Open enrollment opened November 1. For most people the application is tedious. For a working musician, a session player, a songwriter, a photographer or a freelance video editor in Middle Tennessee, it asks a question you honestly cannot answer yet: what will you make next year?
On the marketplace side that is not a small question. It is the number a premium tax credit is built on. And it is the one thing a creative career does not hand you in advance.
Back in the summer I wrote a longer piece on how coverage works for working musicians. This one is narrower. It is about the decisions you make during this window, while the year ahead is still mostly a guess.
The application wants a number your calendar cannot give you
When you apply on the marketplace, you estimate your household income for the coming year. If a premium tax credit is in play, the size of it rides on that estimate. Then the real year happens, and at tax time the estimate and the real number get compared.
For someone on a salary that comparison is boring. For a creative it can be the whole story. A tour that adds dates, a cut that gets recorded, a residency that ends early, a client who pays in March for work you finished in December. Any of it can move the real number away from the one you wrote down in November.
I go through the mechanics in how income affects your premium. I will say this plainly: I am a licensed insurance agent, not a tax preparer. How a credit settles on your return is a question for whoever does your taxes, and if you have someone, a short call with them before you enroll beats one after.
Estimate from what is booked, not from what you hope for
The habit that helps most is not exciting. Build the estimate from what you can actually see.
Start with what is already on the calendar. Booked dates, signed work, standing gigs, students who are actually paying for lessons. That is your floor.
Look at the last two years, not the best one. Most creatives I talk with have a year they remember fondly and a year they would rather not. Neither one is a forecast. The pattern across both is closer to the truth.
Know that the estimate is not carved in stone. The marketplace asks you to report income changes during the year. If a big month changes the picture, updating it as you go usually beats finding out at tax time.
If your income tends to land well above the range where credits help, this whole section matters less and the comparison shifts toward the other lanes below. The post on enrolling with 1099 or commission income walks that line in more detail.
Your network has to go where the work goes
The second open enrollment decision for creatives is geography. A plan that works for someone who stays home in Davidson County can get thin fast for someone who plays Atlanta on Friday and Austin on Sunday, or shoots weddings across three states every summer.
Before you compare premiums, write down where you actually were last year. Not the address on your license, the places you spent real time. Then check how each plan you are considering handles care outside its home area. Some are built around a regional network. Some carry a national one. The difference does not show up on a renewal notice, and it tends to surface in an urgent care lobby a long way from Nashville.
The Nashville version of this argument, check the network before the price, applies to touring musicians twice over.
Your body is the instrument, so think past the health plan
A sprained wrist is an inconvenience for most people. For a drummer or a guitarist it is canceled dates. A sinus infection can cost a vocalist a week of work. Open enrollment is about the main health plan, but it is also a good moment to ask what happens to your income when an injury or an illness takes you off the stage or out of the studio for a while.
That is a separate question from health insurance, and some creatives answer it with disability coverage or a supplemental plan that pays cash after an accident. Not everyone needs either one. It is worth deciding on purpose instead of finding out later that you skipped it.
The three lanes, in a creative's year
The ACA marketplace. Guaranteed issue, so your health history cannot be used to turn you down, and open enrollment is when it is open to everyone. If a premium tax credit is in reach, this lane is often hard to beat. The trade is that it ties your price to that income estimate.
A medically underwritten private PPO. These ask health questions and can come back as a no, so nobody can promise you an approval. Where they fit, the price is not tied to an income projection, some carry a national network, and they can be applied for any month of the year, not just during this window.
A spouse's plan or a day job's plan. Plenty of creatives in this town have a partner with benefits or a part-time job that offers them. Compare it once instead of defaulting into it.
If you want the first two lanes side by side, that comparison is here, and the musician coverage page lays out how the lanes tend to sort for people in the music business.
What to bring to the conversation
A rough picture of this year's income and what is already booked for next year. Ranges are fine. Nobody expects a creative to know the exact number.
Where you traveled for work in the last year. States and cities, and roughly how long you were there.
Every doctor, specialist and pharmacy you actually use, including anyone you see for the physical side of the work, like a hand specialist or a voice doctor.
Your current plan's renewal notice, if you have one. Do not let it auto-renew just because it showed up. It tells you the new premium. It does not tell you whether the plan still fits the year you are about to have.
Frequently asked questions
I have no idea what I will make next year. What do I put on the marketplace application?
Your honest best estimate, built from what is already booked and from the pattern of the last couple of years rather than your best year. The marketplace asks you to report income changes during the year, so the estimate is not locked in. Because the estimate can affect a premium tax credit at tax time, it is worth checking with whoever prepares your taxes. I am a licensed insurance agent, not a tax preparer.
Will my health plan work when I am on tour?
It depends on the plan's network. Some plans are built around a regional network and may leave you with limited in-network options outside it. Others carry a national network. Check how each plan handles care away from home before you compare premiums, especially if you spend real time out of state.
Do I have to enroll during open enrollment?
For the ACA marketplace, open enrollment is when it is open to everyone, and outside it you generally need a qualifying life event for a special enrollment period. Medically underwritten private plans can be applied for any time of year, though they ask health questions and can be declined. Coverage availability and eligibility vary by individual circumstances.
Is a private plan better for musicians than the marketplace?
Sometimes, and sometimes not. A private plan's price is not tied to an income estimate and some carry a national network, but it is medically underwritten and can come back as a no. The marketplace cannot turn you down for your health history and may come with a premium tax credit. The right answer depends on your health, your income and where you work, which is why it is worth comparing both.
Should I think about disability or accident coverage too?
It is worth deciding on purpose. A health plan pays for care. It does not replace your income when an injury or illness keeps you from working. Some creatives add disability coverage or a supplemental plan that pays cash after an accident. Not everyone needs them, and it depends on what a few lost months would do to you.
Where to start
Creative work does not come with an HR department, and open enrollment is one of the few times a year the whole market is laid out in front of you at once. Use it. Settle the income estimate with what you can see, check the network against where you actually work, and look at all three lanes once, properly.
If you work in music or any creative field here, the conversation usually takes fifteen minutes and a rough picture of the year. It goes a lot better in November than it does after a missed show in March.
DC Insurance is an independent health insurance agency serving Middle Tennessee. This is general information about how coverage works, not advice about your particular situation. Coverage availability and eligibility vary by individual circumstances.
Denton helps self-employed individuals, 1099 contractors, and small business owners in Middle Tennessee find coverage that actually fits, comparing every lane available, not just what's easiest to sell. Learn more about Denton →