By Kevin Devoto

November 26, 2022

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How to Use Medical Insurance as a Travel Nurse

Medical insurance is a necessity for everyone. It covers the treatment that you will receive if you are hurt or injured. As a contract employee, there are several options for you to consider as you make plans for your next assignment. Here are a few ways to use this coverage as a traveling nurse. 

Get Insurance From Your Employer

Before you can utilize medical insurance, you have to have it. There are a couple of options available for you to consider. First, you can join the plan that the company that you are employed by offers. Although you may be several miles away from your home office, there might be insurtech that can assist you in filling out an application. This option is cheaper and has better coverage than the other potential solutions. However, if you switch from one corporation to another for each assignment, you will have to continually change programs. This can be difficult to keep up with and could cause issues for you if an emergency arises, and you are between policies. 

Buy a Policy On Your Own

Another option for you to consider is to purchase medical insurance on your own. This can be an expensive venture. However, you can be sure that you will always have the coverage you require. Research agencies that offer policies to traveling nurses. Look into what it will pay for and what you will have to take care of out of pocket. This is a great opportunity to look into other types of insurance, such as life or pet. Once you have found one that works for you, contact an agent, and ask what steps you must take to get it started. Be prepared to put money down immediately for your first month and have whatever documents they ask for to get everything into place.

Talk To Your Employer

There are a few questions that you should talk to a representative from the organization that you work with before you determine what to do about your medical insurance. You want to find the best option that will save you money but take care of as many expenses as possible if you were to get sick or injured.  Ask what the premium will be for you and your family and how much they will be paying for you to take it. Find out if they have a policy that will extend past your employment with them to bridge the gap with your next assignment. You can also inquire if they will give you cash back or raise your pay if you choose to get your own. You can use these answers to leverage what is the best solution for you.

Think About How Your Lifestyle Relates To This

Consider what your life is like as you make these decisions. Your family will need continual care. In this situation, you should purchase a policy of your own outside of the company that you are contracted with. You may also consider being included on your spouse’s medical insurance and pay the fees. Another debate to have with yourself is what level of coverage is right for you. You may need dental, vision, and prescription, which could be difficult to come by with an independent provider. Be sure that you can contact the corporate office to get new cards and any additional help when your schedule allows, which can be a challenge when you are away from home. Medical insurance is an important part of your employment. As a traveling nurse, finding the right policy that will fit what you do can be challenging. Determining whether you should partner with your employer or find coverage on your own and be sure that it relates to your lifestyle will help you find one that is affordable and takes care of your needs.

Our job board is a great place to search for your next travel nurse assignment. We have you covered with our housing page if housing is an issue. You can search for what you are looking for.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By Katie Fitts

July 2, 2022

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Ensuring Peace of Mind: The Best Health Insurance for Travel Nurses

As travel nurses, we know the importance of having health insurance. Making a decision regarding travel nurse insurance is a tough decision, and a lot depends on your specific needs when it comes to your health. 

So what do you do for travel nurse insurance? Really there are two options: using your travel nurse company insurance or getting your own. There are pros and cons to each, so let’s take a look. 

Travel Nurse Insurance From Your Company

Most travel nurse companies these days offer travel nurse insurance. Some of the bigger travel nurse companies will work with providers like United, Blue Cross Blue Shield, and Cigna. Some of the smaller companies may only work with smaller insurance companies that aren’t as well known and may not cover your preferred providers. If you make a decision to go with company-provided insurance, I suggest thoroughly researching which companies offer the insurance companies you prefer. 

Pros of Travel Nurse Insurance From Your Company

1- Usually a good plan!

A good plan meaning with a reputable insurance company. It will likely provide you with a fairly moderate deductible and doctor’s office visits with preferred providers for a copay and may include free regular yearly physicals. You can be at ease knowing your bills shouldn’t unexpectedly be astronomical, assuming you use the preferred providers. If they have one, you can expect it to be similar to your staff job’s insurance plan. 

2- One less thing to worry about!

