Estimating a year you have not lived yet
Nobody knows. The application still needs a number, and the number that is being asked for is a good-faith projection of this year’s income, not a guarantee.
A method that holds up:
- Start with the last twelve months, not the last tax return. A calendar year that ended nine months ago is a worse predictor than the trailing year.
- Subtract ordinary business expenses. What counts is net self-employment income, so the figure is after the costs of doing the work.
- Adjust for anything you already know will change — a client ending, a contract signed, a season you always have.
- Write down how you got there. One paragraph in a note. If the number is ever questioned, the reasoning is the answer.
- Revisit it at least twice a year, and whenever something large changes.
An estimate that turns out wrong is normal. An estimate that is never revisited is what causes problems.
What actually counts as income
The measure is MAGI, and for self-employed people the input is net self-employment income — gross receipts minus ordinary business expenses — rather than everything that arrived.
Two consequences worth stating plainly:
A freelancer who bills a large gross and has real expenses is frequently lower on the scale than they assume, and some discover they qualify for the Essential Plan when they had been pricing full-premium marketplace plans.
Income that is not from work still counts. Interest, dividends, certain distributions. The figure is household income for the tax household, not business revenue. What MAGI includes.
Which door is likely to be yours
The Essential Plan. At or below 200% of the federal poverty level: $0 a month, no deductible, no enrollment season. A lot of working freelancers in this city sit inside that line after expenses and have never checked. What it covers.
Medicaid, at lower income, also with no season. Medicaid in New York.
A marketplace plan with a premium tax credit above that, priced on your projected income. How the credit is calculated · The 2026 limits by household size.
Not short-term insurance, which cannot be sold in New York at all: every individual plan here must be comprehensive and cover essential health benefits. The product marketed to freelancers in most states is unavailable to you, and that is protective rather than restrictive.
The two questions before choosing a plan
Freelancers change plans more often than salaried people, which makes these two worth more here:
“Is my doctor in this specific plan?” Asked of the practice, using the exact plan name on the card rather than the carrier’s brand, and asked again about whether they are taking new patients with it. The two-question call.
“Which plans exist in my county?” Participation is set county by county, so the menu depends on the address on the application. Plans by county.
If you have employees, or are about to
That is a different set of rules, starting at the numbers 2, 20 and 50. What changes when you are the employer.
Questions people ask
What income do I put on the application if I am self-employed?
The net self-employment income you expect for the current year — after ordinary business expenses — as a good-faith projection, not a guarantee.
What if my estimate turns out wrong?
That is normal. Report the change within 30 days and the credit is recalculated forward. An estimate that is never revised is what produces a repayment at tax time.
Do I use last year’s tax return?
As a reference, not as the answer. The last twelve months adjusted for what you already know will change is a better predictor than a calendar year that ended months ago.
Can a freelancer get free coverage in New York?
Often. The Essential Plan costs $0 a month at or below 200% of the federal poverty level, and that line is measured after business expenses, which surprises people who bill a large gross.
Is there an enrollment season for me?
For marketplace plans yes, November 1 to January 31. For Medicaid, the Essential Plan and Child Health Plus there is no season at all.
Can I buy a short-term plan between contracts?
No. Short-term insurance is prohibited in New York, because every individual plan sold here must be comprehensive and cover essential health benefits.
Sources
- NY State of Health (checked 2026-09-14)
- NY State of Health — Essential Plan (checked 2026-09-14)
- NYS Department of Health — Medicaid attestation of income (checked 2026-09-14)
More in Coverage by the Kind of Work You Do
- Home Care Work: Covering the People Who Do the Covering — For home health aides, coverage depends on who employs you: an agency, CDPAP or a household. What union funds cover, and the thresholds written in hours.
- Construction: Two Different Systems, and Saying the Wrong One Costs You — On a construction site, the first sentence at the hospital desk decides whether workers' compensation pays the whole bill. Immigration status does not matter.
- Several Part-Time Jobs: Full-Time Hours, Nobody's Employee — Work fifty hours across three employers and none of them owes you coverage. The income still adds up for eligibility, and that combined number is usually the good news rather than the bad.
This page explains how the system works. It is not medical advice. More.