Budget health insurance as a freelancer.
Health cover costs premiums plus what you pay towards care, and the second part follows the plan's structure: everything up to the deductible is yours, then you pay a coinsurance share, and the out-of-pocket maximum caps the total. Budgeting on premiums alone is what leaves freelancers exposed, because a plan with a low premium usually pairs it with a high deductible. The worst case is the number to hold reserves against — it is the most the year can cost you regardless of what happens.
Out-of-pocket
Out-of-pocket = min(claims, deductible) + max(0, claims - deductible) x coinsurance, capped at the out-of-pocket maximum
Annual cost
Total = (monthly premium - subsidy) x 12 + out-of-pocket costs
This is a budgeting estimate, not insurance or medical advice. Actual premiums, deductibles, out-of-pocket limits, subsidy eligibility and what counts as a covered service depend on your plan documents, your jurisdiction and your circumstances. Read the plan's terms and check current subsidy rules with the relevant exchange, insurer or a licensed adviser before enrolling.
Only in a low-claim year. Enter your realistic expected costs and compare the total: the premium saving on a high-deductible plan is often smaller than the extra deductible you would pay if anything goes wrong.
No. The maximum caps what you pay towards covered care only; premiums are additional, which is why they are shown as a separate line here.
In several jurisdictions, partly or wholly, subject to conditions. That materially changes the net cost, so check the current rule with an accountant rather than assuming either way.