It’s a set it and forget it kind of thing… a weekly withdrawal from your paycheck (or biweekly if you get paid as such) that you don’t even miss coming out of your paycheck. Getting your own insurance is usually a monthly lump sum. Even if the prices are comparable, it seems to hurt a little less coming from your paycheck weekly versus a lump sum! 😂

Cons of Travel Nurse Insurance From Your Company

1- May not be with your preferred providers or cover you across all 50 states

When discussing insurance with your recruiter, be sure to get down to the nitty-gritty! Speak to a benefits specialist if they have one so you can really get the low down. As I said, most of the bigger companies work with bigger name insurance companies like BCBS, Cigna, and United. But if you plan to try to stay mostly with your own doctors, you want to be sure they are covered by the insurance company, which may not be the case with the smaller insurance companies. Also, make sure your insurance is portable across all 50 states!

2 – It can be costly!

I suppose this may be due to the more short-natured coverage for travel nurses, but it certainly can be very pricey! I paid nearly $400-$450 a month with my company insurance! It isn’t cheap, even with the big companies! It was certainly more expensive than my coverage with my permanent staff job, where it maybe was around $200 a month. Definitely, something to think about in the budget realm!

3- Insurance gaps

This is probably one of the biggest cons. You may not be covered in between contracts and have insurance gaps. This is what I like to call insurance roulette and part of the “insurance game” (More details at the end of this article). 

Travel nurse companies all seem to be different in regards to the timing of the travel nurse insurance. Sometimes your insurance will start on the 1st day of your contract, sometimes not until the 15th of the month. With some companies, your coverage will end on your last day; in some companies, you can finish out the month. Some companies allow up to two weeks off or longer in between contracts with coverage, assuming you will work with them again. Make sure you get the specifics of how your insurance works with your recruiter!

I say insurance roulette because you are just hoping and praying that you won’t need to use it if you do have a gap in insurance. Maybe most of the time, you are lucky, but it’s a risk. So buyer, beware!

4- Switching agencies

Personally speaking, I tend to switch around travel nurse companies. I go to which one may offer me the best contract at the location I want for the best money. Not all companies have the same contracts and at the same price! However, some people stick with one travel nurse company for the duration of their time as a travel nurse. This may make it a little easier when it comes to insurance to not have to switch insurance companies each time.

However, if you hop around companies like I do, it stinks. That means a whole new insurance company every few months and a whole new deductible each time! I have gotten the short end of the stick doing this a couple of times. I had to have a couple of procedures done in 1 year. I had to pay the full deductible out of pocket for both even though I had forked out the money that should have met my deductible for that year with the one plan! No fun. 

So getting a new deductible every few months certainly makes it to where you have to pay more money out of pocket!

Getting Your Own Travel Nurse Insurance

The other option, of course, is to get your own travel nurse insurance. You can either go through a broker or purchase a plan through the marketplace at healthcare.gov or another entity like eHealth insurance. Brokers work with travel nurses to get the best plans and provide customer service along to help navigate your plan. Examples include US Health Group or The Healthy Insurance Dude. I have even done a more short-term approach, such as a sharing program, at times in between contracts. A sharing program is not an actual healthcare plan. You pay a monthly fee that goes to essentially a shared pool of money that can help cover your healthcare costs. Examples include Christian Healthcare Ministries or Medishare

Shopping for your own travel nurse insurance can be a daunting task, and as stated, there are pros and cons.

Pros of Your Own Travel Nurse Insurance

1- No coverage gaps!

The BIGGEST pro of your own travel nurse insurance! You don’t have to worry about having any gaps in your insurance. So that means if you want to take 1, 2, or 6 months off in between contracts, you are still covered! If you want to live your best life and go live in Greece for a month like me, you are covered! 😂 (Although I have additional international insurance as well). 

But you can rest easy when taking time off in between contracts. That was certainly a stressor for me as a travel nurse. I was always trying to plan doctors’ appointments and such within a certain time frame when I was covered. But now that I have my own insurance, I can relax a bit more.

