Your contract ended, your agency benefits stopped, and your next assignment does not begin for another few weeks. Or perhaps you work per diem, home health, hospice, therapy, coding, or billing shifts and never receive an employer health plan in the first place.
That is the coverage challenge for many travel nurses and 1099 healthcare contractors. You may earn good income, but it arrives in irregular contracts, hourly shifts, stipends, and travel payments. You need health insurance that can follow your work, not a plan that disappears every time your assignment changes.
This morning-friendly guide explains how to estimate your income, compare health plans, understand the 2026 ACA landscape, and build a practical coverage strategy in Texas, Florida, Tennessee, or Georgia.
Michael Peck is a licensed insurance agent, not a legal or financial advisor. This article is educational and does not replace personalized advice.
Start With Your Assignment Calendar and Annual Income Estimate
Before comparing plans, create a realistic picture of your household income for the year. Your eligibility for financial assistance and your choice of coverage can change significantly when your income moves up or down.
Start with the income sources you expect:
- 13-week contracts: Estimate your taxable contract pay, then consider how many contracts you may complete during the year.
- Per-diem nursing: Multiply expected hours by your average hourly rate and the number of weeks you realistically expect to work.
- Home-health and hospice assignments: Include expected visits, hourly pay, mileage arrangements, and contract changes.
- Medical coding, billing, and remote support: Estimate your monthly contract revenue and how consistently each client is likely to continue.
- Housing stipends: Ask your tax professional how your stipends and travel pay should be treated for your assignment and tax-home situation.
- Travel pay: Travel-related payments may be treated differently from wages, so ask your tax professional how your specific payments should be reported.
- Your tax-home base: Tax-home rules for travel contractors are specific. Ask your tax professional how your permanent tax home and the records you keep may affect how your travel benefits are treated.
For ACA purposes, the important number is generally your projected household income, not simply your gross contract invoices. Business deductions and other household income may matter, so coordinate your estimate with a qualified tax professional.
If you want a broader overview, read Real Health Quote’s guide to health insurance for gig workers and its explanation of ACA tax credits for self-employed people.
Call Rachel at 512-850-6604 before the shift starts.
Use the Big Three Filters Before Choosing a Plan
Your work situation may change from month to month, but three filters help organize your decision.
1. Tax History
ACA financial assistance is tied to your projected household income and tax information. For a 1099 worker, estimating too low may create a repayment problem later if your actual income rises.
You can choose to use advance tax credits to lower your monthly premium, use a smaller amount, or potentially decline the advance credit and reconcile later. Your tax professional can help you decide which approach fits your situation, based on your income stability and comfort with uncertainty.
The 2026 landscape also reflects the return of the original ACA rules now that enhanced subsidies have expired. Keep your income estimate updated when a new contract, bonus, stipend, or major schedule change affects your annual projection.
2. Pre-Existing Conditions
ACA plans cover pre-existing conditions. That can matter if you need ongoing prescriptions, treatment, specialist care, therapy, or follow-up after an injury.
Short Term Medical plans generally do not provide the same protections. Medical underwriting, exclusions, and limitations may apply, which is why your health history must be part of the conversation before you consider a temporary plan.
3. The Subsidy Cliff
The Subsidy Cliff affects ACA eligibility for tax credits. With the enhanced subsidies gone, a household above the applicable 400% FPL threshold may be ineligible for the applicable ACA premium tax credit, depending on household size, coverage year, current federal guidance, and other eligibility factors. As general planning estimates—not universal limits—that threshold is roughly $64,000 for an individual or $132,000 for a family.
This is especially important for successful travel nurses, therapists, and other contractors whose income rises during a busy year. If you are above the Subsidy Cliff, an ACA plan may still be available, but you may have to pay the full premium.
For some eligible applicants, Short Term Medical may have a lower premium than unsubsidized ACA coverage, but the comparison depends on the applicant, carrier, state, underwriting, policy terms, network, and benefits. However, STM is not Major Medical, does not replace ACA protections, and must be evaluated for exclusions and benefit limits.
Your Health Plan Options, in Practical Order
Your needs may call for one product or a combination. Consider these categories in this order.
1. ACA
An ACA plan is often the strongest anchor for year-round coverage you own yourself. It can cover pre-existing conditions and may offer financial assistance when your projected income qualifies.
It may also be a practical choice when you need consistent prescriptions, regular care, maternity benefits, behavioral health services, or protection that does not depend on medical underwriting.
Losing agency coverage at the end of a contract may create a Special Enrollment Period, but you should confirm the dates and documentation requirements promptly. You can also review the basics in this Open Enrollment and Special Enrollment guide.
2. Short Term Medical
STM can serve as a bridge between assignments, during a missed enrollment window, or when you are above the Subsidy Cliff. Some STM policies may use broad PPO networks, but network access, covered services, exclusions, underwriting, duration, and benefits vary by carrier, state, applicant, and policy. That variability matters for professionals moving between hospitals and contract locations. STM is not Major Medical. It may exclude pre-existing conditions, limit benefits, or use different approval rules.
