Short answer: when an agency plan ends with a contract, you have three ways to cover the gap. You can elect COBRA on that plan: you get at least 60 days to decide, and it is backdated to the day the plan ended. You can buy a marketplace plan, because losing the agency coverage opens a 60-day enrollment window. Or you can keep your own year-round plan and skip the agency plans. If you move between agencies a lot, the year-round plan is the one that ends the gaps.
Three Ways to Cover the Gap
| What it costs | Best when | |
|---|---|---|
| COBRA on the agency plan | The full premium plus up to 2%, with no agency share | The gap is short, you are mid-treatment, or you have met most of the deductible |
| A marketplace plan for the gap | Priced on your income for the whole year; a tax credit is possible | The gap is a month or more and you have no affordable agency offer in that time |
| Your own year-round plan | Marketplace or private, paid every month | You change agencies often and want one plan, one card and one deductible |
COBRA applies to employers with 20 or more employees. A marketplace plan chosen after the old coverage ends starts on the first day of the next month, so pick it before the agency plan ends where you can.
Check the Exact End Date First
Agency plans do not all end the same way. Some stop on the last day of the contract, others run to the end of that month, and some have a waiting period before coverage starts on the next contract. Ask for both dates in writing: the day this plan ends and the day the next one begins. The gap between them is what you are insuring.
Contract ending soon? Cover the gap before it starts.
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Your Stipends and the Marketplace Price
Travel pay usually splits into a taxable hourly wage and tax-free housing and meal stipends. The marketplace prices your tax credit on your household’s modified adjusted gross income for the year, which is built from taxable income, so tax-free stipends generally do not count. A nurse with large stipends can land under the 2027 line, $63,840 for one person or $132,000 for a family of four, even when total pay is higher. Stipends are only tax-free if you keep a genuine tax home, which is a question for your tax preparer.
The catch: for any month an agency offers you a plan that counts as affordable (your share of the cheapest self-only option is no more than 10.22% of household income in 2027) and meets minimum value, you cannot take a marketplace tax credit, even if you turn the agency plan down. So the credit usually helps in the gaps and with agencies that offer no plan, not on every contract.
Which State, and Which Network
Most travel nurses keep their own plan in their home state, where their tax home is. A short assignment is not a permanent move, so on its own it does not open an enrollment window. Away from home, emergency care is covered anywhere, but routine care depends on the network: HMO and EPO plans usually cover it only in their own area, while some PPO plans include providers in other states.
In 2026, seven of the 17 HealthCare.gov states this site covers had no marketplace PPO in any county: Indiana, Kansas, Mississippi, Ohio, Tennessee, Texas and Utah. Nebraska and Wisconsin had them in some counties only (PPO availability by state).
Private plans sold outside the marketplace can come with access to a national PPO network such as UnitedHealthcare or PHCS. They pay set cash amounts for covered care rather than working like an ACA plan, they are medically underwritten, and they are not major medical coverage, so they suit healthy people who don’t need maternity, mental health or rehab benefits. For someone in that position above the tax-credit line, they often cost about half the full marketplace price. Private plans can also start any time of year, without waiting for Open Enrollment.
Common Questions
Does travel nurse insurance cover me between contracts?
Usually not. Agency plans typically end on the last day of the contract or at the end of that month, and the next agency’s plan may have a waiting period. COBRA, a marketplace plan or your own year-round plan covers the gap.
Is losing an agency health plan a qualifying life event?
Yes. Losing job-based coverage opens a 60-day window to pick a marketplace plan. It does not count if the coverage ended because you stopped paying for it or chose to drop it.
Do travel nurse stipends count as income for marketplace subsidies?
Generally no. Tax-free housing and meal stipends are not taxable income, so they are not part of the modified adjusted gross income the marketplace uses. Only stipends that are genuinely tax-free stay out, so confirm your tax home with a tax preparer.
Can I get a marketplace tax credit if the agency offers me a plan?
Not for months when the agency’s offer is affordable and meets minimum value, even if you decline it. For 2027, affordable means your share of the cheapest self-only option is no more than 10.22% of household income.
Sources
- HealthCare.gov and 45 CFR § 155.420: special enrollment after loss of coverage.
- U.S. Department of Labor, An Employee’s Guide to Health Benefits Under COBRA.
- 26 CFR § 1.36B-2(c)(3): employer coverage that bars the premium tax credit.
- IRS Rev. Proc. 2026-26: the 2027 required contribution percentage (10.22%).
- IRS Publication 463: travel expenses and the tax home.
- CMS, Qualified Health Plan Landscape file, plan year 2026: plan types by county.