2- Usually cheaper!

Usually, the plans come out a little cheaper than the travel nurse company-provided insurance. As I said, I was paying nearly $500 a month for insurance! Now I pay around $315 for both health and dental insurance. Not too shabby at all. Typically speaking, this option is cheaper, but you will have to shop around, and it depends on which specific health benefits you will need.

Cons of Your Own Travel Nurse Insurance

1- It may not be a comprehensive plan/more limited benefits

Speaking from my current experience, many things seem to have to be pre-approved or have to have a workaround in order to get coverage. I didn’t feel the need to get things pre-approved with company insurance. My doctor ordered something, and I got it done, and it was covered. 

2- May be more out of pocket

Although the insurance is generally cheaper, that also leaves a lot of room to skimp benefits on. Deductibles may be higher, and it may not be the “copay” type plan you are used to.

I consider myself a healthy person with only basic needs of healthcare, fortunately. My doctors are “covered” under my insurance, so the insurance will pay some towards doctors’ visits. But it is not like a copay, so I was used to it. I have always had both a PCP and an OBGYN being a woman, but only 1 of my provider visits was covered. The other, I had to pay more out of pocket as I only got one wellness visit a year. So as much as I have enjoyed having to not worry about gaps in coverage, I sure do miss those copays!

3- Lump sum withdrawal versus weekly

Somehow getting money drawn out weekly versus a lump sum makes it seem to hurt less in the bank account department, even if it is cheaper! 😂 It comes down to just making the budget for it!

Conclusion

Now are you utterly confused about which option to choose? That makes two of us! 😂 As a person who has done both, I don’t have a strong conviction for either option, honestly. I think it’s just a matter of trial and error for you to see what works best for you!

Currently, I have my own insurance right now. I do love the fact that I don’t have to worry about gaps in insurance and that it is significantly cheaper than the company’s insurance. However, I feel like I have to pay more out of pocket for things such as regular doctors’ office visits or bloodwork, etc. Luckily this is not often, just yearly, but still!

So again may just come down to trial and error for you. However, it also depends on your specific health needs and the time you plan on taking off between contracts. If you use the insurance often for multiple doctor visits, it may be worth it to do the company insurance. However, you just have to worry about consistency: It works best if you stay with the same company and only have a limited time off in between contracts. 

Personally speaking, I use multiple different companies and don’t like being limited to, say, only two weeks off in between contracts! Maybe they will come up with a middle-ground option! But in the meantime, for my lifestyle, I prefer getting my own insurance. 

The Insurance Game

As promised, I will discuss a little of the “insurance game” and some of my insider tips! This is for if you choose to take company insurance.

So the “insurance game” is basically just trying to make the most of your company insurance during the actual time you are covered. As a nurse, I value maintaining established relationships with my regular doctors. I have had them for years, and if I ever had to have anything done, I want to be home where I know which doctors I want to use. So here’s where it gets tricky!

You want to be sure to get really clear with your recruiter regarding the start and end of your coverage. Does it start on either the 15th or 30th of the month? Is it the 1st day of the contract? Somewhere in between? When does it end? Sometimes it ends on the last day of your contract; sometimes, you can finish out the month.

Insurance Start Dates 

  • If it starts on either the 15th/30th or something to that effect, it will likely end on the 15th or 30th AFTER your contract. So you’ve got a little time to scoot home and get your regular doctor’s office visits in before coverage needs. 
  • If it starts on the 1st day, it may very likely end on the last day of the contract (unless you sign up for another contract with the company). If it’s a time I need to get something done like an eye appointment, dentist, or yearly checkup, I try to take some time off in the middle of the contract and go home and get that done. It kinda stinks going home mostly for that, but BONUS, you get to go home! 🙂

Insurance End Dates

  • If it ends on the last day of your contract, you definitely want to see if you can squeeze time off in the middle of your contract to go home and get doctors’ appointments done. 
  • If it ends at the end of the month, you have got some time! 

Pro Tip!

