Marketplace is usually the first serious comparison
Self-employed people can use the individual Health Insurance Marketplace. The application generally uses estimated net self-employment income, household size, state, and eligibility details.
Income estimates matter because premium tax credits and cost-sharing reductions can change if income changes.
Off-market and private options
Private plans outside the Marketplace may be useful for some people, but they may not qualify for subsidies and some products may have medical underwriting, exclusions, or limited benefits. Compare carefully before replacing ACA-compliant coverage.
Questions to ask
- Is this coverage category available for my location, age, residency status, and enrollment window?
- Which doctors, hospitals, pharmacies, labs, and imaging centers are in network?
- What deductible, copays, coinsurance, and out-of-pocket maximum could apply?
- Are prescriptions, referrals, prior authorization, or medical records required?
- What should I get in writing before I enroll, travel, or schedule care?
Red flags
- A salesperson avoids written plan documents or official carrier links.
- The pitch focuses only on monthly premium and skips deductible, network, exclusions, and maximum exposure.
- Someone says a doctor, hospital, country, or procedure is covered without written verification.
- A limited-benefit, short-term, travel, or discount product is described like full major medical insurance.
Official sources to verify
Next step
Use the navigator to organize your situation, then verify plan-specific details with official sources, insurers, employer benefits teams, or licensed professionals.