How to Choose Health Insurance as a Single-Member LLC (2025 Guide)
Learning how to choose health insurance as a single-member LLC can feel overwhelming. Do you own a single-member LLC? Are you confused about health insurance? You’re not alone. Over 73% of self-employed business owners say picking health insurance is their biggest problem.
Here’s good news. If you’re healthy, you can get better rates. You can also get better coverage. Many LLC owners save $2,000 to $5,000 per year. They do this by picking the right plan for them in the season of life they are in.
What is a single-member LLC? It’s a business where you’re the only owner. This gives you flexibility. It also protects your personal money.
As an LLC owner, you don’t get health plans from an employer. But here’s a secret most people don’t know. This can actually help you get better options.
You’re in the right place to make a smart choice. This guide will show you how to find good, cheap coverage. Coverage that works for your business.
What is Health Insurance for a Single-Member LLC?
Health insurance for LLC owners is coverage you buy yourself. You buy it from insurance companies. Or you buy it from government websites. You don’t get group plans like employees do.
You have two main choices. Private health insurance plans. And ACA plans (also called Obamacare). The right choice depends on your health. It also depends on your income and business needs.
Private health insurance comes straight from insurance companies. Companies like Blue Cross, Aetna, or Cigna. You don’t go through Healthcare.gov. These plans can look at your health when setting prices. This often makes them cheaper for healthy people.
PPO plans are very popular. PPO means you can see any doctor. You don’t need permission first. These plans work everywhere in the country.
ACA plans follow strict government rules. They can’t say no because of health problems. You find these on Healthcare.gov. They cover basic health needs. But if you make too much money, they can be expensive.
Here’s what many LLC owners don’t know. Being healthy opens doors to cheap private options. These can cost 30% to 50% less than ACA plans. And they often have better benefits.
Want help finding the best plan for your LLC? Get free help from our experts. We’ll give you advice based on your specific needs.
Why Private Health Insurance is Often Better for Healthy LLC Owners
For healthy self-employed people, private health insurance usually gives better value. It beats ACA plans. Here’s the math that matters for your business budget.
ACA plans charge everyone the same price. Everyone in your age group pays the same. It doesn’t matter if you’re healthy or sick. If you’re healthy, you pay extra to help cover sick people. Private plans can give you better rates because you’re healthy.
Real Example: Josh’s Smart Choice
Josh is 29 years old. He’s a web developer with his own LLC. An ACA HMO plan cost $277 per month. He found a private PPO plan for only $241 per month. That saves $432 per year. But the real value is much more than the monthly savings.
Josh’s ACA HMO plan required him to:
- Pick one main doctor
- Get permission to see specialists
- Stay with local doctors only
- Pay more when traveling for work
- Wait weeks for specialist visits
His private PPO plan gave him:
- Freedom to see any doctor anywhere
- No permission needed for specialists
- Coverage that works when he travels for business
- Shorter wait times for appointments
- Better customer service
For Josh, paying $36 less per month was great. Getting much better benefits made it perfect. The PPO plan paid him to get better coverage.
More Benefits of Private Plans:
- Often include video doctor visits for free
- Better prescription drug coverage
- Can add dental and vision coverage
- Doctor networks stay more stable
- Better customer service ratings
The catch? You need to be healthy to qualify. But if you’re healthy with no ongoing health problems, private insurance often gives 2 to 3 times more value. Keep in mind, this is his example. Rates and plans vary due to several factors.
Not sure if private health insurance is right for you? Let’s find out together in a free call.
Step 6: Work with the Right Insurance Helper
Self-employed people have special needs. General insurance agents often don’t understand these needs. Here’s how to find expert help that actually helps.
What to Look For in an Insurance Helper
Works with Self-Employed/1099 Workers They should understand:
- Tax effects of different plan choices
- Doctor networks for business travelers
- How changing income affects plan selection
- State rules affecting LLC owners
Can Show You Multiple Insurance Companies Avoid agents who only sell one company’s plans. You want someone who can compare:
- Private insurance options
- ACA marketplace plans
- Short-term medical plans
- Association health plans (where available)
Honest About How They Get Paid Good helpers will explain how they make money. They’ll tell you about any conflicts of interest.
Questions to Ask Any Helper
- How many single-member LLC owners do you work with?
- Can you show me plans from at least 3 different insurance companies?
- Do you understand the self-employed health insurance tax break?
- What’s your process for helping with claims problems?
- How do you handle plan renewals and rate changes?
Red Flags to Avoid
- Pressure to buy right now
- Won’t explain different plan types
- Only shows you the most expensive options
- Doesn’t ask about your health or travel needs
- Can’t explain network differences
Ready to work with LLC insurance specialists? Get your free consultation with helpers who understand your unique business needs.
Common Mistakes That Cost LLC Owners Thousands
Avoid these expensive errors that trip up many self-employed business owners.
Mistake #1: Choosing Based Only on Monthly Cost
The Problem: A $150/month plan with a $10,000 deductible can cost more than a $300/month plan with a $2,000 deductible. The Fix: Always calculate total yearly costs. Include deductibles and copays.
