Yes, independent creators can get health insurance. Here’s how.
Wondering about your options for U.S. health insurance coverage? Here are answers to creative entrepreneurs' most common questions.
Sometimes your physical and mental well-being often takes a backseat to your business — but it doesn't have to. At a special event, Patreon invited Stride Health's Dexter Hill Schmidt and Leesa Renée Hall, creator of Inner Field Trip, to help us answer some common questions and bust some myths about the often-confusing world of U.S. health insurance for independent creators, and to share strategies for tackling burnout.
Finding affordable health insurance can be a major challenge for independent creators in the U.S., but no matter who you are or how you earn a living, healthcare and health insurance can be an essential tool for supporting your physical health and mental well-being. Choosing a plan that's right for you can feel overwhelming and stressful in the short-run, but it can pay dividends when it comes to day-to-day care and emergencies. It's also a huge step in the right direction for safeguarding your overall mental health and protecting yourself against possible burnout.
To help you set aside the health insurance headaches, let's walk through the best ways to find a health insurance plan that matches your needs.
Is it even possible to get health insurance as an independent creator?
Yes! Although health insurance is typically handled through employers in the U.S., it's universally accessible for everyone. And, recently, private health insurance for independent creators has become more affordable, of higher quality, and easier to get than ever before. As for where to enroll, there are a few options:
Where to sign up on the U.S. government's marketplace
Healthcare.gov is the federal U.S. government website. It's where most people go to enroll in a plan. Currently, about 18 states do not go through the federal government exchange; so if you live in California, Colorado, Connecticut, District of Columbia, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, or Washington, you'll need to sign up through your state's exchange instead.
For more plans, try Stride
Each year, open enrollment typically runs through January 15 for Healthcare.gov, but some individual state exchanges (the ones listed above), deadlines may vary; some have open enrollment deadlines of January 31, for example.
Is picking a plan stressful?
There's no point sugarcoating it — picking a health insurance plan can be tough. But understanding how plans are categorized can help you filter through them and pick the best plan. The two main ways of differentiating plans are by types of plan networks or by "metal tiers," which are organized by how the cost of coverage is split between you and the insurer.
Decoding insurance plan network types
HMO, EPO, PPO — the world of health insurance can feel like an alphabet soup of abbreviations. Understanding the differences between your options is important, since the type of plan you select can affect where you can receive care, whether or not you'll need a referral in order to see a specialist, and how much of the cost you'll be on the hook to pay. Here, we explain common types of health plans that creators based in the U.S. are likely to come across.
HMO (health maintenance organizations), $
- Only covers doctors within a particular network
- You can't see other doctors without a referral from your primary care physician
- The least expensive premiums
EPO (exclusive provider organization), $$
- Allows you to see some out-of-network providers
- No referral needed from your primary care physician to see a specialist
- Useful if you have any doctors you want to keep
- Cost of premiums is between a HMO and PPO, so grants flexibility without breaking the bank
PPO (preferred provider organization), $$$
- Offers coverage when you go to out-of-network doctors
- No referral needed from your primary care physician to see a specialist
- The most expensive monthly premiums
For more information and a quiz for determining which type of plan is the best fit for you, read Stride Heath's article, Plan Network Types Explained: HMOs, PPOs, EPOs and POSs.
How metal tiers work
Metal tiers differ based on how the cost of healthcare services are split between you and your insurer. They are named after metals, in the order of preciousness: bronze, silver, gold, and platinum. The fancier the metal, the more coverage you get — and the more you'll pay:
In the bronze tier ($) you (the insured person) pay the lowest monthly rate, and the insurer covers 60% of costs
The silver tier ($$) is the lower middle-priced tier, and the insurer covers 70% of costs
The gold tier ($$$) in the higher middle-priced tier, and the insurer covers 80% of costs
In the platinum tier you pay the highest monthly rate, and the insurer covers 90% of costs covered
Choosing the right plan can be tricky. To get the right answer, you'll need to consider your financial situation, your best guess on how much care you'll need next year, and your risk profile.
For more details, read Stride Heath's article, Your Guide to Choosing a Metal Tier.
How much does health insurance cost if I don't have a traditional employer?
Your health insurance premium will be unique to you, and it's based on your zip code, your taxable household size, and your income. But, according to the U.S. Department of Health & Human Services, the majority of Americans can find a plan for under $10 a month, even without an employer.
To get an estimate for an affordable plan, deduct eligible business expenses from your income. Subtracting all business expenses — such as studio rental, editing software, or project management tools — will generate your adjusted gross income. With that number, you will likely qualify for even greater subsidy amounts and a cheaper plan from the federal government. With the implementation of the American Rescue Plan Act (ARPA), the odds you qualify for a cheaper plan have never been higher.
Can I change my plan mid-year?