3. Accident
Accident coverage can provide a cash benefit after a covered injury. For a 1099 healthcare contractor without traditional workplace benefits, it may help with transportation, household bills, or other expenses while you recover.
4. Hospital
Hospital indemnity coverage can provide a fixed benefit for a qualifying hospital stay. It is a supplemental product, not a substitute for medical insurance, but it may help reduce the financial shock of an admission.
5. Critical Care
Critical illness or critical care coverage may pay a benefit after certain serious diagnoses. It can help you protect savings while you focus on recovery and avoid taking assignments immediately.
6. Term Life Insurance
If someone depends on your income, term life insurance can protect your household during your working years. It is separate from health insurance, but contract workers often need to build this protection without an employer benefits department.
7. Dental
Dental coverage can help with preventive visits and other covered services. If you move frequently, check whether your preferred dentist participates in the available network.
8. Vision
Vision coverage may help with exams, lenses, or contacts. It is usually a simple supplemental layer to add alongside your medical plan.
Call Rachel at 512-850-6604 to turn a coverage gap into a plan.
Licensed Agent vs. Marketplace Navigator or CMS Support Staff
Government-funded Marketplace Navigators and CMS support staff may provide impartial Marketplace information, explain application steps, and assist with enrollment paperwork. They generally do not recommend a specific plan or act as the consumer's insurance agent.
A licensed health and life insurance agent has a different role. A licensed agent such as Michael Peck can compare available options, explain tradeoffs, recommend plans based on your doctors and work locations, and help you enroll. The relationship can also continue after enrollment when you have a billing question, need to report a life change, or lose coverage between contracts.
That distinction matters when you work irregular assignments. You are not just filling out a form. You are deciding how to protect your health, income, and mobility.
Real Health Quote is an independent agency licensed in 15 states: Texas, Delaware, Florida, Indiana, Kansas, Mississippi, Missouri, North Carolina, South Carolina, Ohio, Oklahoma, Michigan, Tennessee, Georgia, and Virginia. Michael is a sole proprietor and a real person who knows your name, not a call center that disappears after enrollment.
State Notes for Texas, Florida, Tennessee, and Georgia
Texas
Texas has not adopted full Medicaid expansion. If your income is irregular or you are between contracts, review your eligibility carefully rather than assuming you will qualify for a public program.
For people researching self employed health insurance options, the main comparison may involve an ACA plan, STM, supplemental protection, or another individual plan that fits your income and medical needs.
Florida
Florida has also not adopted full Medicaid expansion. A travel nurse or contractor whose agency coverage ends may need to act quickly when a qualifying loss of coverage creates a Special Enrollment Period.
Because Florida is a common destination for travel healthcare professionals, check provider networks carefully if you maintain a home base in another state.
Tennessee
Tennessee has not adopted full Medicaid expansion. Per-diem clinicians and independent therapists should keep documentation of assignment changes, income, and coverage termination dates in case they need to apply during a special enrollment window.
Georgia
Georgia uses Georgia Access for individual health coverage. Georgia residents may also encounter Georgia Pathways to Coverage, a Medicaid option with specific eligibility and qualifying activity requirements. Rules can change, so review current information directly through the Georgia Access website.
If you regularly travel between these four states, remember that your legal residence and tax home are not necessarily the same as your temporary assignment location. Ask how a plan handles out-of-state care, emergencies, specialists, and routine visits.
Your Morning Coverage Checklist
Before your first shift, take these five steps:
- Write down your current coverage end date. Do not rely only on a verbal statement from an agency.
- List every expected contract and income source. Include 13-week assignments, per-diem hours, stipends, travel pay, and side work.
- Identify your tax-home state and permanent address. Keep records that support your situation.
- Apply the Big Three Filters. Review Tax History, Pre-existing Conditions, and the Subsidy Cliff.
- Compare the entire protection strategy. Look at ACA, Short Term Medical, accident, hospital, critical care, term life, dental, and vision in the proper role.
You do not have to solve every insurance question before your coffee gets cold. You do need a clear starting point and someone who can explain what changes when your next contract, state, or income level changes.
Call Rachel at 512-850-6604 to get a real person on your side.
Meet Eva, Our Executive Assistant
Eva, our Executive Assistant, helps keep the moving pieces organized so clients can receive thoughtful follow-up and dependable support. For contract workers balancing assignments, travel, tax questions, and enrollment deadlines, that behind-the-scenes coordination can make the process feel much less overwhelming.
If you are ready to compare health plans that fit your contract schedule and budget, visit the Real Health Quote quote page.
Or call us directly at 512-850-6604
There are always ways to find you coverage—all you need to do is schedule an appointment with me and I will find you something.
Rachel at 512-850-6604
Michael Peck is a licensed insurance agent, not a legal or financial advisor. Real Health Quote is an independent health insurance agency licensed in 15 states (TX, DE, FL, IN, KS, MS, MO, NC, SC, OH, OK, MI, TN, GA, VA). Products and availability vary by state. We are not affiliated with or endorsed by any government agency, the federal Marketplace, or Medicare. Health insurance regulations and plan details can change; always consult with a professional regarding your specific tax or legal situation.
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