Blog · Health Insurance · October 18, 2026

Health Insurance for Self-Employed People in Georgia: Your Options, Explained

When you work for yourself, you get to be the boss. You also get to be the HR department, which means figuring out health insurance on your own. No open enrollment email from work, no benefits portal, no employer chipping in.

I work with a lot of self-employed folks on their taxes, and health insurance is one of the biggest questions they bring me. So let's walk through your options and how each one affects your taxes.

Virginia S. Harris is a licensed Life and Health insurance agent.

Your Main Health Insurance Options When You're Self-Employed

1. A marketplace plan through Georgia Access

In Georgia, individual marketplace coverage is sold through Georgia Access, the state's own marketplace. HealthCare.gov notes that if you're self-employed with no employees, you can use the individual marketplace to buy coverage, and you may qualify for savings based on your estimated household income.

Pros: You may qualify for premium tax credits; plans must cover essential health benefits and can't deny you for pre-existing conditions. Watch out for: Premiums are rising for 2027, and the extra subsidies from 2021–2025 have ended.

2. Coverage through a spouse's job

If your spouse has employer coverage that includes family members, that can be a strong option. Compare costs carefully. Employer family coverage isn't always cheaper.

3. COBRA from a previous job

If you recently left a job, you may be able to continue that plan through COBRA. It keeps your doctors the same, but you usually pay the full premium plus an admin fee, so it can be pricey.

4. Small business coverage (if you have employees)

If you have employees, you may be able to offer group coverage, including through the Small Business Health Options Program (SHOP).

5. Medicaid or PeachCare for Kids

If your income is low, you or your kids may qualify. These programs accept applications year-round.

A note on non-ACA plans

You may see short-term or other non-marketplace plans advertised. These may not cover pre-existing conditions or all essential benefits, and they don't qualify for marketplace subsidies. Read the fine print, and ask questions before you buy.

Estimating Your Income: The Self-Employed Challenge

Here's the tricky part. Marketplace savings are based on your estimated household income for the year, and for self-employed people that's your net self-employment income (after business expenses), not your gross sales.

When your income goes up and down, estimating is hard. And starting with tax year 2026, the stakes are higher: if you receive more advance premium tax credit than you qualify for, you must repay the full excess at tax time. The old repayment caps no longer apply.

My tips for self-employed folks:

Use last year's Schedule C net profit as a starting point, then adjust
Track income monthly so you can see where you're heading
Report big changes to Georgia Access during the year so your credit can be adjusted
Remember the deductions that reduce your income for marketplace purposes. That's where good tax planning and good health insurance planning meet

The Self-Employed Health Insurance Deduction

This is one of my favorite tax breaks for self-employed people.

If you're self-employed and have a net profit, you may be able to deduct health insurance premiums you paid for yourself, your spouse, and your dependents. It's taken as an adjustment to income, so you don't have to itemize. It's generally figured on Form 7206.

Key rules to know:

You generally can't take it for any month you were eligible for an employer-subsidized plan, including through your spouse's employer, even if you didn't enroll
The deduction is generally limited to your net earnings from the business
If you received a premium tax credit, the deduction and the credit interact. The calculation can get technical, so this is one to get right

HSAs: A Bonus for Bronze Plans

Under the new federal tax law, starting in 2026, Bronze and catastrophic plans are treated as HSA-compatible. Georgia Access notes that all Bronze plans are HSA-eligible.

For 2026, HSA contribution limits are $4,400 for self-only coverage and $8,750 for family coverage (plus a $1,000 catch-up if you're 55 or older). HSA contributions can be deductible, growth is tax-free, and withdrawals for qualified medical expenses are tax-free.

For a healthy self-employed person, a Bronze plan plus an HSA can be a smart combo. For someone with ongoing medical needs, a higher metal level might save more overall.

When Can You Enroll?

Open enrollment for 2027 Georgia Access coverage runs November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage starting January 1.
Outside that window, you need a qualifying life event, such as losing job-based coverage, which is common when someone goes out on their own.

Leaving your job to go full-time self-employed? Losing employer coverage can open a special enrollment period. Don't wait. These windows are limited.

How to Compare Plans as a Self-Employed Person

Total yearly cost: premiums + expected deductible and copays, up to the out-of-pocket max
Network: are your doctors and the hospitals near you in it?
Prescriptions: check the plan's drug list
Cash flow: can your business handle a big deductible in a slow month?
Tax impact: premium deduction, HSA eligibility, and premium tax credit reconciliation

Mistakes Self-Employed People Make With Health Insurance

Using gross sales instead of net profit for marketplace income. That can overstate income and shrink your help.
Underestimating a great year. Then you repay the excess credit, in full, at tax time.
Skipping coverage to save money. One emergency can wipe out a year of profit.
Missing the self-employed premium deduction or claiming it for months when a spouse's employer plan was available.
Not using an HSA with an eligible Bronze plan.
Waiting too long after leaving a job. Special enrollment windows are limited.

Frequently Asked Questions

Where do self-employed people get health insurance in Georgia?

Most buy individual coverage through Georgia Access, the state marketplace. Other options include a spouse's employer plan, COBRA, small-group coverage if you have employees, or Medicaid or PeachCare for Kids if eligible.

Can I deduct health insurance premiums if I'm self-employed?

Often, yes. The self-employed health insurance deduction lets eligible people deduct premiums for themselves, a spouse, and dependents, generally on Form 7206, if they weren't eligible for an employer-subsidized plan.

What income do I use for marketplace coverage if I'm self-employed?

Your estimated household income, which uses your net self-employment income after business expenses, not your gross receipts.

What happens if my self-employment income ends up higher than I estimated?

Starting with tax year 2026, you must repay the full amount of any excess advance premium tax credit when you file. Report income changes to Georgia Access promptly to reduce that risk.

Are Bronze plans HSA-eligible?

Yes. Starting in 2026, Bronze and catastrophic plans are treated as HSA-compatible under federal law, and Georgia Access says all Bronze plans are HSA-eligible.

Get Your Health Insurance and Taxes Working Together

Most people get help with health insurance or taxes. When you're self-employed, you really need both to line up. Book at virginiaharrisenterprise.com or call 770-375-0353, and let's look at the whole picture.

Disclaimer: This article is general educational information, not insurance, tax, or legal advice. Plan availability, premiums, benefits, networks, and financial assistance depend on your location, income, household, and eligibility as determined by Georgia Access and the insurer. Nothing here guarantees any specific premium, subsidy, deduction, or coverage.

Notes & Sources

Self-employed marketplace options, savings based on estimated income: HealthCare.gov "Health coverage if you're self-employed." SHOP: CMS.
Georgia Access as state marketplace since PY2025; OEP dates: georgiaaccess.gov; healthinsurance.org Georgia guide.
Full excess APTC repayment from TY2026: IRS "Repayment caps eliminated for excess advance payments of the Premium Tax Credit" (Oct. 7, 2026).
Self-employed health insurance deduction and Form 7206: IRS Instructions for Form 7206.
Bronze/catastrophic HSA compatibility: IRS IR-2025-119 / Notice 2026-05; Georgia Access "All Bronze plans are eligible for a Health Savings Account."
2026 HSA limits $4,400 / $8,750: Rev. Proc. 2025-19 (IRB 2025-21). The $1,000 catch-up is statutory.
Enhanced PTC expiration: Commonwealth Fund (Oct. 8, 2026).