Health Insurance for Contractors and the Skilled Trades
You work with your hands, your income comes in by the job, and nobody is handing you a benefits packet. Here is how tradespeople get covered without overpaying.
Health insurance is not workers' comp
Workers' compensation covers injuries on the job and only if you carry it or your GC does. A health plan covers everything else: the flu, a kid's broken arm, a surgery, a cancer diagnosis. Most tradespeople I talk to have one and assume it covers the other. You need both.
Your options
- Marketplace plan. Guaranteed acceptance, priced on your household income. Good fit if your net income is moderate or you have a health condition.
- Private PPO plan. Medically underwritten, year-round enrollment, usually nationwide networks. Good fit if you are healthy and your income is strong.
- Group plan for your crew. Once you have a few W-2 employees, a small group plan can make sense and helps you keep good people. I set those up too.
Project-based income and subsidies
Marketplace subsidies are based on net income for the year. Trades income is lumpy: a big commercial job, then a slow winter. Estimate conservatively, and update the marketplace if income changes, or you can owe money back at tax time. If you expect a strong year, a private plan avoids the problem entirely because income does not affect the premium.
Accident and disability coverage
An injury that keeps you off a ladder for three months is more likely than a major illness, and it hits both your health and your income. Accident protection and short-term disability are inexpensive add-ons for trades and I recommend them more often than anything else on this site.
The deduction
Self-employed premiums are generally deductible up to your net profit. S-corp owners handle it through payroll. Your CPA files it; I set up the coverage.
Dental and vision
Trades beat up teeth and eyes. Standalone dental and vision plans are cheap and can be added to any of the options above.
Frequently asked questions
I'm a 1099 sub under a general contractor. Can I get on their plan?
Almost never. As a subcontractor you are not their employee. You buy your own coverage, and the premium is generally deductible on your return.
Does a private plan cover injuries from my work?
Health plans cover injuries regardless of where they happen, but if you have workers' comp that is the primary payer for on-the-job injuries. Check your policy language.
What if I only have a couple of employees?
Small group plans can start at two enrolled employees in many states. Whether it beats everyone buying individually depends on ages and health. I will run it both ways.
Can I add coverage mid-year?
Private plans, any month. Marketplace plans need open enrollment or a qualifying event.
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Written by Frank Caballero, licensed insurance producer, NPN 21032307. Last updated 2026-10-16. General information, not tax or legal advice.