Travel Nurse Health Insurance Between Assignments: Your Complete Guide to Staying Covered

“What happens to my health insurance between contracts?”

This question pops up constantly in travel nursing forums, and for good reason. Unlike staff nurses with continuous coverage, we face potential gaps every time an assignment ends. One unexpected ER visit during a gap could cost thousands.

After navigating this myself for seven years—and making some expensive mistakes early on—here’s everything you need to know about staying insured between assignments.

The Problem: Agency Insurance Gaps

Most travel nursing agencies provide health insurance, but there’s a catch: coverage typically ends when your assignment ends.

Common agency policies:

• Coverage ends on your last day of work
• Coverage ends 30 days after your last day
• Coverage continues only if you have a new contract signed
• Coverage extends if the gap is 14-30 days or less

The risk: If you have a 6-week gap between assignments and your coverage ended, you’re uninsured. A broken arm could cost $2,500-7,500 out of pocket. An appendectomy? $30,000+.

Your Insurance Options Between Assignments

Option 1: COBRA Continuation

COBRA lets you continue your agency’s group health plan after employment ends.

Pros:

• Same coverage you had (familiar doctors, prescriptions)
• No new application or underwriting
• Retroactive coverage (you can elect within 60 days)

Cons:

• Expensive: You pay the full premium plus 2% admin fee
• Typical cost: $500-800/month for individual coverage
• Only available for 18 months maximum

Best for: Short gaps (1-2 months) when you want continuous coverage without paperwork.

Cost example:

• Agency-subsidized premium: $150/month
• COBRA premium: $650/month
• For a 6-week gap: ~$1,000 total

Pro tip: COBRA has a 60-day election window. If you’re healthy and expect a short gap, you can wait to see if you actually need it. If nothing happens, you don’t elect and pay nothing. If you need care, you can retroactively elect and have coverage.

Option 2: ACA Marketplace Plans

The Health Insurance Marketplace (healthcare.gov) offers plans with potential subsidies based on income.

Pros:

• Comprehensive coverage (pre-existing conditions covered)
• Subsidies available if income qualifies
• Can be cheaper than COBRA
• Coverage in any state

Cons:

• Normally requires “qualifying life event” to enroll outside open enrollment
• May have different provider networks
• Plans vary significantly by state

Qualifying Life Events for Travel Nurses:

• Moving to a new state (triggers 60-day special enrollment)
• Losing employer coverage (triggers 60-day special enrollment)
• Getting married/divorced
• Having a baby

Best for: Longer gaps (2+ months) or if you’re taking time off between assignments.

Cost example:

• Silver plan without subsidy: $400-600/month
• Silver plan with income-based subsidy: $50-200/month
• Note: Travel nurses often have variable income, which can affect subsidy eligibility

Option 3: Short-Term Health Insurance

Short-term plans provide temporary coverage for specific periods.

Pros:

• Lower premiums ($100-250/month)
• Fast enrollment (coverage can start next day)
• No qualifying event needed
• Flexible term lengths (1-12 months)

Cons:

• Limited coverage (may not cover pre-existing conditions)
• Higher deductibles and out-of-pocket costs
• May not cover prescription drugs, mental health
• Not ACA-compliant (fewer protections)

Best for: Healthy nurses with short gaps who want cheap catastrophic coverage.

Cost example:

• Monthly premium: $150/month
• Deductible: $2,500-5,000
• Best for emergencies, not ongoing care

Option 4: Private Health Insurance

Individual health insurance purchased directly from insurers (not through the marketplace).

Pros:

• Year-round availability
• Consistent coverage regardless of employment
• No gaps when changing agencies
• You control your plan

Cons:

• More expensive than employer coverage
• No employer contribution to premiums
• May cost more than taking agency benefits

Best for: Experienced travelers who switch agencies frequently or want complete independence.

Cost example:

• Monthly premium: $400-700/month individual
• Annual cost: $4,800-8,400
• Compare to: Potential $5,000-50,000 uninsured hospital bill

Option 5: Spouse or Partner’s Plan

If your spouse or domestic partner has employer coverage, getting added to their plan may be your best option.

Pros:

• Often cheaper than individual options
• Comprehensive coverage
• No gaps when changing assignments
• Dependent premium may be partially employer-subsidized

Cons:

• Requires a partner with employer coverage
• You’re dependent on their employment status
• Open enrollment timing considerations

Best for: Married or partnered nurses whose spouse has solid employer benefits.

