Health Insurance for Self-Employed Relief Vets: Every Option Explained
As a 1099 relief vet, you're responsible for your own health insurance. Here's a breakdown of every option — marketplace plans, professional associations, HSAs, and the self-employed health insurance deduction.
Health insurance is the benefit that employed associates take for granted and self-employed relief vets lose sleep over. It's expensive, confusing, and the rules change constantly.
But it's also one of the largest tax deductions available to you. The self-employed health insurance deduction lets you write off 100% of your premiums — which can save you thousands in taxes while keeping you covered.
Here are all your options.
Option 1: ACA Marketplace Plans
The Affordable Care Act marketplace (healthcare.gov) is where most self-employed relief vets buy individual health insurance.
How It Works
Open enrollment: November 1 through January 15 annually
Special enrollment: Available if you have a qualifying life event (losing other coverage, moving, getting married, having a child)
If your income qualifies, the government subsidizes your premiums. The credit amount is based on your Modified Adjusted Gross Income (MAGI) relative to the Federal Poverty Level (FPL).
For 2026 (single person):
Income below ~$62,600 (400% FPL): Eligible for premium tax credits
Above 400% FPL: No credits available (the "subsidy cliff" returned in 2026)
Important for relief vets: Your MAGI includes your net self-employment income MINUS deductions like retirement contributions, the self-employment tax deduction, and the self-employed health insurance deduction. Strategic planning can keep you under the subsidy cliff.
HSA-Compatible Plans
If you choose a High Deductible Health Plan (HDHP), you can open a Health Savings Account (HSA).
2026 HSA contribution limits:
Individual: $4,300
Family: $8,550
Catch-up (55+): Additional $1,000
HSA advantages:
Contributions are tax-deductible
Growth is tax-free
Withdrawals for qualified medical expenses are tax-free
After age 65, withdrawals for any purpose are taxed like a Traditional IRA (no penalty)
Triple tax advantage — the only account type with this benefit
For a healthy relief vet, the HDHP + HSA strategy often provides the best combination of low premiums and tax-advantaged savings.
Option 2: Professional Association Plans
AVMA Member Plans
The AVMA offers group-rate health insurance plans through its membership. These can sometimes be more affordable than individual marketplace plans, particularly if you don't qualify for premium tax credits.
Requires AVMA membership ($370/year)
Plan availability and pricing vary by state
May offer options not available on the marketplace
State VMA Plans
Some state veterinary medical associations offer group health plans for members. Check your state VMA for availability.
Relief VMA
The Relief Veterinary Medical Association (ReliefVMA.org) provides resources and occasionally group purchasing options for relief-specific benefits.
Option 3: Health Sharing Ministries
Health sharing ministries are cost-sharing organizations where members pool contributions to pay each other's medical bills.
Popular options: Medi-Share, Liberty HealthShare, Christian Healthcare Ministries, Samaritan Ministries.
Potential advantages:
Monthly contributions are typically 30-50% lower than traditional insurance premiums
No network restrictions (most programs let you see any provider)
Exempt from ACA individual mandate
Critical disadvantages:
NOT insurance — there is no legal guarantee your bills will be paid
NOT tax-deductible as health insurance premiums (you cannot claim the self-employed health insurance deduction)
Pre-existing condition limitations are common
May have religious lifestyle requirements
Annual or lifetime sharing limits
Some exclude mental health, maternity, or certain conditions
Our take: Health sharing ministries can work as a supplement or for healthy individuals comfortable with the risk. But they should not replace actual insurance for most relief vets, especially given the tax deduction you miss.
Option 4: Spouse's Employer Plan
If your spouse has employer-sponsored health insurance, joining their plan is often the most cost-effective option.
Advantages:
Employer-subsidized premiums (typically 50-80% covered by the employer)
Often broader provider networks
No individual market shopping
Tax note: If you're eligible for your spouse's employer plan, you generally cannot claim the self-employed health insurance deduction for the months you're covered by that plan. However, if the employer plan doesn't cover you (only your spouse), you can still deduct your own individual policy premiums.
The Self-Employed Health Insurance Deduction
This is the key tax benefit that makes health insurance more affordable for relief vets.
How It Works
You can deduct 100% of health insurance premiums paid for yourself, your spouse, and your dependents. This applies to:
Medical insurance premiums
Dental insurance premiums
Qualifying long-term care insurance premiums
Vision insurance premiums
Where It's Claimed
The deduction goes on Form 7206, which feeds into Schedule 1, Line 17 of your Form 1040. It's an above-the-line deduction — meaning it reduces your Adjusted Gross Income (AGI), not just your taxable income. This is more valuable than an itemized deduction because it lowers AGI, which affects eligibility for other deductions and credits.
Limitations
Cannot exceed your net self-employment income
Cannot be claimed for months when you were eligible for an employer-subsidized plan (through a spouse or W-2 job)
Cannot be combined with the premium tax credit for the same premiums (you must choose one or the other for each month)
The Circular Calculation
Here's where it gets complex: the self-employed health insurance deduction reduces your AGI, which in turn may increase your ACA premium tax credit eligibility. But if you take the premium tax credit, you can't deduct those same premiums.
The optimal strategy depends on your income:
Below the subsidy cliff (~$62,600 MAGI): The premium tax credit is usually more valuable. Take the credit.
Above the subsidy cliff: Take the self-employed health insurance deduction (since you don't qualify for credits anyway).
Near the cliff: Careful planning can use the deduction to push your MAGI below the cliff, unlocking the credit for the remaining premium amount. This requires a CPA with experience in self-employment and ACA planning.
Disability Insurance: The Forgotten Benefit
While not technically health insurance, disability insurance deserves mention. As a relief vet, your ability to work is your only source of income. If an injury prevents you from practicing, disability insurance replaces a portion of your income.
Key terms:
Own-occupation policy: Pays if you can't perform YOUR specific job (veterinary medicine). This is what you want.
Any-occupation policy: Only pays if you can't perform ANY job. Much harder to claim.
Elimination period: The waiting period before benefits begin (30, 60, 90 days). Longer periods = lower premiums.
Typical cost: 2-4% of your annual income. For a vet earning $150,000, that's $3,000-$6,000/year.
It's not cheap, but the alternative — having zero income if you're injured — is worse.
A Decision Framework
Your Situation
Best Option
Qualifying for ACA subsidies
ACA marketplace with premium tax credit
Above subsidy threshold, healthy
HDHP + HSA (marketplace or AVMA)
Above subsidy threshold, chronic conditions
Gold/Platinum marketplace plan with SE deduction
Spouse has good employer plan
Join spouse's plan
On a W-2 relief platform
Use their benefits
Want absolute lowest monthly cost
HDHP + HSA (but make sure it's real insurance)
Annual Health Insurance Checklist
October: ACA open enrollment begins November 1. Review current plan and compare options.
November-January: Enroll or re-enroll in marketplace plan. Don't auto-renew without checking — plans change annually.
January: Confirm HSA contribution amount for the new year. Set up automatic contributions.
April: File taxes. Claim the self-employed health insurance deduction (Form 7206) or reconcile premium tax credits (Form 8962).
Year-round: Keep all premium payment receipts for tax documentation.
The Bottom Line
Health insurance is expensive. But between premium tax credits (if you qualify) and the self-employed health insurance deduction (if you don't), the after-tax cost is significantly lower than the sticker price.
Don't skip coverage because of cost. A single ER visit or surgery without insurance can cost more than years of premiums. Find the right plan, claim your deductions, and protect your ability to keep practicing.
Kal Saad