It’s that time of year again: Open Enrollment for buying health insurance through the federal government or your state (aka Obamacare). This isn’t your only health insurance, option, though. As a self-employed freelancer, there are several ways you can pay for all or some of your medical bills. Let’s take a look at what’s out there.

Health Insurance Marketplace aka Obamacare
You can sign up for insurance through the federal government’s website,, or through your state’s health insurance marketplace. Check this list to see if your state has its own marketplace. The open enrollment period is until January 15, 2022, though you will need to sign up by December 15, 2021, if you want your coverage to start on January 1, 2022,

Small Business Health Options Program
You may be able to get health insurance for you and your family through your registered business. The federal Small Business Health Options Program sometimes has lower rates for businesses than you’d get as an individual through Obamacare. States may have special business programs, too, though the rules for qualifying will vary by state.

Direct Primary Care Program
This is a health care program where you pay a flat monthly or yearly membership fee directly to a primary care physician of your choice in exchange for receiving a set of defined services from the doctor. Specialist visits, emergency services, surgeries and hospital stays aren’t covered. Here is a map of Direct Primary Care providers across the United States.

Health Care Sharing Ministry Plans
This is a form of health care coverage where people make monthly payments into a common pot of money to pay for each other’s health care needs. Most ministries are faith-based and require you to be part of that faith or profess the faith’s beliefs. Two non-religious health care sharing ministries are Zion Health and Sedara. You can sign up for these ministries at any time (there’s no set enrollment period) but they often do not accept people with chronic health conditions.

You can read news about health care sharing ministries in this New York Times article and this Lexington Herald-Leader article and this Helena Independent Record article. None of these reports is very rosy though I searched for positive news, too.

Full disclosure: I was part of a health care sharing ministry for several months a few years ago. I had a good experience with it, claiming for just one bill, which got fully reimbursed by the organization.

You may not think you qualify for Medicaid, but check your state’s income requirements to be sure.

This isn’t insurance at all but I’ve included it on this list because it is an option for health care: pay for everything when you need it. As most American know, this can be quite expensive given the cost of health care in the United States. But as this New York Times article shows, sometimes paying for care out-of-pocket — without ANY insurance at all — is cheaper than paying for care with insurance.

Spouse or Partner’s Health Insurance Plan
I put this option last because oftentimes this isn’t an option at all. This is either because you don’t have a partner (me for most of my life) or don’t have a partner with health insurance (also me, for a chunk of my married life).


Out of all the types of insurance that a freelance photographer needs, I think health insurance is one of the most important. If you don’t have your health — both physical and mental — then you really don’t have anything. As I wrote before on this website:

The unfortunate fact in the United States is that Americans are in $140 billion worth of medical debt, according to data from July 2021. Many people even declare bankruptcy due to medical debt. A recent Gallup poll showed that 50% of Americans worry a medical event could lead to bankruptcy.

Having health insurance isn’t a guarantee against expensive medical bills. But it does mean you’re likely to pay less for care than if you were uninsured.

What kind of health insurance coverage do you have? What were the main deciding factors for you? Let me know in the comments (and hopefully we can all learn from each other).