Best Health Insurance Companies for the Self-Employed

Blue Cross Blue Shield (BCBS) is the best overall health insurance company for self-employed people for several reasons. It features the best overall cost scores of all providers we reviewed. The combined premiums, deductibles, and copays are more affordable than other providers on this list.

In addition, BCBS has the lowest-cost silver plans of all the insurers we reviewed. Older adults starting or winding down a business while waiting for Medicare to kick in will also find the best rates, according to our sampling of average costs for 60-year-olds. 

BCBS is also our pick for the best overall health insurance company. With coverage in 36 states and a network of 1.7 million health care providers, you’re more likely to find available BCBS health care options. (For this analysis, we excluded Anthem from our BCBS evaluation because the two compete in some markets.)

Shoppers on the ACA exchange should find many choices, including plan types: health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), and point-of-sale (POS) plans, as well as six metal levels. BCBS also offers catastrophic plans, which may be a good fit for freelancers under 30 or those not yet earning much. Outside of traditional health insurance plans, BCBS offers short-term coverage and travel medical insurance for contractors headed overseas. 

Third parties generally give BCBS high ratings, including the NCQA ratings of all the providers on this list. However, since BCBS is a group of companies, member experience varies by region. For example, the J.D. Power 2024 U.S. Commercial Member Health Plan Study has BCBS in top positions in places like New York and Ohio but below average in other regions. 

Oscar is our top-ranked provider for copays, with the lowest physician-visit copays of the companies we researched. Copays are particularly affordable for silver plans.

Oscar’s solid app allows you to visit a primary-care physician for $0, providing a predictable charge for self-employed people with variable income. You can also use the app to message your care team or for prescription refills and virtual urgent care, even while traveling. The app rewards you for hitting your daily step goals—between $25 and $100 per year, depending on your state. 

Oscar offers a variety of plan types and every available type of medical management program we researched. These include programs for asthma, diabetes, depression, pain management, heart disease, high blood pressure and cholesterol, low back pain, and pregnancy. It’s also the only insurer we surveyed that offers a weight-loss program. 

That said, Oscar’s NCQA rating for member experience was 3 out of 5 stars, lower than most competitors. In addition, Oscar plans are only available in 18 states. And you can’t use the app to book a $0 primary-care doctor visit outside your home state, which may cramp your style if you’re a digital nomad.

If you’re looking for an affordable plan with excellent ratings, Kaiser offers both features. In many of the quotes we gathered, it had the lowest premiums available. However, that can mean higher out-of-pocket costs, so read the plan carefully. 

Kaiser Permanente boasts the best average NCQA rating among all the providers we reviewed and is the only provider with a rating above 4 stars. Kaiser also dominates customer satisfaction rankings in many of the regions it’s offered, according to the 2024 J.D. Power Survey.

Self-employed people with limited schedules may like Kaiser because the company has its own hospitals and doctor’s offices. The provider-and-plan ecosystem may minimize paperwork and hassles. 

However, Kaiser was the least-available plan we reviewed, only offering coverage in eight states and Washington, D.C. Some people may chafe at the plan’s HMO setup, which won’t cover out-of-network providers in most cases. 

Every Aetna plan sold on the federal marketplace is eligible for premium tax credits, which could reduce premium costs to $0 for people who qualify for the maximum credit.

That doesn't mean they're all free. Some $0 bronze plans may have higher consumer cost-sharing (deductibles and copays) than higher-premium plans. 

Even if you don’t qualify for tax credits, Aetna offers better-than-average rates across its plans. For example, Aetna has the second-lowest costs (premiums and deductibles) for bronze plans and for 45-year-olds and 60-year-olds. 

Busy contractors who shop at CVS pharmacies will also appreciate the wide range of $0 MinuteClinic services included with Aetna’s plans. You can walk into a MinuteClinic (typically housed within a CVS) or book an appointment online. Aetna also throws in a quarterly $25 allowance to spend on CVS-branded wellness products and 20% off CVS Health brand products. 

Aetna offers HMO, PPO, and EPO plans, and various medical management programs for different conditions. The company’s average NCQA rating is 3.46 out of 5 stars, which is better than average. Aetna was top-ranked for customer service in the 2024 J.D. Power Survey in several large U.S. regions, including the Northwest and Southwest. 

Aetna is only available in 12 states. If you don’t live near a CVS, many of the plan’s best advantages may not be available. Aetna offers only three metal-level plans—the fewest among the providers we surveyed—and no catastrophic plans.