Private Health Insurance for Travel Nurses

Where the gaps come from

Agency health insurance is a job-based group plan. That’s fine while you’re on contract, but it’s tied to your employment with that agency, so the cracks show up at the edges of each assignment:

• The plan ends when the job does. Many agency plans stop on your last day or at the end of that month. Ask your recruiter for the exact date in writing.
• New plans can have waiting periods. Federal rules let a group plan make a new hire wait up to 90 days after becoming eligible before coverage starts. Some agencies cover you from day one; others don’t.
• Switching agencies resets the clock. A new employer means a new plan, new deductible and possibly a new waiting period.
• Time off between contracts. Planned breaks, a delayed start date or a cancelled contract can all leave you off payroll – and off the plan.
• Networks may not travel well. A plan built around one area may have few in-network doctors where your next assignment is.

None of this is a reason to turn down agency benefits. It’s a reason to know exactly when each plan starts and stops, and to have the next step lined up.

A COBRA trick many nurses don’t know

Because you get 60 days to elect COBRA and 45 more days to make the first payment, and because coverage is restored back to the day your plan ended, COBRA can work as a safety net during a short break. If you start a new agency plan quickly and stay healthy, you may never need to elect it. If something happens during the gap, you can still elect within the window and pay for those months.

A COBRA price can be high because you pay the full cost of the plan plus up to a 2% fee. Being offered COBRA doesn’t stop you from getting a premium tax credit on a Marketplace plan; being enrolled in COBRA does.

Tax home basics (and why your insurance address matters)

Travel nurse pay often includes tax-free stipends, which depend on having a tax home. In IRS Publication 463, your tax home is generally your regular place of business or work, and an assignment in one place is usually treated as temporary if it’s realistically expected to last – and does last – one year or less. If you have no regular place of work and no place where you regularly live, the IRS considers you an itinerant, and your tax home is wherever you work.

That matters for insurance too. The address on an individual health plan should be the place you actually live and keep as home, because plans are sold by service area. Keep your story consistent across your tax return, your license and your health plan, and talk to a tax professional about stipends – we only handle the insurance part.