The complete health insurance manual for self-employed creators

Without an HR professional to guide you through your options, you need to understand how to assess different healthcare plans. It is also important to think about the specific needs of self-employed entrepreneur -- such as staying healthy so you can continue to grow your business.

It's vital to get a plan that's affordable and protects your physical and mental health needs, which is why we're committed to helping in this journey. Read on to find out how to use insurance and some solutions that can be beneficial for self-employed creators like yourself.

Do you really require insurance?

No question. Yes!

Hospital or emergency room bills will quickly add up even for seemingly simple issues.. Counseling for mental health or burnout could cost up to $250 per hour.

Let's face it: burnout is common among the self-employed. Indeed, Vibely found that a nearly 90% of self-employed creators are burned out at one point or another in their career.

Hopefully, you'll never need to submit an insurance claim. But when a health issue comes out, you'll be happy that you're protected.

Health insurance that is affordable for self-employed

Like it sounds, the Affordable Care Act (ACA) was created to be affordable and accessible. Open enrollment happens each year from November 1st until January 1st or January 15th.

However, you might be able to enroll at any time during the year, if you encounter one of four qualifying circumstances in your life:

• Losing health coverage
• Changes in the household, such as being married, having a child, or experiencing a death in the family
• Residence changes, such as relocation to a new ZIP code or county
• Other qualifying events, such as income changes or the gaining of an U.S. citizen

The ACA has a wide range of plans that allow users to choose the best balance of cost and coverage:

• Platinum will cover 90% of your medical costs, with a 10% copay.
• Gold covers the majority of medical expenses, and comes with the option of a 20% co-pay.
• Silver covers 70% of your medical expenses, and the option of a 30 percent copay.
• Bronze will cover 60% of your medical expenses, and a 40 per cent copay.
• Catastrophic plans cover three primary health visits as well as preventive. All other medical expenses up to a high deductible.

How much does self-employed health insurance cost?

In selecting the appropriate coverage for your needs, you aren't limited to health insurance plans. You can also opt for dental or vision insurance or combine your medical insurance with a savings account, often referred to as an HSA.

Your cost depends on:

• You can pick the coverage that you want
• The types of insurance you select
• Age
• Your location

The greater the coverage you select, the higher your premium. You don't need to foot the entire bill. To ease the burden, the government offers tax credit that allows self-employed individuals and their families to buy health insurance through the Health Insurance Marketplace(r).

The tax credit concept to help pay for health insurance

When you sign up for insurance in the Marketplace In the Marketplace, you'll be asked for your estimated income and household information. This determines your potential tax credit.

In order to qualify, your earnings must be at or above 100percent and 400 percent of the federal poverty level (FPL) that includes earnings and tips. Do not worry if your earnings tops 400% of the FPL. 2022 Marketplace health insurance plans also offer a tax credit for higher incomes.

This tax credit lowers the price of premiums to health insurance coverage for your spouse, you as well as any dependent children who are under the age of 26.

Be aware, you don't require tax credit. You may use all, some, or none of your credit prior to the start of your monthly premium.

When you do your taxes at the end of the year it is possible that you will have to pay back some of these credits if you earn higher than you estimated. In the alternative, if you took more tax credits than the amount you're eligible for, then you'll receive the difference as a refund credit on your tax bill.

Alternate insurance

When you browse the web for alternatives to health insurance plans such as healthshare, short-term plans, as well as other healthcare insurance policies.

They allow you to protect yourself against catastrophic medical events or injury. But, it's important to know that they do not meet the definition of health insurance and don't have to offer the same medical benefits that are provided by ACA plans.

They don't have to cover preexisting conditions -- generally, they won't. Additionally, they may ask the patient to cover their medical bills on your own and send bills to be reimbursed.

Small business group insurance

An alternative for those who are self-employed are small-business group insurance offered through The Small Business Health Options Program (SHOP).

It's available for small businesses which have 50 or more full-time workers. If you are less than 25 employees, you can get the Small Business Health Care Tax Credit and it covers 50% of the cost.

You can enroll through an insurance provider or the help of a SHOP-registered agent.

Notice:This coverage is only available if you have employees that work more than 30 hours per week. If you're sole proprietor or a partnership, you need individual insurance.

