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2023 Self-Employed Health Insurance


In 2023, self-employed individuals continue to have the opportunity to leverage the self-employed health insurance tax strategy. This approach allows for the reimbursement or payment of health insurance premiums for the business owner, shareholder-employees, and their families, with the added benefit of deducting these costs from business taxes.

Eligibility for the Self-Employed Health Insurance Deduction

Eligible entities include S corporations, partnerships, and sole proprietors. They can all reduce their tax liability by covering and deducting the cost of health insurance premiums for their shareholders and family members.

2023 Self-Employed Health Insurance Details

The deduction encompasses premiums paid for the business owner/shareholder-employer, their spouse, and dependents, including children up to the age of 27. The premium expenses flow to the employee, who then deducts them on their personal tax return.

  • S Corporation Strategy: S corporations can reimburse or pay directly for health insurance premiums for shareholders owning 2% or more. The cost is deductible by the S corporation, and the amount paid must be included in the W-2 earnings of the shareholders, exempt from FICA. Shareholders deduct these premiums on their Form 1040.

  • Partnership Strategy: Partnerships can elect similar treatment for insurance premiums as S corporations. However, premiums must be recorded as guaranteed payments.

  • Sole Proprietor Strategy: Sole proprietors can directly pay for and deduct health insurance premiums on their Form 1040.


  • Reduces taxable income.

  • Qualifies as salary for S corporation shareholders.

  • Lowers self-employment tax burden.


  • Cost of health insurance premiums.

  • Potential increase in administrative tasks.

  • Conflicts with Medical Reimbursement Plan strategies.

Assumptions and Requirements

  • The business must be generating a net profit.

  • Full year of family insurance coverage is necessary.

  • The business owner(s) must not have access to other health insurance, including that of a spouse.

Conflicting Strategies

  • Medical Reimbursement Plan.

Eligible Business Entities

  • Schedule C

  • Schedule F

  • S Corporation

  • Partnership

  • Schedule E


For 2023, the self-employed health insurance deduction remains a significant tax strategy for small businesses and self-employed individuals. It offers a dual benefit: health security for the business owner and their family, and a reduction in taxable income, thus lowering overall tax liability. With the ongoing changes in health insurance policies and tax laws, it's crucial for business owners to stay informed and consult with tax professionals to maximize their benefits and ensure compliance. This strategy underscores the importance of balancing health needs with fiscal responsibilities, making it a wise choice for eligible businesses seeking to optimize their financial health in the coming year.

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