Updated July 2026 · 7 min read
Part of the Nurse Money Hub — benefits, insurance, and nurse financial planning in one map.
Hospital nurses at full-time staff positions have it straightforward: employer-sponsored coverage that's almost always the best financial option. But per diem nurses, travel nurses, and those between jobs face real decisions. Here is a cost comparison and coverage guide for each scenario nurses actually encounter in 2026.
| Plan Feature | Typical Hospital Employer Plan | ACA Marketplace (Silver) |
|---|---|---|
| Monthly employee premium | $120–$280 (employee only) | $380–$650 (after subsidy, if eligible) |
| Annual deductible | $500–$2,000 | $1,500–$4,500 |
| Out-of-pocket max | $3,000–$6,000 | $6,000–$9,100 |
| Network | Hospital system + broad network | Varies; narrow networks common |
| HSA eligible | If HDHP option selected | If HDHP option selected |
Travel agencies offer health insurance, but quality and cost vary enormously. Many travel nursing agency plans have narrow networks that work in your contract state but may not cover your home state providers. Typical travel nurse agency premiums run $150–$400/month for individual coverage, with higher deductibles and less comprehensive coverage than staff plans. Options to consider:
Agency plan: Most convenient. Works in the contract location. May require active assignment to maintain coverage — gap weeks without a contract can mean no coverage.
ACA marketplace plan: Available at any time through a Special Enrollment Period if you leave staff employment (qualifying life event). At $100,000+ travel nursing income, ACA subsidies typically don't apply, making full-price marketplace plans expensive. A Bronze HDHP at full price runs $4,500–$7,200/year — cheaper than agency plans at some income levels.
Spouse's employer plan: If available, typically the best option for travel nurses. Adding a spouse to employer coverage is generally cheaper than any self-purchased plan.
Per diem RNs who work fewer than 20–30 hours per week (the typical employer coverage threshold) are not eligible for employer health insurance. Options: ACA marketplace, spouse plan, or joining a professional association like the ANA that offers group health rates. At a $65/hour per diem rate, a nurse working 25 hours/week earns $84,500/year — above ACA subsidy thresholds ($58,320 for a single adult in 2026). Full-price marketplace coverage for a 30-year-old female RN in most states runs $350–$550/month individual.
COBRA allows you to keep employer coverage for up to 18 months after leaving a job — but you pay the full premium plus a 2% administrative fee. On a plan that cost you $200/month as an employee, COBRA can cost $650–$1,100/month because you're now paying the full employer + employee share. COBRA is most useful for short gaps (1–3 months) or if you have pending expensive care and need continuity of providers. For gaps over 3 months, shop the ACA marketplace instead.
If your employer offers an HDHP (High Deductible Health Plan) option, an HSA (Health Savings Account) lets you contribute $4,300/year (individual, 2026) in pre-tax dollars. Those funds invest, grow tax-free, and are never taxed if used for qualified medical expenses — making the HSA the only triple-tax-advantaged account available. Nurses in their 30s who max their HSA and invest the funds for future healthcare costs in retirement can accumulate $100,000+ in tax-free healthcare dollars by their 60s. See our hospital benefits value guide for the full HSA calculation.
Related: Hidden Value of Hospital Benefits, Travel vs Staff Income Comparison, 7 Financial Mistakes New Grad Nurses Make
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