Comparison: Which Option Is Right for You?

Strategy: Building Your Insurance Safety Net

Here’s the approach I recommend after years of trial and error:

Step 1: Know Your Agency’s Policy

Before accepting any contract, ask:

• When does insurance coverage end?
• Is there a grace period between assignments?
• What qualifies for extended coverage?
• How quickly can coverage restart?

Get this in writing. Policies vary widely between agencies.

Step 2: Time Your Assignments Strategically

If your agency offers 30-day coverage extensions for nurses with signed contracts, line up your next assignment before the current one ends. Even if there’s a gap in work, your insurance continues.

Step 3: Have a Backup Plan Ready

Don’t scramble when a contract ends. Know your options:

• Research marketplace plans in your tax home state
• Know the short-term insurers available to you
• Understand COBRA costs for your current plan

Step 4: Consider Private Insurance for Long-Term

If you’re committed to travel nursing long-term and switch agencies regularly, private insurance eliminates the constant enrollment/re-enrollment hassle. Yes, it costs more monthly, but you never have coverage gaps.

What to Do Right Now

If Your Contract Is Ending Soon:

1. Check your end date — When does coverage actually stop?
2. Ask about extensions — Will signing a new contract extend it?
3. Get COBRA paperwork — Even if you don’t use it, have the option
4. Research marketplace plans — Losing coverage is a qualifying event
5. Consider short-term — Quick, cheap backup while you figure things out

If You’re Between Assignments Now (Uninsured):

1. Don’t panic — You have options
2. Apply for marketplace coverage — Job loss qualifies you for special enrollment
3. Get short-term immediately — Catastrophic coverage is better than nothing
4. Retroactively elect COBRA — If within 60 days and you need care

If You’re Starting Travel Nursing:

1. Save for insurance costs — Budget $200-500/month for between-assignment coverage
2. Understand agency benefits — Ask detailed questions before signing
3. Consider private insurance — Calculate whether it’s worth the independence
4. Don’t assume you’re covered — Verify everything in writing

Real Cost of Being Uninsured: Why This Matters

I learned this the hard way. During my second year traveling, I had a 5-week gap and didn’t bother with coverage. “I’m healthy, nothing will happen.”

Then I got a kidney stone.

The bill:

• ER visit: $3,200
• CT scan: $1,800
• Physician fees: $950
• Total: $5,950

That wiped out most of what I’d saved from my previous assignment. Had I spent $300 on short-term insurance, I would have paid maybe $500 out of pocket total.

Don’t learn this lesson the expensive way.

FAQs

How long can I go without health insurance?

Legally, there’s no penalty since 2019. But financially, one major medical event could cost tens of thousands. Even a 2-week gap is risky.

Does travel nurse insurance cover me in any state?

Usually yes for agency plans, but verify. Some plans have network limitations. If you’re working in California but have a Texas-based plan, check provider networks.

Can I use COBRA if I switch agencies?

Yes, COBRA applies when you leave an employer. If you switch from Agency A to Agency B, you can elect COBRA on Agency A’s plan during the transition.

What if I can’t afford insurance between assignments?

• Short-term plans are often $100-150/month
• Marketplace plans may have subsidies (check based on your income)
• Some states have Medicaid for low-income periods
• At minimum, get catastrophic coverage

How do I prove I lost coverage for marketplace special enrollment?

Your agency should provide a “certificate of creditable coverage” or termination letter. This documents when your coverage ended and qualifies you for special enrollment.

The Bottom Line

Travel nursing offers incredible pay and flexibility, but it requires managing things staff nurses never think about—like health insurance gaps. The key is planning ahead:

1. Understand your agency’s coverage terms
2. Have a backup plan before you need it
3. Budget for insurance costs between assignments
4. Don’t go uninsured—the risk isn’t worth it

One unexpected medical event can cost more than an entire assignment’s worth of savings. Protect yourself.

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Related Resources

• Best Travel Nurse Agencies 2026
• First-Time Travel Nurse Checklist
• Travel Nurse Pay Breakdown
• Contract Cancellation Guide
• Pay Calculator — Factor in insurance costs when comparing packages