In most cases, you do need to change or enroll in a plan during open enrollment , the big health insurance season, which takes place between November 1 and January 15 every year. It's the best time to make switches, change to a different plan, or enroll for the first time.
But it's not the only time you can enroll. Under certain circumstances, you may qualify for a special enrollment period in the middle of the year, which would allow you to change plans or enroll in a new plan. These circumstances (also called "qualifying events") include:
- Losing coverage unexpectedly
- Turning 26 years old
- Adding to your family
- Changing your marital status
- Having a drastic change in income
- Becoming a U.S. citizen
What are the benefits of disability insurance?
Paying for your monthly premiums if you're not working and not earning an income is not easy. But purchasing disability insurance, as well as health insurance, can supplement your income if ever you were to fall sick or get injured.
There are two types of disability insurance: Supplemental Disability Insurance and Social Security Disability Insurance
Supplemental Disability Insurance (SDI)
This is a policy you purchase for yourself which is designed to partially replace your income if you were ever to get ill or injured and unable to earn for any timeframe under a year.This type of insurance typically costs 1–3% of your annual income and ensures you will receive a consistent stream of income — usually 65% of what you'd typically earn, depending on factors like age and gender. This can be put towards paying for your health insurance premiums or other expenses. Stride, for example, partners with the disability insurance provider Breeze, but there are lots to choose from.
Social Security Disability Insurance (SSDI)
If your medical condition or illness lasts longer than a year, you can apply for Social Security Disability Insurance online or by calling the Social Security department. The processing of Social Security Disability Insurance applications typically takes between three to five months, so make sure you apply as soon as you pass the one-year mark of your illness or condition.
What if I never use my plan?
Health insurance is a medical and financial safety net, and it will help you recover if something bad happens. Whether it's worth it is a question only you can answer for yourself. But here are some pros and cons of getting a health insurance plan to help you decide.
Benefits of having health insurance
You'll have emergency coverage if you need it. You can't predict the future and often emergency-room costs and surgeries turn out to be more expensive than planned treatment. Having coverage cushions you for any drastic and unexpected health costs.
You'll know that in that worst-case scenario, you're covered. This kind of peace of mind is priceless.
All plans have an out-of-pocket maximum which guarantees that you won't pay above a certain amount towards health insurance, or toward healthcare costs. If a plan has an $8,000 out-of-pocket maximum, you will not pay more than $8,000 in the worst case scenario.
You can drop a plan at any time. If you aren't using the insurance, don't want to pay for it, or the peace of mind doesn't feel worth it, there are no consequences to exiting a plan mid-year. But you will need a qualifying event to re-enroll again outside of the open enrollment period.
Potential downsides of having health insurance
Paying a monthly premium can be a substantial cost to shoulder depending on your circumstances, and there's no denying that financial worries can impact your mental health. If this is the case, a catastrophic plan could be a suitable alternative. It's available to people under the age of 30, offering low monthly premiums and very high deductibles (the amount you pay out of pocket when you make a claim). This could be a good option if you don't see any major medical expenses in the future.
Note: You can't switch out of a catastrophic plan midway through the year without a qualifying event.
Is mental health coverage included?
Yes! Thankfully, the Affordable Care Act, which was passed in 2010, required all health insurance plans to cover some mental health, substance abuse and behavioral services. It also enforced cost parity, which means plans cannot charge you more for mental health services than they do for other benefits on the plan (this includes preventative care). Also, all plans also offer free autism screenings for children, as well as free depression and tobacco- and alcohol-misuse screenings for adults and teenagers.
How can I take care of my mental health and avoid burnout as a creator?
Creators and creative business people are particularly susceptible to burnout because the reward is always changing. But it doesn't have to be that way. Anti-bias facilitator and Patreon creator Leesa Renée Hall has experienced burnout several times, and she offers some excellent guidance on preventing burnout, as well as easing it when it happens. Her approach is to take a break from her social media sites and from checking the notifications page of her Patreon community.
"As creators we are more than the numbers," Leesa explains. "The numbers tell us if we're growing, but if we assign our identity to those numbers, that's going to impact our mental wellness."
So how can you develop a better relationship with your stats?
Examine your expectations. Do your social media followers and subscribers match the numbers of members you're hoping for? If they far exceed them, and you have the number of members you're looking for, that could be enough.
Embrace the space. Part of self-care after burnout can be slowing down and resetting your own expectations outside of other people's gaze.
Reconsider why you're doing the work you're doing. Understand that beyond the numbers, you're probably not doing this work to gain popularity. Refocusing your aim on your greater vision and on leaving some kind of a legacy can help you bounce back better.
Where are you on your health journey? Share your experiences and tips with fellow creators on our official Patreon Creator Community Discord server.
*This post is intended to summarize and highlight material presented as part of Patreon's #OwnYourGrowth workshop series, and it's not intended as financial, business, or legal advice from Patreon.