So let’s say your contract ends on the 30th of the month, and your insurance runs out at the end of the month, the 31st. Well, that’s not very much time or good use of your insurance! 

If I am interested in extending, I will extend for whatever time I can, but at least until the beginning of the next month. So let’s say you end the 5th, then you have the whole rest of the month to get your insurance benefits! More time off in between for you, and you still have coverage! You can go home and get whatever you need done!

Isn’t the insurance game FUN?! 😂

Prescription PRO tips:

  • Keep all your prescriptions at something very generic that is transferrable. I usually use Walmart or Walgreens, something that usually every major city has. Makes it WAY easier to transfer prescriptions
  • If you have refills on prescriptions and can get them early, do so before your contract/coverage ends. Same with eye contacts. I’ll go ahead and refill early before my prescription runs out so I can delay the need for regular eye appointments if I am not close to home.
  • Push for 90-day supplies with your prescriptions!
  • Walmart has quite a few selections of $4 prescriptions; check them out! 

Good luck in the insurance games, and may the odds ever be in your favor! ✌️ 

Gypsy love,

Katie

We hope you found this article on travel nurse insurance and tips on using company insurance or getting your own helpful. Do you have any tips on travel nurse insurance to share with fellow travel nurses? Comment them below.

Are you looking for your next travel nurse assignment? Click here to view our job board. Do you need housing for an upcoming travel nurse assignment? Click here to search our housing page.

If you are a new travel nurse or looking into becoming a travel nurse:

Travel Nurse Guide: Step-by-Step (now offered in a PDF Downloadable version!)

By Amber Pickler

October 11, 2019

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Frequently Asked Friday: Insurance Options for Travel Nurses

Insurance options for travel nurses are always a hot topic in our Facebook group.  We found that many people can’t afford what is offered through their agency or even the marketplace. Many don’t work with just one agency or want a better policy than their agency offers.  So, for this week’s Frequently Asked Friday article, we went through all the comments and found some of the most popular answers and put them together to make it just a bit easier for you! 

Insurance Options for Travel Nurses

Farm Bureau

Finding your own insurance through different insurance agencies seems to be popular among travel nurses. However, the rate for this policy through Farm Bureau is meager and the other costs associated with it.  Some bigger insurance companies may offer better rates than what you can get through your staffing agency. You also don’t have to worry about staying with the same agency, having a gap in assignments, or changing plans every time you go with a news agency.

Company Offered Plans

While not all travel nurses travel strictly with one travel nurse agency, some do.   There were a few comments about using agency insurance.  As you can see above, some nurses get great insurance policies through their agency.  While this is a good option for some, it is still important to do your homework. 

United Healthcare

Another company that was mentioned is United Healthcare.   United Healthcare offers a variety of plans as well as other options such as vision and dental.  United also offers different price point plans.  While some may still be out of your budget it still may be a good option to look into.

Health Share (Liberty, Christian Health or Samaritan Health)

Health Share is a different type of option.  While similar to insurance, it isn’t the same.  You do pay in, and they do cover medical expenses. As you can see below, the price points aren’t terribly high.  They state on their website that “Our most comprehensive and most popular program, Liberty Complete, gives you ultimate control and peace of mind. After you fulfill your annual unshared amount ($1,000 for an individual, $1,750 for a couple, $2,250 for a family—the same threshold for each of our programs), you may share eligible medical costs up to $1 million per incident.”

Medi-Share

Medi-Share is similar to Health Share.  It is a health share program that you pay into along with others.  They offer different plans as well. However, you have to input your information to see what price points they offer.   Those who suggested these types of policies recommended them for healthy people.  So, it may benefit those who don’t have pre-existing conditions or conditions that require frequent doctor visits. 

Do your research

The biggest piece of advice we can offer travel nurses looking for insurance is to make sure you do your research before signing the dotted line.  Know what the deductible is, the copay, what is covered (pre-existing conditions, well-being, and preventative, to name a few).  While the policy’s price is a big deal, some of these other things can add up if not covered. We hope you found this

If you have found an awesome insurance plan and would like to share it, please comment below!

