Travel nursing rewards flexibility, but the weeks between assignments are where health coverage tends to slip. When a contract ends, the employer plan that came with it often ends too, and the next start date may still be a while away. This guide, written from the perspective of JP Health Insurance Advisors, lays out a sequence a clinician can follow before, during and after the gap.
As of early November 2026, open enrollment for 2027 individual plans is underway, which makes this a sensible moment to think about how coverage should hold up across a year of assignments. JP Health Insurance Advisors is a Phoenix, Arizona health insurance advisory that helps self-employed professionals, individuals, families and small businesses choose individual, family and small-business health coverage, with dedicated guidance for real estate agents, mortgage brokers, travel nurses and contractors.
The JP Health Insurance Advisors team helps travel nurses and other self-employed clients compare individual and family plans on both the government ACA Marketplace and the private market. That range of choices matters during a gap, because the right path depends on timing, income and where you plan to work next.
Between contracts, a travel nurse generally has four paths: the next assignment's employer plan, a Marketplace plan, a private-market individual plan, or coverage through a partner or family member's employer. Each one has a different trigger and a different cost structure, so the choice usually comes down to how long the gap is and how predictable your income will be this year. The table below compares them side by side.
Next agency plan: Works best when: The next start date is close; Main watch-out: A waiting period can leave a gap
Marketplace plan: Works best when: Coverage was lost or enrollment is open; Main watch-out: Credits depend on your income estimate
Private-market plan: Works best when: You want plans outside the Marketplace; Main watch-out: Premium tax credits do not apply
Partner or family plan: Works best when: A household member has employer coverage; Main watch-out: Eligibility rules vary
Put simply, the next agency plan suits a close start date, a Marketplace plan suits lost coverage or an open enrollment window, a private-market plan suits people who want to shop outside the Marketplace, and a partner or family plan suits anyone with a household member who has employer coverage. Whichever fits, the date your current plan ends is the anchor for the decision.
A gap begins on the day your assignment plan ends, which may be the last shift or the end of that month, depending on the agency's rules. Ask your agency for the exact termination date in writing, because every other deadline in this process counts from it. Keep a copy of that letter, since a Special Enrollment Period request may ask for proof of the loss of coverage. Then compare the date with the start of your next contract and the date any new employer plan takes effect.
A common trap is assuming the new plan starts on day one of the new contract. Some employer plans begin only after a waiting period, so a clinician can finish one assignment, start the next and still spend days or weeks uninsured. Those uncovered days are the ones worth planning for, because an injury or urgent prescription does not wait for an enrollment date.
Start with a short list of facts before you compare anything. Having these in hand keeps each decision grounded in dates and needs rather than guesses:
The exact date your agency plan ends, confirmed in writing
Your expected start date for the next assignment and whether its plan has a waiting period
A realistic estimate of your income for the calendar year
The doctors, facilities and prescriptions you want covered
Proof that your previous coverage ended, such as a termination letter
With those items gathered, work in order. First, decide whether a new employer plan will begin soon enough to cover you. If it will not, price a Marketplace or private-market plan for the gap months, and check whether a Special Enrollment Period applies. Finally, confirm in writing when the new coverage starts so there is no uncovered day between plans.
Do not skip the provider check. Plans on the Marketplace and the private market differ in which doctors, hospitals and drugs they cover, and a clinician who moves between states may find that a network that works in Arizona does not follow them across the country. Confirming coverage areas before enrolling avoids a surprise at the first appointment.
Losing other coverage can open a Special Enrollment Period, though whether your situation qualifies depends on the details. Arizona uses the federal HealthCare.gov Marketplace, where open enrollment for individual plans has run November 1 to January 15 in recent years. For 2027 coverage, the window runs from November 1, 2026 to January 15, 2027, so it is not a December-only deadline.
Timing inside that window matters. Enrolling or changing a plan by December 15 is the cutoff for coverage starting January 1, while enrolling by January 15 means coverage starts February 1. A clinician whose contract ends this winter can use those dates to decide whether a January 1 or February 1 start fits the gap, and whether the next employer's plan will begin sooner.
Premium tax credits taken in advance on a Marketplace plan are reconciled against your actual income on IRS Form 8962 when you file the federal return. Travel assignments make income hard to predict, so a year with extra shifts or an extended contract can change what the reconciliation shows. Update your income estimate with the Marketplace when your plans change instead of waiting until tax season.
Self-employed people may be able to take the self-employed health insurance deduction on Schedule 1 of Form 1040. It does not apply for any month they were eligible for an employer-subsidized health plan, and it is limited to net self-employment earnings. That can matter for a clinician who does independent contractor work, but a nurse paid as an agency employee should ask a tax professional how it applies before counting on it.
Some employers fund individual coverage instead of offering a group plan. The Individual Coverage Health Reimbursement Arrangement, or ICHRA, became available for plan years beginning on or after January 1, 2020, under final rules issued by the Treasury Department, the Department of Labor and HHS in 2019. Employers of any size can offer it, and employees must be enrolled in individual health coverage to receive reimbursements.
Its smaller cousin, the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), was created by the 21st Century Cures Act of 2016 for employers with fewer than 50 full-time equivalent employees that do not offer a group health plan. Both arrangements reimburse employees, not independent contractors. For a travel clinician, that means the answer depends on whether a given engagement is employment, and these are general options only, not products every agency or clinic offers.
Coverage between contracts is easier to protect when it is treated as part of the assignment, not an afterthought. Note the end date, check the enrollment window, estimate income honestly and confirm the start date of whatever comes next. JP Health Insurance Advisors positions itself as an advisor-first guide for people who find the health insurance market confusing, and that is a fair description of what a clinician needs at the end of a contract: a clear sequence, not more options.
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