Best Health Insurance for Travel Nurses
It's really important for travel nurses to have health insurance to protect their health and financial stability. When you're working in a new place, you never know what kind of risks you might be exposed to, whether it's an infectious disease or a physical injury. Without insurance, the cost of medical treatment can quickly become overwhelming.
Travel nurses can decide to get health insurance from their travel nurse company, the public marketplace, or the private side. There are benefits and disadvantages for each route.
Regardless of the source, it is crucial to ensure that the health insurance is on a PPO network. PPO plans are the ideal choice for travel nurses since they provide nationwide coverage, which is essential when traveling across state lines.
Travel nurses should avoid HMO and EPO plans as they are more limited in coverage areas. You can view the different types of health insurance networks here.
1. Choosing health insurance from your travel nurse agency
The pros: simple and easy
Obtaining health insurance from your travel nurse agency is incredibly easy. You only need to accept the contract and the health insurance will be automatically set up for you. Most travel nurse agency plans are PPO networks, which are ideal for travel nurses.
The payment for insurance coverage is typically through weekly or biweekly payroll deductions.
Popular Travel Nurse Agencies and their Health Insurance:
Fastaff Travel Nursing - Anthem BlueCross BlueShield PPO
TNAA - Cigna PPO
Fusion Medical Staffing - Highmark BlueCross BlueShield PPO
Medical Solutions - Unitedhealthcare PPO
Onward Healthcare - Kaiser Permanente PPO
The cons: can be costly and potential for insurance gaps
Health insurance through your travel nurse agency can be pretty expensive. It’s not uncommon for these plans to cost up to $450/month. Travel nurse contracts are usually more expensive than permanent staffing jobs.
Another common problem with getting health insurance from the agency are the insurance gaps. Health coverage is typically tied to their contracts, and once that contract ends, so does the health coverage. Depending on the agency, a 14-30 day gap in between assignments can mean losing your employee benefits. Additionally, starting a new contract may result in a gap in coverage as some health insurance companies may require a waiting period of up to 30 days before coverage begins. Furthermore, starting a new health insurance plan means resetting your yearly deductible back to $0.
While it's possible to extend health coverage benefits with COBRA, keeping your plan through COBRA means you have to pay the entire bill for that health insurance plan, which can be expensive.
If a travel nurse wants a permanent solution for their health coverage that’s not tied to their agency, where can they find PPO plans outside of their employer? There are two other options:
2. The Public Marketplace
Travel nurses can find PPO plans on the public marketplace, which is also known as ACA (Affordable Care Act), Obamacare, or Healthcare.gov. You can view your options by going to Healthcare.gov.
The pros: guaranteed issued, comprehensive, and may be affordable if you’re in a favorable tax bracket.
Public marketplace plans are ‘guaranteed issued’, which means you can enroll in the plans even if you have pre-existing conditions. Since these plans are regulated by the Affordable Care Act, they are required to cover services like mental health, substance use disorder, and rehabilitative services - making the plans more comprehensive.
Public marketplace plans are based on your income and it may be a very affordable option if you fall into a specific tax bracket.
The cons: high deductibles and may be expensive if you don’t qualify for subsidies.
While a plan that is ‘guaranteed issue’ can be a plus, it also means that health insurance companies need to manage the risk by having high deductibles. Because public marketplace plans cannot reject you, these plans typically have higher deductibles and out of pocket maximums to offset the cost of enrolling people with pre-existing conditions.
Public marketplace plans can be expensive too - monthly premium rates for public marketplace plans will be adjusted according to your estimated yearly household income. Typically, the lower your income, the more tax subsidies you get to reduce your monthly premiums. However, it's possible that a travel nurse will not qualify for enough subsidies to make it affordable.
According to the Bureau of Labor Statistics, the average travel nurse salary is $77,600, which is 571% of the poverty level if they are single. ACA dictates that if your income is higher than 400% of the poverty level, you will only receive subsidies if the plan is more than 8.5% of your income ($550/month in this case). Use the marketplace calculator below to see if you qualify for savings.
Some things to consider about public marketplace plans for travel nurses…
Travel nurses will not qualify for any subsidies if they already have coverage offered to them from their job. One workaround is negotiating a contract to not include health coverage so that they can be eligible for savings on the public marketplace.
Open Enrollment for the Public Marketplace starts November 1st, but a travel nurse can qualify for Special Enrollment when a contract that was providing health insurance ends.