Finished the travel nursing guide and are ready to look for an assignment?

Check out our travel nurse jobs!

By The Gypsy Nurse

July 5, 2019

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Ask a Travel Nurse About Travel Nurse Health Insurance

Gypsy,

I’ll end my travel nurse contract soon and plan to take time off between contracts.  What do you do for insurance between contracts?  COBRA is so expensive.

Thanks!
Jackie, RN

health insurance

Jackie,

Insurance worries are a common issue among travel nurses. Most travel nurse contracts will include insurance, but there is always the worry about insurance between contracts. Personally, I choose to carry private insurance.  I tend to work with multiple different travel nursing agencies and prefer not to have to worry about switching insurances with employment.

COBRA

COBRA is certainly an option for insurance coverage between contracts, but it can be expensive. PANTravelers.org offers the following advice for maintaining health insurance coverage between contracts.

  • You then have 60 days from the end of your contract (or 60 days from the letter’s date) to positively select COBRA coverage.
  • After you elect coverage (no reason not to), you have 45 days to pay the premium.
  • This gives you an effective minimum of 105 days (three and a half months) of insurance coverage without paying a cent.
health insurace

So what does this mean? It means that you are covered by your agency’s insurance for well over three months after the contract ends if you select COBRA coverage at the last moment. And there are no consequences for not paying the premium three months later other than your insurance coverage will be canceled retroactively back to when your contract ended. If you had no events during this period that required insurance, you have just received a free ride! And if any events do occur, they would have to add up to more than $1,000 (your minimum likely premium during this period) to be worth paying the premium. This is an insurance company’s nightmare.  Clients are fully covered but electing to pay only if the insurance benefits are more than the cost of premiums.

There is one possible glitch – you want to ensure this strategy works in the worst possible scenario. If you are incapacitated (think unconscious or major trauma) during this period, you may not be able to make the COBRA election or pay the premium. So you should give clear instructions to a family member on what to do just in case with the appropriate forms. Otherwise, your medical bills will not be covered, and that would be a real catastrophe!

– PANTravelers.org

Insurance Recommendations

There are always new discussions on our Travel Nurse Network Facebook group. Here is one discussing private health insurance that might be helpful. Another post of interest is one discussing gaps in employment between contracts. I hope that this has addressed your question.


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By Joseph Smith @ Travel Tax

June 15, 2015

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Talking Taxes: ACA Tax Credits

In the last article we looked at the Health Insurance mandates and how the penalties apply when there are gaps in coverage which is a common problem for healthcare Travelers. In this article, we will look at the mechanics of the ACA tax credits that are available to certain taxpayers who use the exchanges.

The tax credits are designed to offset health insurance premiums of policies procured through the exchanges or through a private source in which the same exchange policies are purchased. The credit is prospectively granted based on anticipated income but retrospectively adjusted on the tax return for that year.

The Credit

Eligibility for the credit is based on income reported on the previous year’s tax return. When you file your 2014 tax return, an additional form will be used to calculate the amount of credit that you are eligible for to offset 2015 health insurance premiums due to exchange based policies. This formula then goes through two steps: 1) your income on the 2014 return must be below 400% of the Federal Poverty Line and 2) your insurance premiums must exceed 9.5% of your income. In essence, the ACA is a 9.5% tax on earnings per the landmark Supreme Court ruling.

The Payback

There is another calculation going on in the background. Since the credit for 2015 is based on the income reported on the 2014 tax return, the income you report on the 2015 tax return will be used to reconcile the credit that you received. If your income is higher in 2015 than the 2014 baseline year, you will pay back the excess credit in the form of an additional tax on your 2015 tax return. If your income is lower than the 2014 baseline year, you will receive an additional credit which will be applied to the 2015 tax return.

