# Travel Nursing

CYA: Health Insurance for the Travel Nurse

CYA is an “unapproved” acronym commonly used in nursing & stands for Cover Your Ass Butt/Behind/Derriere. It refers to charting everything, because if you didn’t chart it, it didn’t happen.

Nurses know the importance of having health insurance. We take care of plenty of patients without it, and even the ones who have it, are usually screwed over by insurance. Did you know that the #1 cause of personal bankruptcy is related to medical bills?

Working as a travel nurse has its own set of challenges related to obtaining and keeping continuous health insurance coverage. Most travel nursing companies advertise “Free Health Insurance”, but nothing is free. The money for health insurance comes out of the same pot as the housing stipend, travel reimbursement, hourly wage, etc., so don’t think of it as “free”, but as a benefit you can elect to take. Some companies will offer Day 1 insurance, while others start on the 1st of the month, or after 30 days work. Add in the week or two that you want to take off in between assignments, and you’re left paying for COBRA benefits or you get dropped from the company’s insurance.  No bueno.

My preference is to carry my own health insurance, and you may find other travel nurses who do the same. I pay out of pocket for my own monthly plan to ensure continuous coverage. At the moment, I have no health insurance because I am in Shanghai, and it would not cover me here anyways (but I do have travel health insurance). I did carry my own Blue Cross Blue Shield of Michigan plan, up until the beginning of 2015, when I left the U.S. I didn’t want to pay for insurance I could only use at home, so I cancelled it. I guess we’ll see what happens with that at tax time next year…

Anyways, the benefit of carrying your own health insurance is that you maintain continuous health insurance coverage, even when you take time off between contracts. You also don’t have to worry about switching travel nursing companies, switching insurance companies, and looking for a new doctor each contract. Additionally, your travel nursing company may offer you a higher hourly wage if you carry your own health insurance. I’ve worked with Amanda Belloff at Randstad Healthcare for quite a few assignments (great company & recruiter), and was able to get $1/hour added to my pay because I had my own coverage. Over the course of a 13-week assignment, this adds up to $468, which more than covered my $100/month plan I had at the time.

One drawback, is that you end up paying out of pocket for the insurance (with after-tax money). This might not be worth the hassle to some, but I find the benefits outweigh this inconvenience. Come tax time, if you meet certain spending/income requirements laid out by the IRS, you may be able to deduct the expenses.

There are plenty of options available for health insurance, and a simple internet search will provide many options. The Affordable Care Act also established a “healthcare marketplace” at www.healthcare.gov. There are a wide variety of insurance plans available, and no one can be denied for coverage based on the new federal guidelines. I am interested to see what’s available when I am in the market for health insurance again.

Finding and buying your own health insurance may be more leg work initially, but you will have the peace of mind knowing you’ll have continuous health insurance, especially when you decide to take a week or two off in between contracts.

In the meantime happy travels & CYA,