1099 health insurance: what independent contractors need to know
Getting paid on a 1099 instead of a W-2 means health insurance is now on you. There's no employer plan waiting and nothing coming out of a paycheck to cover it. This guide covers what changes when you're 1099, the options that actually exist, and how to choose without paying more than you need to.
What's different when you're 1099
- Nobody's chipping in. A W-2 employer usually covers a big share of the premium. On a 1099, you pay the whole thing yourself, though you can often get some of it back through the self-employed health insurance tax deduction.
- You pick the plan and the network. That's more work, but it also means more say over which doctors you keep and what you spend.
- Your income probably isn't steady. When money comes in unevenly, a plan with clear, predictable pricing is a lot easier to budget around than one full of surprise charges.
Your options as a 1099 worker
- The ACA Marketplace. Comprehensive coverage, and you may qualify for income-based subsidies, though the enhanced pandemic-era subsidies ended on December 31, 2025, which pushed a lot of people's 2026 premiums higher.
- A plan built for independent workers, like Molli. Molli is made for 1099 and self-employed people, with transparent flat-rate pricing (save up to 30% compared with ACA marketplace plans¹), nationwide PPO network access, and $0 virtual primary care and generic prescriptions through Vitable. Because 1099 work doesn't always last, Molli is built to come with you if you take a W-2 role.
- A spouse's employer plan, if you can get on one.
- COBRA, if you just left a W-2 job. It keeps your old coverage going, but it's usually expensive.
What 1099 health insurance costs
What you pay depends on your age, where you live, the plan, and, for Marketplace plans, your income. Compare on total expected cost, meaning the premium plus the out-of-pocket you'll realistically run up, not the premium on its own. Pull a real Marketplace quote (after any subsidy) and a Molli quote, and look at them side by side.
Don't forget the tax deduction
Most 1099 workers with self-employment income can deduct their health insurance premiums through the self-employed health insurance deduction, which lowers the real cost of whatever plan you pick. Check the details with a tax professional.
FAQ
- What is 1099 health insurance?
- It's just health insurance for people who work as independent contractors, paid on a 1099 rather than a W-2. There's no special "1099 plan" you have to buy. You get coverage directly, through the ACA Marketplace, a plan like Molli, a spouse's plan, or COBRA.
- How do 1099 workers get health insurance?
- You buy it yourself. That usually means the ACA Marketplace, a plan built for independent workers like Molli, a spouse's employer plan, or COBRA after leaving a job.
- Is health insurance cheaper for 1099 workers through a plan like Molli?
- Molli advertises savings of up to 30% compared with ACA marketplace plans¹ and $0 everyday care. Whether it's actually cheaper for you comes down to your subsidy eligibility and the care you use, so compare real quotes.
- Can I deduct my health insurance as a 1099 contractor?
- Usually yes, through the self-employed health insurance deduction, as long as you have self-employment income and meet the rules. Ask a tax professional what applies to you.
¹ Savings vary by location, age, and plan selection. Based on comparison of Molli Pro plan rates to ACA Silver benchmark premiums.