See Saw

This seesaw of credits and paybacks adds another layer of complexity to annual tax return when we one holds and exchange based health insurance policy. Some taxpayers will be required to pay back a significant amount of credits that they received in the previous year. To illustrate, assume a traveler has difficulty finding work in 2014 and is eligible for credit. In 2015, they work a full year. On the 2015 tax return, a portion of the credit (or all) will be charged as an additional tax. If the refund is not large enough to absorb this additional tax, the traveler will have an amount due on the return. As you can see, things might get pretty messy.


Would you like to learn more?

Check out the TOP 10 Questions for Travel Nurses on Taxes.


By Joseph Smith @ Travel Tax

January 20, 2015

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ACA Tax Implications for Travelers

Guest Article provided by: Joseph Smith @ Traveltax.com

ACA (aka “Obamacare”) requires all individuals carry health insurance starting with the 2014 tax year. Here is some information on ACA tax implications for travel nurses:

Since travelers are highly susceptible to gaps in employment, they are more likely to be subject to the penalties assessed for the lack of coverage. Additionally, travelers who intend to use the health insurance exchanges and associated tax credits will have difficulty predicting their subsidy due to the income swings that occur with their various contracts.


ACA Tax Implications

The next series of articles will look at the ACA mandate and its impact on travelers by first focusing on how penalties for non-compliance are assessed. In the next installment, we will look at the mechanics of the tax credits that are available to those who procure health insurance from the exchanges.

Penalties

The penalty for not carrying qualified health insurance coverage starts in 2014 at 1% of income or $95, whichever is greater. In 2015, the penalty rises to $325 per person or 2% of income; and in 2016, $695 or 2.5% of income. The penalty applies for any month that an individual is not covered and is prorated if the individual fails to carry insurance less than 12 months of the year. Since travelers run the risk of losing employer based health insurance during the periods between assignments, they are subject to the penalty unless they procure another policy or continue the policy provided by the last employer through COBRA.

GAPS in Coverage

Under the ACA regulations, if an individual has coverage for one day in a month, they are credited as having coverage the entire month. This potentially allows a traveler to gap coverage for nearly two consecutive months so long as the coverage ends and starts in each month. Some health insurance providers follow a calendar month cycle, meaning that coverage continues until the last day of the month even if a traveler finishes an assignment in the first week of the month.

Exemption for Gaps in Coverage

Though the penalty applies for any month an individual does not have coverage, there is an exemption available for those whose coverage gap is less than three consecutive months. This exemption is only allowed once a calendar year so if the exemption is used in the early part of the year, it cannot be used again in the latter part. If there is a second gap in coverage during the calendar year, a separate “hardship exemption” can be requested. “Hardship” exemptions include a number of specific situations including a death of a family member or bankruptcy filings; however, most all of them require some form of documentation. Hardship exemptions are filed separately from the annual tax return unlike the regular exemptions.

Since the ACA regulations incorporate a one day = one month convention, a traveler could have almost 5 months of coverage gaps and still qualify for the exemption, so long as the coverage ended sometime during Month 1 and coverage with a new policy began in Month 5.

Coverage gaps that extend through one calendar year and into the next have a specific counting rule.

If a traveler does not carry coverage the last two months of the year, when they file their tax return for that year, they report a two month gap in coverage which would qualify for a regular exemption. The counting for the second year incorporates the previous year end gap.

EXAMPLE: If the traveler continues without coverage for the first two months of the second year, they will be considered to have a gap in coverage for 4 months in that year and be subject to the penalty. A peculiar situation can arise when a traveler gaps coverage in November, December and January. For the first year, there is a two month gap which is covered under the regular exemptions. For the second year, the gap is a three month gap, again, covered under the regular exemptions; however, since the regular exemption is used, a subsequent second gap in that calendar year requires a hardship exemption.

Filing Taxes

Since ACA compliance disclosure is incorporated in the annual tax return filing, it adds another layer of complexity to set of forms required with each return. Most taxpayers will receive Form 1095 that evidences health insurance coverage. An additional form currently being developed will be used to report the information on the 1095 series forms when the return is filed. Search and download forms HERE.


Would you like to learn more?

Check out the TOP 10 Questions for Travel Nurses on Taxes.