Mistake #2: Not Understanding Deductibles vs. Copays
The Problem: Many people think copays count toward deductibles. They usually don’t. The Fix: Ask specifically: “What do I pay for a doctor visit before and after meeting my deductible?”
Mistake #3: Thinking ACA is Your Only Choice
The Problem: Many healthy LLC owners overpay by thousands. They don’t explore private insurance. The Fix: Get quotes from both ACA and private insurers before deciding.
Mistake #4: Ignoring Doctor Network Quality
The Problem: Saving $50/month doesn’t help if your doctors aren’t covered. The Fix: Check that your favorite doctors and hospitals accept the plan before buying.
Mistake #5: Forgetting About Business Travel Needs
The Problem: HMO plans can leave you with huge bills when you need care away from home. The Fix: If you travel for work, pick plans with nationwide coverage.
Mistake #6: Not Reading the Fine Print on “Extras”
The Problem: Thinking dental, vision, and video doctor visits are included when they’re often separate. The Fix: Ask specifically what’s included and what costs extra. Many private PPO plans include these extras at no extra cost.
Mistake #7: Waiting Until You’re Sick to Buy Coverage
The Problem: Private insurance checks your health when you’re healthy. The Fix: Get coverage while you’re healthy. Even if you’re young and rarely use healthcare.
Questions People Ask
Can single-member LLCs get group health insurance?
Usually, no. True group insurance needs multiple employees. However, some options exist:
- Professional association plans (if you qualify)
- “Groups of one” in certain states
- Spouse’s employer plan (if available)
- COBRA from previous employer (temporary)
Most single-member LLC owners do better with individual private insurance anyway. Group plans average costs across healthy and sick members.
Is private health insurance better than ACA for healthy self-employed people?
Usually, yes. If you’re healthy and don’t qualify for ACA help with costs, private insurance typically offers:
- 20% to 40% lower costs
- Better doctor networks
- More plan flexibility
- Better customer service
The trade-off is health checking. You need to qualify based on your health.
How much can I really save on taxes with health insurance?
It depends on your tax bracket and insurance costs. Examples:
- 22% tax bracket, $6,000 yearly costs = $1,320 tax savings
- 32% tax bracket, $6,000 yearly costs = $1,920 tax savings
- Plus potential HSA money (up to $4,150 in 2024)
The self-employed health insurance tax break can reduce your real insurance cost by 20% to 35%.
What if I travel all the time for work?
Pick a PPO plan with nationwide coverage. Key things to look for:
- Large doctor networks in multiple states
- No permission needed for specialists
- Emergency coverage anywhere in the US
- Video doctor visits for minor problems
- International coverage (if you travel abroad)
How do I know if my medications will be covered?
Every insurance plan has a “formulary.” That’s a list of covered medications. Before picking a plan:
- Ask for the formulary or check it online
- Look up your specific medications
- Check what “tier” they’re in (affects your cost)
- Ask about generic alternatives
- Make sure your pharmacy accepts the plan
What’s the difference between a $2,500 and $7,500 deductible?
Your deductible is what you pay out-of-pocket before insurance starts covering costs. With a $7,500 deductible:
- You pay the first $7,500 of medical costs each year
- Usually has lower monthly costs
- Good for very healthy people who rarely use healthcare
With a $2,500 deductible:
- Insurance starts helping sooner
- Higher monthly costs
- Better for people who see doctors regularly
Can I change plans if I don’t like my choice?
- ACA plans: Only during open enrollment (November-December) or big life changes
- Private plans: Usually can’t change mid-year unless moving or other major changes
- Short-term plans: Limited renewal options
Pick carefully since you’ll likely have the plan for a full year.
What happens to my rates as I get older?
All individual health insurance gets more expensive with age. However:
- ACA plans: Rates go up based on age in predictable ways
- Private plans: May go up based on age plus how much you used the plan
- Both: Can’t cancel you for getting sick, but rates may go up at renewal
Starting with good coverage while healthy helps make sure you keep access as you age.
Take Action: Your Next Steps to Better Health Coverage
Picking health insurance as a single-member LLC owner doesn’t have to be hard. You now know how to make a smart decision. A decision that protects your health and your business budget.
Here’s your action plan:
- Check your health status honestly – Are you a good candidate for private insurance savings?
- Calculate your real costs – Don’t just compare monthly payments. Look at total yearly expenses.
- Think about your business needs – Do you travel? Need flexible networks? Want video doctor visits?
- Get quotes from multiple sources – Compare both private insurers and ACA marketplace options.
- Factor in tax savings – Remember that costs may be 20% to 35% cheaper after tax breaks.
- Pick the right helper – Work with someone who understands LLC owners and 1099 workers.
Remember, the “best” plan isn’t always the cheapest monthly payment. The best plan gives you the coverage you need at the lowest total cost. With networks that work for your lifestyle and business.
If you’re healthy, don’t think you have to pay high ACA rates. Private PPO plans often give better coverage for much less money. Especially when you factor in the tax benefits available to self-employed people.
Still unsure what’s best for your LLC? We’ve helped hundreds of 1099 workers find cheap, flexible coverage that actually works. Click here to book your free consultation and let’s find the perfect plan for your business.
The right health insurance protects both your health and your business success. Take action today to get the coverage you deserve.
