ACA Marketplace Plans for Travel Nurses (2026 Guide)

Introduction

The ACA marketplace can offer travel nurses high-quality health coverage at surprisingly low costs — if you know how to work the system. The key lies in accurately estimating your income, understanding how your travel nurse stipends affect subsidy eligibility, and choosing a plan that works across state lines.

Many travel nurses assume they earn too much for marketplace subsidies, but that assumption often costs them thousands of dollars a year. Because non-taxable stipends for housing and meals do not count toward your Modified Adjusted Gross Income, your subsidy-eligible income may be significantly lower than your total compensation. This guide shows you exactly how to navigate the marketplace, from income estimation to plan selection to enrollment.

This is educational content, not insurance or financial advice. Consult a licensed insurance professional or tax advisor for guidance specific to your situation.

ACA Marketplace Basics for Travel Nurses

The ACA marketplace (often called Obamacare or the Health Insurance Exchange) is a government-run platform where individuals can shop for and purchase health insurance plans. Here are the fundamentals every travel nurse needs to understand.

Who qualifies. Any U.S. citizen or legal resident who is not incarcerated and not eligible for Medicare can purchase a plan on the marketplace. Being employed does not disqualify you. Travel nurses can buy marketplace plans even while working on assignment, especially if they decline agency-sponsored coverage.

Open enrollment for 2026. The annual open enrollment period for 2026 health plans typically runs from November 1, 2025, through January 15, 2026. Plans selected during open enrollment begin on January 1 (if enrolled by December 15) or February 1 (if enrolled after December 15). If you miss open enrollment, you will need a qualifying life event to enroll.

Special Enrollment Periods (SEPs). Travel nurses have a built-in enrollment advantage: losing employer-sponsored coverage (which happens when your agency contract ends) is a qualifying life event that triggers a 60-day Special Enrollment Period. This means you can enroll in a marketplace plan at any time during the year — not just during open enrollment — as long as you have recently lost other coverage. Other qualifying events include moving to a new state, getting married, or having a baby.

Why travel nurses have unique considerations. Your income comes from multiple sources (hourly wages, overtime, non-taxable stipends), you may work in multiple states per year, and your employment status changes every 13 weeks. These factors affect everything from which state’s marketplace you use to how much subsidy you receive.

Estimating Your Income for Subsidies

Getting your income estimate right is the single most important step in the ACA enrollment process. It directly determines your premium tax credit (subsidy) amount.

MAGI calculation for travel nurses. The marketplace uses Modified Adjusted Gross Income (MAGI) to determine subsidy eligibility. For most travel nurses, MAGI is your taxable wages (the amount in Box 1 of your W-2) plus any other taxable income (interest, investments, side gig income), minus certain deductions. Here is the critical part: non-taxable stipends for housing, meals, and incidentals are not included in MAGI.

How stipend structures affect eligibility. A travel nurse earning $100,000 in total compensation might have a pay breakdown of $65,000 in taxable wages and $35,000 in non-taxable stipends. Their MAGI for ACA purposes would be based on the $65,000, not $100,000. At $65,000, a single individual qualifies for meaningful premium tax credits. At $100,000, the credits would be much smaller or nonexistent.

This is why understanding your full pay structure matters. If you maintain a legitimate tax home and qualify for non-taxable stipends, your ACA subsidy eligibility may be much better than you think. For more on tax home requirements and stipend structures, see our guide on travel nurse tax deductions.

Income thresholds for premium tax credits. Premium tax credits are available to individuals and families with income between 100 percent and 400 percent of the Federal Poverty Level (FPL). For 2026, the approximate income range for a single individual is roughly $15,000 to $62,000. However, enhanced subsidies (which have been extended in recent years) may provide credits even above the 400 percent FPL threshold, capping the required premium contribution at a percentage of income.

