Self-employed health cover

What this actually is

Self-employed households buy the same Marketplace plans everyone else does, but three things work differently. Your income estimate is a forecast rather than a payroll number. Your premium may be deductible above the line on your return. And a mid-year swing in earnings changes your subsidy in a way a salaried person never has to think about.

We treat the income estimate as a working document. Most of our 1099 clients set it in November using last year's Schedule C plus what they know about their book of work, then revisit it in June and again in October. That habit is the difference between a small correction and a four-figure reconciliation.

If your net profit is high and steady, we also look at whether a high-deductible plan with a health savings account beats a richer plan, because the HSA deduction and the premium deduction stack. If your income is low and lumpy, we look hard at silver, because the cost-sharing reductions only attach there.

What we do on this line

• An income worksheet built from Schedule C, not from a salary figure you do not have
• Subsidy modelling at three income scenarios, so you can see the cliff edges before you pick
• HSA eligibility screening against the current high-deductible plan definitions
• A plain explanation of how the self-employed health insurance deduction interacts with the premium tax credit
• Mid-year check-ins in June and October to re-forecast income before it costs you
• Dental, vision and accident options priced separately so you can see what each one buys