There are many companies on the public marketplace so which one should a travel nurse go with? Since travel nurses want nationwide PPO coverage, the most important aspect to consider is network size. Travel nurses want to be confident that wherever they are, they will be able to find a provider in-network. Based on reported data as of 2021, below is a rank of 10 insurance companies according to network size.
UnitedHealthcare -1.3 million physicians and other health care professionals
2. Aetna - 1.2 million health care professionals
3. Cigna - 1.1 million health care professionals
4. Anthem - approximately 1 million health care professionals
5. BlueCross BlueShield - over 1 million health care professionals
6. Molina Healthcare - over 1 million health care professionals
7. Humana - over 550,000 health care professionals
8. Oscar Health - over 400,000 health care professionals
9. Ambetter - over 300,000 health care professionals
10. Kaiser Permanente - over 23,000 physicians and approximately 83,000 nurses and other health care professionals within its own network of medical centers and hospitals
PPO plans are becoming less common on the public marketplace, so it's possible that a travel nurse won’t be able to find one in their area. If this is the case or if the plans are not affordable, travel nurses can find PPO plans from the private side.
3. Private Side PPO Plans
Private side plans are simply health coverage that is not on the public marketplace. Traveling nurses can qualify for a PPO plan on the private side. There is no enrollment period for private plans.
pros: low deductibles/out-of-pocket maximums, more affordable if ACA is too expensive
Since these plans aren't subject to Affordable Care Act regulations, they can reduce administrative costs and offer competitive premiums, deductibles, and coverage. One way they do this is by underwriting applicants - meaning they'll look at your medical history. Look for a private plan that underwrites at the time of application, rather than at the time of claims, to avoid potential issues.
cons: not guaranteed issued, not as comprehensive as ACA
If you have pre-existing conditions like diabetes, history of cancer, or even chronic back pain, a private plan might decline your enrollment for coverage.
Private plans are not regulated by the Affordable Care Act, so aren't as comprehensive as marketplace plans - they don't cover mental health, substance use disorder, or rehabilitative services.
Some things to consider about private health insurance for travel nurses…
There are three main types of private side plans: short-term plans, health care sharing ministries (HCSMs), and fixed indemnity plans.
Short-term Plans
Short-term plans offer temporary health insurance coverage for individuals between jobs or waiting for employer-based coverage to start. Some examples of companies that offer short-term plans include Golden Rule Insurance, BlueCross BlueShield, Pivot Health, and National General.
This could be a viable option for travel nurses between assignments, but it doesn’t solve the problem of finding a permanent or comprehensive solution for health coverage.
Health Care Sharing Ministries (HCSMs)
HCSMs are faith-based organizations in which members share the cost of each other's medical expenses. They may have restrictions on coverage for certain medical procedures, and members must typically adhere to certain religious or ethical beliefs. Companies that offer these types of private plans include Medi-Share, Samaritan Ministries, Liberty HealthShare, and Christian Healthcare Ministries.
HCSM’s are not considered real insurance so if a claim is denied, there is no recourse available. HCSM’s are not legally required to pay for claims.
Fixed Indemnity Plans
Fixed indemnity plans are health insurance policies that pay a fixed amount of money for specific medical services or expenses. Fixed indemnity plans are generally less expensive than traditional health insurance plans.
A standalone fixed indemnity plan mixed with features of a traditional health insurance like deductibles and a cap on out-of-pocket expenses is desirable. Lots of travel nurses tend to go with these if there are no good options on the public marketplace. The caveat is that you have to qualify for these plans with a relatively clean bill of health.
UnitedHealthcare, Cigna, and Mutual of Omaha offer these type of indemnity plans.
So should a travel nurse take the company’s insurance, public marketplace, or private side?
If you plan on sticking with the same travel agency for a long time and don’t foresee any gaps in assignments, then getting health insurance from your travel nurse agency is a viable option if you’re satisfied with the price.
When choosing between the public marketplace and private side, consider the price and coverage you need. If you qualify for subsidies on the public marketplace, it may be the more affordable option. However, if you're spending more than 10 times your age per month on the marketplace, the private side may be a better choice. If you have pre-existing conditions or need mental health coverage, the public marketplace may be more appropriate for you, regardless of price.
My name is Yaron Gonzalez and I am licensed health insurance agent in 32 states through healthcare.gov and with private side companies. I wrote this article to provide valuable information on where a travel nurse can find health insurance. If you still have questions or if you would like a free consultation, you are more than welcome to fill out the contact form below so I can point you in the right direction in terms of health coverage.