Trades work is hard on the body and the paperwork almost never accounts for that. If you are a sub, a one-truck operation or a small crew, nobody is handing you a benefits packet, and the plans you find on your own rarely answer the questions that actually matter in your line of work.
Losing prior coverage, moving, marrying or having a child opens a special enrollment period. Medically underwritten private plans are generally available year round. If you are uninsured right now, the priority is closing the gap, not finding the perfect plan.
This is the exact sequence we run. No portal maze, no call-center roulette, no quote and vanish.
Comp addresses injuries that happen on the job. It does not cover you at home, on the weekend, or for anything unrelated to work, and if you are a sub carrying your own policy the boundaries matter even more. Health insurance covers the rest of your life.
Knees, shoulders, backs and hands. That is the trades. How a plan handles imaging, specialist visits, outpatient surgery and physical therapy visit limits matters more to you than it does to an office worker, and those details are buried well past page one.
Trades income moves with weather and the pipeline. Marketplace subsidies are set on your projected annual income, so a strong spring does not automatically mean you fail the test. Project the year honestly rather than the best month.
Once you have even two or three employees there are options that are not available to a solo operator. Small group and defined contribution arrangements are worth pricing rather than assuming you cannot afford anything.
Electricians, plumbers, HVAC techs and contractors carry a risk profile that generic coverage advice ignores completely. These are the five places where the job and the policy meet, and where the wrong plan costs real money.
| The situation | What usually goes wrong | What to check before you buy |
|---|---|---|
| The line between workers’ comp and health insurance | People assume comp covers anything that happens on a job site. It covers work-related injury only, and the determination is not always the one you expect. | Confirm you have both. Health coverage is what pays when the injury is ruled non-work-related, and that ruling is out of your hands. |
| Orthopedic care and physical therapy | This trade’s most common claims are shoulders, knees, backs and hands, and physical therapy is exactly where plans impose visit caps. | Find the annual therapy visit limit and whether imaging or surgery needs prior authorisation. This matters more here than almost any other benefit. |
| The slow season | A premium set against summer cash flow becomes unaffordable in February, and a lapse restarts any waiting period you had already served. | Price against your leanest quarter. A plan you keep is worth more than a better plan you drop. |
| Working while injured | Coverage pays for treatment. It does not replace the income you lose while you cannot lift, and that is usually the larger number. | Treat income protection as a separate question. Do not expect a health plan to solve it. |
| The crew growing past a few people | Once you have employees, group coverage becomes possible and the maths changes entirely, including the tax treatment. | Ask whether a group plan beats everyone buying their own. Sometimes it does, and sometimes it very much does not. |
This table describes how coverage generally works. It is not a quote, it is not specific to any one insurer, and benefits vary by policy and by state. Confirm the details against the actual plan documents before you enroll.
The enhanced premium tax credits expired going into 2026. These are the four numbers that describe what followed, and they apply whatever line of work you are in.
Most people compare plans on premium and deductible. In the trades the benefit that most often decides the real cost of a bad year is the annual physical-therapy visit limit, because a rotator cuff or a lumbar injury is a course of treatment measured in dozens of visits, not two. That number is usually in the schedule of benefits rather than the summary page, which is precisely why it gets missed.
The enhanced premium tax credits expired going into 2026 and the average deductible across the marketplaces rose 37%, from $2,759 to $3,786 — more than a thousand dollars per person.[1] The average premium actually paid, after any credit, rose 58% from $113 to $178 a month.[1]
For a self-employed tradesperson those two numbers compound: you are exposed to a higher monthly cost and a higher first-dollar cost in the same year. Insurers filed a median 18% increase for 2026 across 312 filings, and about 40% of them asked for 20% or more.[3] Nothing in the stated drivers — medical trend around 8%, specialty drug spending, and a worsening risk pool — has reversed.[3]
This is the single most common gap in the trades, and it is expensive when it goes wrong. Workers comp responds to an injury that happens on the job. It does not touch anything that happens off the clock, it does not cover your family, and it does not handle illness. A man who tears a rotator cuff moving his own furniture on a Sunday is in exactly the same position as anyone else without health insurance. If you are a sub who carries comp because a general contractor requires it, you may be carrying proof of insurance that does nothing for you at two in the morning.
There is a second version of this problem. Some tradesmen carry an accident-only or limited benefit product because it was cheap and it sounded like coverage. Those products pay fixed amounts for specific events. They are not built to absorb a surgery, a hospital stay or an ongoing condition, and they are marketed hardest to exactly the people who most need real coverage.
One call. Licensed producer, not a call center. If your current plan is still the better deal, I will tell you that.
Read the plan for what your body actually does. That means checking how imaging is handled, whether an orthopedic specialist requires a referral, what outpatient surgery costs you, and critically, whether physical therapy is capped at a certain number of visits per year. Recovery from a shoulder or a knee routinely runs past a low visit cap, and paying cash for the back half of a rehab program is a real and avoidable expense. These details rarely appear in a quote comparison. They have to be pulled out of the plan documents.
A roofer in the summer and a roofer in February are two different income situations, and the marketplace does not price you month by month. It prices you on the modified adjusted gross income you project for the whole year. That means the goal is an honest annual projection, not a snapshot of your best week. You can update the projection during the year as things change, and you reconcile at tax time. Getting this roughly right up front avoids both a surprise repayment and twelve months of overpaying.
Tell us your trade, whether you are solo or running a crew, what your health history looks like, and roughly what you expect the year to look like. We price the marketplace with and without a subsidy, we price medically underwritten private coverage, and if you have employees we price the group side too. You get a licensed producer, and the answer includes the parts of the plan that matter for physical work rather than just a monthly number.
Figures on this page last verified against the primary sources on August 13, 2026
Scotty Jaymes Insurance is a private, independent insurance agency. We are not affiliated with, endorsed by, or connected to any government agency, the federal Medicare or Medicaid programs, or any state or federal health insurance marketplace including Healthcare.gov. The market data above is published by the organisations cited and is provided for context only. It does not describe the pricing, benefits or availability of any policy we offer. Plan availability, benefits and pricing vary by state and by applicant. Nothing here is tax advice.
No. Workers compensation responds to injuries arising out of employment. Anything that happens off the job, plus illness and your family's care, falls to health insurance. The two are not interchangeable and carrying one does not substitute for the other.
The same four doors any self-employed person has. Marketplace coverage with or without a subsidy, medically underwritten private coverage, or a spouse's group plan. Which is best depends on your projected income, your health history and your state.
Orthopedic and specialist access, imaging costs, outpatient surgery, and physical therapy visit limits. Those four items drive most of the real spending in physical trades and they vary widely between plans that otherwise look similar.
No. Subsidies are based on projected annual income, not a single month. Project the full year in good faith, update it if the year turns out differently, and reconcile at filing.
Yes. Once you have employees, small group plans and other employer arrangements become available and are often more workable than people assume. It is worth pricing rather than dismissing.
Under-65 coverage only. We do not sell Medicare.