Cost-sharing reductions (CSRs). If your MAGI falls between 100 and 250 percent of the FPL, you may qualify for cost-sharing reductions. CSRs lower your deductible, copays, and out-of-pocket maximum — but only on Silver-tier plans. This makes Silver plans the best value for qualifying travel nurses.

What happens if your estimate is off. When you file your taxes, the IRS reconciles your actual income with the estimate you used to calculate your subsidy. If you earned less than estimated, you may receive additional credit. If you earned more, you may need to repay some or all of the excess subsidy. To minimize surprises, update your income estimate on the marketplace whenever your situation changes (new contract, gap between assignments, significant overtime).

Choosing the Right Plan Tier

The ACA marketplace offers four plan tiers (plus catastrophic plans for those under 30). Each tier represents a different balance between monthly premiums and out-of-pocket costs.

Bronze plans. Lowest premiums, highest deductibles and out-of-pocket costs. The plan pays about 60 percent of average medical costs; you pay 40 percent. Best for healthy nurses who rarely use healthcare and want the lowest monthly cost. Many Bronze plans qualify as High Deductible Health Plans (HDHPs), making them eligible for pairing with a Health Savings Account — see our HSA vs. FSA guide for details.

Silver plans. Moderate premiums and moderate out-of-pocket costs. The plan pays about 70 percent of average costs. Silver plans are the only tier eligible for cost-sharing reductions, which can boost the plan’s effective value to 73, 87, or even 94 percent coverage for lower-income enrollees. If you qualify for CSRs, Silver is almost always the best choice.

Gold plans. Higher premiums, lower out-of-pocket costs. The plan pays about 80 percent of average costs. Good for nurses who use healthcare regularly — frequent doctor visits, ongoing prescriptions, or planned procedures. The higher premium is offset by lower costs at the point of care.

Platinum plans. Highest premiums, lowest out-of-pocket costs. The plan pays about 90 percent of average costs. Rarely the best value for travel nurses unless you have very high, predictable healthcare expenses.

Catastrophic plans. Available to individuals under 30 (or those with a hardship exemption). Very low premiums with very high deductibles. These plans cover three primary care visits and preventive services before the deductible, making them a bare-bones option for young, healthy nurses.

Which tier for which nurse:

• Healthy, rarely uses healthcare, wants HSA: Bronze HDHP
• Qualifies for cost-sharing reductions: Silver
• Regular healthcare user, no CSR eligibility: Gold
• Very high, predictable medical costs: Gold or Platinum
• Under 30, healthy, just wants catastrophic protection: Catastrophic

Navigating Networks Across States

Network access is the biggest practical challenge for travel nurses on ACA plans. You need a plan that works not just in your home state but in whatever state your next assignment takes you.

Home state vs. assignment state. You enroll through the marketplace for the state where your permanent address (tax home) is located. Your plan’s network is built around providers in that state. If your assignment is in a different state, you need out-of-network benefits or a plan with a national network.

PPO vs. HMO — why it matters for travelers. PPO (Preferred Provider Organization) plans allow you to see out-of-network providers at a higher cost but still with some coverage. HMO (Health Maintenance Organization) plans typically provide no out-of-network coverage at all (except emergencies). For travel nurses, a PPO is almost always the right choice. The flexibility to see providers in any state, even at out-of-network rates, is essential.

Nationwide PPO options. Some marketplace plans offer PPO networks with national coverage through carriers like Blue Cross Blue Shield (via the Blue Card program), Cigna, or Aetna. These plans may cost more than local HMO options, but the national network access is worth the premium for a travel nurse. When shopping, filter for PPO plans and check whether the plan explicitly includes out-of-state providers.

Verifying provider access. Before enrolling, check the plan’s provider directory for providers near your likely assignment locations. Call the providers directly to confirm they accept the specific plan (not just the insurer in general). Online directories are frequently outdated.

