Is Solo Right for You?
What to know before you enroll — and why the plan works the way it does.
Solo isn't for everyone, and we'd rather you know that up front. Here's a straight look at who Solo fits, the trade-offs of a high-deductible plan, and what's covered at $0. Questions? Talk to our team.
Solo is a self-funded, captive-based major medical health plan built exclusively for self-employed business owners. It is not a healthshare, not a limited-benefit plan, and not short-term coverage. It's comprehensive major medical — the same class of coverage large employers offer — structured differently to keep costs lower for healthy, self-employed individuals.
Because Solo is self-funded, we bring together best-in-class specialists for each part of your coverage rather than bundling everything through a single traditional carrier. Vault Admin Services processes medical claims. FairosRx manages your pharmacy benefit. Clever Health provides telemedicine. Each partner is purpose-built for its role — which gives you better tools and more transparency, and means you should be comfortable with a plan that has a few moving parts.
Major Medical
No annual or lifetime benefit limits. Real coverage for real events.Nationwide PPO
Multiplan PHCS (now Claritev) network. See any doctor. No referrals required.Simple Cost Structure
Deductible = out-of-pocket max. 100% covered medical after you hit it.Solo is a high-deductible health plan (HDHP). Lower monthly costs come with a meaningful trade-off: you're responsible for paying the negotiated cost of non-preventive medical services until you reach your deductible. The plan then pays 100% of covered medical expenses for the rest of the year.
Solo is a strong fit if you're generally healthy, have low expected medical utilization, and are comfortable self-funding routine care. It may not be the right fit if you expect frequent visits, have ongoing treatment needs, or aren't prepared to cover costs up to your chosen deductible.
Eligibility itself is simpler than most people expect — our blog covers whether you can get health coverage with just an EIN. The bigger question is fit:
- You're generally healthy with low expected medical utilization
- You want lower monthly costs and are comfortable self-funding routine care
- You want comprehensive major medical — not a limited or short-term plan
- You want a nationwide PPO network with no referral requirements
- You want to pair your plan with an HSA (V2500 or V5000)
- You're self-employed with an active EIN
- You're comfortable with dedicated specialists for claims, pharmacy, and telemedicine
- You have frequent medical visits or ongoing treatment needs
- You aren't prepared to cover costs up to your deductible out of pocket
- You expect to order labs, imaging, or specialist visits regularly
- You have a condition requiring regular specialist management
- You have a household member with high anticipated utilization
- You prefer a single carrier that handles everything in one place
Like all ACA-aligned plans, Solo covers preventive care at $0 with no deductible required. Everything else — including services ordered at a preventive visit — is subject to your deductible.
- Annual wellness visit (no complaints raised)
- Screening mammogram (age 40+, routine)
- Colorectal cancer screening (first-time, no prior polyps)
- Pap smear / cervical cancer screening
- Blood pressure, cholesterol, and diabetes screening
- Routine immunizations and vaccines
- Well-child visits
- ACA-listed preventive medications (Tier 1, $0)
- Specialist visits
- Diagnostic lab work ordered to investigate a symptom
- Imaging — X-rays, MRIs, CT scans, ultrasounds
- Urgent care and ER visits
- Surgery and inpatient hospital stays
- Vitamin and micronutrient testing (Vitamin D, B12, ferritin, etc.)
- Breast ultrasound
- Any service at your physical that goes beyond routine screening
Services not on the ACA preventive guidelines count toward your deductible regardless of when or why they were ordered — and every dollar counts toward your out-of-pocket maximum for the year.