks. Marketplace family premiums are the sum of individually rated members, with no charge for the fourth and subsequent children under 21 in most states.
What Drives Your Premium
HealthCare.gov is explicit that insurers may use only five things to price a marketplace plan, and health is not one of them.
Age. The single biggest lever. Premiums can be up to three times higher for older adults than for younger ones. That 3:1 band is why a 60-year-old in the table pays roughly double a 40-year-old for the same tier, and it is the whole reason the subsidy cliff hurts older self-employed people most.
Where you live. Rates are set by rating area, usually a group of counties, and they swing hard by state. Local hospital prices, how many insurers are competing, and state rules all feed in. Two freelancers with identical ages and incomes can pay very different prices across a state line.
Tobacco use. Insurers can charge tobacco users up to 50% more. The tobacco surcharge is not subsidized, so it lands on you in full even if you qualify for a premium tax credit.
Metal tier. Bronze, silver, gold, platinum and catastrophic differ in how much of the bill the plan picks up, which is what the premium buys. Bronze buys the lowest premium and the highest deductible.
Who is on the plan. Adding a spouse or dependents adds their individually rated premiums.
What insurers cannot do is underwrite you. Gender cannot change the price, and neither can your current health status or your medical history. HealthCare.gov states that all health plans must cover treatment for pre-existing conditions from the day coverage starts. This is the sharpest practical difference between a marketplace plan and the alternatives further down this page: a marketplace insurer has to take you and has to price you like everyone else your age in your county.
Premium Tax Credits and the Self-Employed Health Insurance Deduction
These are two different benefits that people constantly merge into one. Both can apply to the same plan in the same year, and they interact in a way that trips up first-time filers.
The premium tax credit is a subsidy. It is calculated from your household income as a percentage of the federal poverty line, and it covers the gap between a required contribution and the cost of the benchmark silver plan in your area. The required contribution comes from an applicable percentage table the IRS republishes every year.
That table is where the big 2026 change lives. The enhanced credits created by the American Rescue Plan in 2021 and extended through 2025 by the Inflation Reduction Act pushed required contributions down to a 0% to 8.5% range and, critically, removed the income ceiling. They expired on December 31, 2025. HealthCare.gov now states plainly that the additional savings available because of the COVID pandemic ended on that date and that people who qualify for savings in 2026 will likely pay more.
IRS Revenue Procedure 2025-25 shows exactly what replaced them. For 2026, required contributions run from 2.10% of income below 133% of the poverty line up to 9.96% for households between 300% and 400%, and the table simply stops at 400%. Revenue Procedure 2026-26, issued in July 2026, does the same for 2027 with a range of 2.15% to 10.22% and the same hard stop at 400%.
That stop is the cliff. One dollar of income over the line and the credit goes to zero. For 2027 coverage the marketplace measures your income against the 2026 poverty guidelines, which put 400% at roughly $63,840 for a single person and $132,000 for a family of four in the 48 contiguous states. A 60-year-old freelancer at $64,000 pays the full $15,914 benchmark price. The same person at $63,000 pays a capped share of income.
As of September 2026 the enhanced credits have not been restored. Several bills to extend or make them permanent were introduced in the 119th Congress and none had been enacted. Treat that as the current state of play rather than a settled ending: if Congress acts, the applicable percentage table changes and your subsidy changes with it, so re-run your numbers at open enrollment rather than assuming last year’s answer holds.
The self-employed health insurance deduction is a different animal. Per the IRS Instructions for Form 7206, if you had a net profit reported on Schedule C or Schedule F, were a partner with self-employment earnings, or were a more-than-2% S corporation shareholder, you can deduct premiums for medical, dental and vision coverage plus qualified long-term care premiums for yourself, your spouse, your dependents and children under 27. It goes on Schedule 1 (Form 1040), line 17, which makes it an above-the-line deduction: you get it whether or not you itemize. Two limits matter. You cannot claim it for any month you or your spouse were eligible for a subsidized employer plan, even if you turned that plan down. And the deduction cannot exceed the net earned income from the business the plan is established under, so it never creates a loss.
How they interact. Because the deduction lowers your adjusted gross income, and the credit is calculated from household income, taking the deduction can increase your credit. But the credit reduces the premium you actually paid, which reduces the deduction. That is circular, and the IRS treats it as such. Publication 974 provides two ways out, an Iterative Calculation Method and a Simplified Calculation Method, and imposes a hard limit: your deduction plus your premium tax credit cannot exceed the premiums you actually paid for the qualified health plan. Good tax software handles the loop. If yours does not, this is the one part of the process worth paying a preparer for.
Cheaper Routes
Check the marketplace first, even if you assume you make too much. Household income for subsidy purposes is not the same as revenue. Business expenses, a solo 401(k) or SEP-IRA contribution, and the self-employed health insurance deduction itself all reduce the figure the credit is measured against. People land under 400% who did not expect to.
Buy the tier that fits, not the cheapest premium. If you are not eligible for a cost-sharing reduction, compare gold against silver directly. In 2026 the lowest-cost gold plan averages less than the benchmark silver plan nationally while covering more.
Catastrophic plans, if you qualify. These are open to people under 30 and to anyone with a hardship or affordability exemption. HealthCare.gov notes they carry the same ten essential health benefits, cover preventive services at no cost, and include at least three primary care visits per year before the deductible. Premium tax credits do not apply to them, so they only make sense if you were not getting a credit anyway. See catastrophic health insurance for the tradeoffs.
A spouse’s employer plan. Losing coverage or getting married triggers a special enrollment period on their plan. Note the tax side: any month you are eligible for a subsidized employer plan through your spouse, you cannot take the self-employed health insurance deduction for that month.
Health sharing and short-term plans. Health sharing ministries and short-term health insurance both undercut marketplace pricing, and both do it by not being insurance in the ACA sense. They can decline you, exclude pre-existing conditions, and cap what they pay. Short-term policies are also capped in duration by federal rule. Read those two guides before you sign anything.
Direct primary care plus a high-deductible plan. A direct primary care membership covers routine visits for a flat monthly fee, and starting in 2026 a qualifying arrangement no longer blocks HSA eligibility. See HSA without insurance for how the account rules work.
Go self-pay for routine care. If you end up on a bronze plan with a $7,000 deductible, most of your ordinary care is cash anyway. Cash prices for a doctor visit without insurance are often lower than the billed rate your plan would apply to the deductible. Use GoodRx vs SingleCare for prescriptions, free clinics and sliding-scale care if your income is low, and hospital price transparency files before any scheduled procedure. Self-pay vs health insurance walks through when going without a plan is a defensible risk and when it is not.
If you are between jobs rather than permanently self-employed, compare marketplace pricing against COBRA and read health insurance for the unemployed. Losing job coverage opens a special enrollment period, and a subsidized marketplace plan usually beats full-freight COBRA.
The Bottom Line
Budget roughly $450 to $650 a month for an unsubsidized marketplace plan in your forties, and roughly $950 to $1,350 in your sixties, at 2026 national averages. Then find out whether a premium tax credit applies, because it is the only lever that moves those numbers by hundreds rather than tens.
The one thing that changed this year and changes the answer for a lot of self-employed people is the 400% cliff coming back. If your income lands just above it and you are over 50, you are paying full price for the first time since 2020. That is the scenario worth planning around, ideally before December, and worth revisiting each open enrollment while the law is unsettled. If you are new to buying your own coverage, uninsured start here covers the rest of the map.