Health Insurance for Real Estate Investors and Landlords

Private first, for a simple reason

A private, medically underwritten plan is priced on your age, zip code and health. It does not ask about rent rolls, depreciation schedules or the duplex you plan to sell next year. If approved, it can start the first of any month, including the month after you close on a sale or leave a W-2 job to invest full time. Many private plans use national PPO networks, which suits an investor who owns property in more than one state or spends weeks at a time on out-of-town projects. You answer health questions, and approval is not guaranteed.

Private plans are not ACA Marketplace plans, and benefits and pre-existing condition rules vary by plan. I review the coverage details with you before you apply.

The Marketplace drawbacks, in investor terms

• Your income can swing by six figures. The 2027 credit stops at 400 percent of the poverty level: $63,840 for one person, $86,560 for two, $109,280 for three and $132,000 for four. A single sale can move you from well under the line to far over it.
• The credit comes back at tax time. Advance credits are reconciled on your return. If your final household income lands above the line, you repay the entire advance.
• Full prices are rising. KFF's review of 2027 filings from 276 Marketplace insurers found a median proposed increase of 15 percent.
• Local networks. Many Marketplace plans are HMO or EPO designs that cover little outside their service area except emergencies.
• High exposure. The 2027 out-of-pocket maximum is $12,000 per person and $24,000 per family.
• One enrollment window. Open enrollment runs November 1, 2026 to January 15, 2027, with December 15 the deadline for a January 1 start.

How rental income reaches the Marketplace

The Marketplace uses modified adjusted gross income. According to HealthCare.gov, that is your adjusted gross income plus untaxed foreign income, non-taxable Social Security benefits and tax-exempt interest. Net rental income reported on Schedule E flows into adjusted gross income after expenses such as mortgage interest, repairs, insurance, property taxes and depreciation, so the number the Marketplace sees is often far below your gross rents. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Depreciation helps until you sell

Residential rental property is generally depreciated over 27.5 years, and that annual depreciation reduces net rental income, sometimes to zero or below, even when the property throws off cash. That is why some landlords look at the Marketplace and see a large credit on paper. General information, not tax advice — confirm with your CPA based on your specific entity structure.

The catch arrives in the year you sell. Depreciation you claimed lowers your basis, which increases the taxable gain, and that gain counts toward the year's income. A landlord who qualified for a credit through June can finish the year far above the line after a closing in October and owe back every dollar of the advance. A like-kind exchange can defer gain into a replacement property, which changes the picture, but the rules are strict and the timing has to be planned with your CPA. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Passive losses and the $25,000 allowance

Rental activities are generally passive. If you actively participate, for example by approving tenants and setting rents, you may be able to deduct up to $25,000 of rental losses against other income, but that allowance phases out as modified adjusted gross income rises from $100,000 to $150,000. That phase-out uses the tax code's own definition of modified income, which is not the same calculation the Marketplace uses. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Investors who qualify as real estate professionals, which generally requires more than half of your working time and more than 750 hours a year in real property businesses where you materially participate, are treated differently. See IRS Publication 925 for the tests. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Health premiums on a landlord's return

Often not in the way a business owner can. The self-employed health insurance deduction generally requires a net profit on Schedule C or F, net earnings from self-employment as a partner, or wages from an S corporation in which you own more than 2 percent. Rental income on Schedule E is not on that list, so a pure buy-and-hold landlord may not qualify, while an investor who runs a property management company, a flipping business or another active operation might. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Why engineering income under the line is fragile

I talk with investors who plan to keep income just under the line with depreciation and timing. It can work, but it is a bet you settle in April. An unusually strong rent year, a forced sale, a spouse's raise or a late-year closing can each push household income over, and the penalty is repayment of the full advance credit, not a gradual phase-down. For many investors, a private plan whose price never depends on that bet is worth more than the credit they might keep. Our subsidy cliff guide walks through the math.

Leaving a W-2 job to invest full time

When you leave an employer plan, you get a 60-day special enrollment period for the Marketplace. Federal COBRA applies to employers with 20 or more employees, lasts up to 18 months and can cost up to 102 percent of the full premium. If approved, a private plan can start the first of the month after your job coverage ends, so the transition has no gap. If you own your properties through an LLC, the LLC owner guide covers related questions.

When the Marketplace is the better choice

If you or a family member has a significant health condition, the Marketplace is the guaranteed option, and I will tell you so. It can also make sense when your household income will reliably stay under the line, with no sale or other spike in the coming year. Bronze and catastrophic plans have been HSA-eligible since 2026, with 2027 HSA limits of $4,500 self-only and $9,000 family, plus a $1,000 catch-up at 55.

Compare both

I work by phone or video in 31 states, including Florida and Texas. Send your zip code, ages, a brief health summary and whether you expect a sale next year, and I will lay out private plans next to the Marketplace. Get a quote or call (786) 218-2384.