Directly from insurance companies

A different option is to purchase health insurance with the company you trust: Cigna, United Healthcare, Aetna, Kaiser Permanente, Anthem, or Oscar Health. It's a good alternative if you have the type of plan you loved at a former employer and want to access these providers and facilities.

Remember, you must select a qualifying plan in order to be eligible for the premium tax credits that are available through the Marketplace.

Some of these companies also offer dental and vision coverage. Also, you could receive coverage through a special company such as Delta Dental or VSP Vision Care.

Myths about health insurance

The process of choosing health insurance can be difficult. It doesn't help that there are so many myths surrounding the process. We'll address some of the frequently-repeated misconceptions right now.

 Myth No. 1: With or without employers, insurance won't be an option.

Thanks to the ACA and government tax credits Individual insurance can be accessible to everyone. It is important to choose the appropriate plan, however.

If you don't get sick often and need to ensure that your insurance premiums are kept low, you can do that by choosing a plan with a higher deductible and co-pay. If you or your family suffers from chronic illnesses it is possible to cut costs by choosing the HMO plan.

 Myth #2 I'm covered as soon when I join the health insurance company.

Depending on the healthcare policy you select There could be an interval of time before you're covered fully. If, for instance, you purchase insurance from the Marketplace at the time of open enrollment the coverage will not begin on January 1st of the year following. Take the time to review the information or get in contact with your insurance company to answer any questions.

 Myth 3 The health insurance policy will pay 100% of my healthcare costs.

Insurance plans do not cover 100 percent of your expenses. Your coverage depends on the amount of copays, deductibles, as well as the annual maximum out of pocket in your chosen plan.

The deductibleis the amount you pay before insurance coverage kicks in. Generally, the smaller your monthly premium for insurance, the higher your deductible will be.

A copay is the amount you pay towards the cost of healthcare. In the majority of cases, even after hitting your deductible, it's likely that you'll still be responsible for 10-30% of the healthcare costs, depending on your plan.

The annual maximum out of pocket is the total amount that you'll pay throughout the course of the year. After you've paid this sum of money for healthcare costs, insurance will begin paying all of your costs up to the close of the calendar year.

 Myth #4: Lower premiums will help me save money.

There is a chance that you will select the one with the lowest costs, but over the long term this could cost you more.

This is especially true when you suffer from an illness that is chronic, such as diabetes or asthma that needs periodic medication and maintenance in the event that you or someone in your family requires emergency surgical intervention.

Choose a plan that gives sufficient coverage to meet your likely medical emergencies (including the possibility of unexpected medical needs) however it doesn't exceed your budget. It's possible that you won't use all of your coverage, but you'll have what you require in the event of a medical emergency arises.

 Myth #5: Health insurance covers every doctor I choose.

Depending on the type of policy you select You may be limited in your options when choosing your doctor.

HMOs, or Health Maintenance Organizations, are the cheapest of health insurance options. It is essential to select the primary physician within their network, and you are only able to see specialists if they refer to you. There is no coverage for out of network healthcare with the exception of an emergency.

Point of Service, or Point of Service, plans have a similar structure to HMOs in the sense that you require the approval of your primary physician in order to see specialists. You do have the option to utilize doctors who are not in your network however, you'll be paying less for the in-network provider.

EPOs or Exclusive Provider Organizations, only cover services if you use doctors, specialists, and hospitals in the plan's network (except in emergencies). But their network is generally greater than that of an HMO's. There are some who may need recommendation before seeing a specialist.

PPOs also known as Preferred Provider Organizations permit users to choose every provider you'd like to, though you'll pay lower if you choose to use network providers.

 Myth #6 The health insurance policy only covers physical illnesses.

Most insurance policies today consider behavioral and mental health problems to be vital. So, your plan could provide counseling, drug abuse, and related issues. Certain healthcare providers offer better accessibility than others, so before choosing a plan, read reviews about how it's like for accessing mental health services through their network.

NOTE: Different states and insurance companies provide different mental health advantages. Compare plans in the Marketplace for a better chance of getting the insurance you need.

The bottom line on health healthcare options for those who are self-employed

If you're a business owner, you now have more power than ever to make medical choices. With the advent the health insurance exchanges SHOP, the SHOP program, as well as HSA plans There's never been a more ideal time for self-employed people to manage the costs of their healthcare. Remember, to choose the right plan, take time to understand your healthcare requirements prior to deciding on a plan.