Self-employed independent contract work, also known as freelancing, 1099 work or gig work, is becoming increasingly popular thanks to the flexibility and autonomy it offers. But one thing it doesn’t offer is health coverage.
Common types of gig work include:
- Driving or delivery services (like rideshare or food delivery apps)
- Freelance or contract work (writing, design, consulting, IT services)
- Home and personal services (cleaning, tutoring, childcare, pet care)
- Skilled trades or project-based work (construction, photography, event services)
- Content creation or digital work (streaming, influencing, online courses)
Because gig workers are typically self-employed, they don’t receive employer-sponsored benefits like health insurance, paid time off or retirement plans. This means they’re responsible for finding and managing their own health coverage.
What are my health coverage options as a gig worker?
Although you may not have traditional employer-sponsored health coverage, you do have options when it comes to choosing a health plan.
- A family member’s plan – If you are younger than 26, you can join a parent’s health plan. You can also join a spouse’s employer-sponsored health plan.
- Medicaid – Medicaid is a joint federal and state program that provides free or low-cost health coverage to individuals and families with limited incomes.
- Affordable Care Act plans – The Affordable Care Act (ACA) is the federal law that helps make health coverage more affordable and accessible for individuals and families. The ACA allows people with pre-existing conditions to enroll, requires plans to cover essential health benefits and provides financial help for eligible members. There are many options to choose from, so you can find one that best fits your specific health needs and budget.
Common health coverage options for gig workers
| Coverage option | What it is | Best for |
|---|---|---|
| ACA plans | Individual and Family health plans, often with income-based subsidies that lower premiums | Gig workers with variable or moderate income |
| Medicaid | Low‑ or no‑cost health coverage based on income and eligibility | Gig workers with limited or inconsistent income |
| Spouse or parent’s plan | Coverage through a spouse/partner’s plan or a parent’s plan (if under age 26) | Gig workers with access to coverage through a family member |
How can I make health coverage more affordable?
There are several ways to make health coverage more affordable:
- High-deductible health plans (HDHPs): High-deductible plans typically come with a lower monthly premium. With an HDHP, you can also open a Health Savings Account (HSA), a savings account for medical expenses. Contributions are made with pre-tax dollars, which can lower your taxable income.
- Narrow Network plans: Narrow Network plans typically have a lower monthly premium in exchange for using a specific network of doctors and hospitals. These plans allow you to save money without sacrificing quality of care.
- ACA subsidies: There is financial help available for ACA plans, depending on your income and family size. In fact, people who make up to 400% of the federal poverty level can receive financial help, making this a great option for gig workers.
One thing you should not do to save money is go without health coverage. There are real financial risks to going without health coverage, no matter how healthy you may currently be.
- Average ambulance ride: $500 – $1,2001
- Average emergency room visit: $1,150 – $2,0001
- Average cost if you’re admitted: $10,000 – $30,0001
How do I choose the right health plan?
Before choosing a health plan, you should consider:
- Your budget
- How often you need care and prescriptions
- The full cost of care, not the just monthly payment
- Whether your preferred doctors are in network
- If you’re eligible for ACA subsidy savings
Take a short, 2-minute quiz to help you find your plan type.