Telehealth as a supplement. Many marketplace plans include telehealth visits at no or low cost. Telehealth can handle primary care, prescription refills, mental health appointments, and minor acute issues from anywhere in the country. For a travel nurse, telehealth fills the gap when you cannot easily find an in-network provider at your assignment location.

Enrollment Step-by-Step

Here is a practical walkthrough of the enrollment process for travel nurses.

Documents you need:

• Social Security number
• Permanent home address (tax home)
• Estimated annual income (taxable wages, not total compensation)
• Information about any current health coverage
• Immigration documents (if applicable)

Walking through Healthcare.gov (or your state exchange):

1. Create an account at Healthcare.gov or your state’s exchange website.
2. Complete the application with your personal and household information.
3. Enter your estimated annual income. Remember: use your projected taxable income (MAGI), not your total compensation with stipends.
4. If you are enrolling via Special Enrollment Period, select your qualifying life event (loss of coverage) and enter the date.
5. Review your eligibility results and subsidy amount.
6. Browse available plans, filtering for PPO network type.
7. Compare plans by total estimated annual cost (premium + expected out-of-pocket), not just monthly premium.
8. Select your plan and confirm enrollment.
9. Set up autopay for premiums to avoid accidental coverage lapses.

State-based marketplace differences. Some states run their own marketplace exchanges (California, New York, Massachusetts, and others). The plans, subsidies, and enrollment process are similar, but you will use the state website instead of Healthcare.gov.

Reporting life changes mid-year. If your income changes significantly (new contract, gap between assignments, substantial overtime), update your marketplace application. This adjusts your subsidy in real time so you do not face a large reconciliation at tax time.

Managing Your Plan During Assignments

Once enrolled, here are tips for getting the most out of your marketplace plan while traveling.

Paying premiums on time. Set up automatic payments. Missing a premium payment can result in a grace period (typically 90 days if you receive subsidies), but if you do not catch up, your coverage will be terminated. Losing coverage for non-payment does not trigger a new Special Enrollment Period.

Using out-of-network benefits. If you have a PPO and need care in your assignment state, check for in-network providers first. If none are available, your plan will still cover out-of-network care but at a higher cost-sharing level. Emergency care is always covered at in-network rates regardless of where you are.

Updating your address and income. If you move your permanent address (not your temporary assignment address), you may need to switch marketplace plans. A permanent address change to a new state triggers a Special Enrollment Period. Temporary assignment addresses do not affect your enrollment.

When your assignment state differs from your plan state. This is normal for travel nurses. As long as your plan has out-of-network benefits or a national network, you can receive care in your assignment state. For routine care, telehealth can bridge the gap. For specialists and ongoing treatment, plan visits during trips back to your home state when possible.

Frequently Asked Questions

Do travel nurses qualify for ACA marketplace subsidies?

Many travel nurses do qualify for premium tax credits on the ACA marketplace, and the amounts can be substantial. The key is that subsidies are based on your Modified Adjusted Gross Income, which only includes your taxable wages and does not count non-taxable stipends for housing and meals. A nurse earning $100,000 in total compensation might have a MAGI of $60,000 to $70,000, which falls well within the subsidy-eligible range. Always estimate based on your projected taxable income for the year, not your total compensation package.

Can I use an ACA marketplace plan while working on assignment in a different state?

Yes, but your plan choice matters. You enroll through the marketplace for the state where your permanent tax home is located, not your assignment state. The plan you choose should be a PPO with a broad or national network so you can access providers in whatever state your assignment takes you. HMO plans typically do not cover out-of-network providers and should be avoided by travel nurses who move between states every 13 weeks.

What happens if I underestimate or overestimate my income on the marketplace application?

When you file your tax return, the IRS reconciles your actual income with the estimate you used. If you earned less than estimated, you may receive an additional credit as a refund. If you earned more, you may need to repay some or all of the excess subsidy you received. To minimize surprises, update your income estimate on the marketplace whenever your situation changes, such as starting a new contract, entering a gap between assignments, or working significant overtime.

Can I enroll in an ACA plan outside of open enrollment?

Yes. Losing employer-sponsored health coverage, which happens every time a travel nurse contract ends and agency benefits stop, is a qualifying life event that triggers a 60-day Special Enrollment Period. During this window, you can enroll in a marketplace plan at any time during the year. Other qualifying events include moving to a new state, getting married, or having a baby. This built-in flexibility makes the ACA marketplace particularly well-suited for travel nurses.

Should I take agency health insurance or buy my own ACA plan?

The answer depends on your specific situation, but many experienced travel nurses find that buying their own ACA marketplace plan and declining agency insurance puts more money in their pocket. When you decline agency insurance, most agencies increase your hourly rate by three to five dollars per hour. Over a 13-week contract at 36 hours per week, that is an extra $1,400 or more. If your subsidized ACA plan costs $150 to $300 per month, the math often favors the personal plan, plus you get continuity of coverage between assignments with no enrollment gaps.

Frequently Asked Questions

Do travel nurses qualify for ACA marketplace subsidies?

Many travel nurses qualify for significant premium tax credits on the ACA marketplace. The key is that subsidies are based on your Modified Adjusted Gross Income, which includes only your taxable wages and not your non-taxable stipends for housing, meals, and incidentals. A travel nurse earning $100,000 in total compensation might have a MAGI of only $60,000 to $70,000, putting them well within the subsidy-eligible range. Always estimate your income using your projected taxable wages, not your total compensation package.

Can I use an ACA marketplace plan in a different state from where I enrolled?

Yes, but network access is the critical factor. You enroll through the marketplace for the state where your permanent tax home address is located, and your plan’s network is built around that state. If you choose a PPO plan with out-of-network benefits or a national network like Blue Cross Blue Shield’s Blue Card program, you can receive covered care in your assignment state. HMO plans typically provide no out-of-network coverage outside of emergencies, making them a poor choice for travel nurses who work across state lines.

What happens if I underestimate or overestimate my income on the marketplace application?

When you file your taxes, the IRS reconciles your actual income with the estimate you used to calculate your subsidy. If you earned less than you estimated, you may receive an additional tax credit. If you earned more, you may have to repay some or all of the excess subsidy you received. To minimize surprises, update your income estimate on the marketplace whenever your situation changes, such as starting a new contract, experiencing a gap between assignments, or earning significant overtime. Estimating slightly conservatively helps avoid unpleasant tax-time adjustments.

Is it better to take agency health insurance or buy my own ACA marketplace plan?

It depends on your specific situation, but many experienced travel nurses find that buying their own ACA marketplace plan and declining agency insurance results in higher total compensation. When you decline agency insurance, most agencies increase your hourly rate by three to five dollars per hour, which over a 13-week contract can add over $1,400 to your pay. If your ACA plan costs $200 per month after subsidies, the math often favors the personal plan, plus you get continuity of coverage between assignments with no enrollment headaches every 13 weeks.

When can I enroll in an ACA marketplace plan outside of open enrollment?

Travel nurses can enroll outside of open enrollment through a Special Enrollment Period triggered by a qualifying life event. Losing employer-sponsored health coverage, which happens every time an agency contract ends and benefits stop, qualifies as a triggering event. You have 60 days from the date you lose coverage to enroll in a marketplace plan. Other qualifying events include moving to a new state, getting married, or having a baby. This built-in enrollment advantage means travel nurses essentially have year-round access to the marketplace.

Key Takeaways

• ACA marketplace plans are often the best value for travel nurses. Subsidies can make comprehensive coverage surprisingly affordable.
• Your stipend structure directly impacts subsidy eligibility. Non-taxable stipends reduce your MAGI, potentially qualifying you for significant premium tax credits.
• Choose a PPO for maximum flexibility across state lines. HMO plans are too restrictive for nurses who move every 13 weeks.
• Silver plans with CSR subsidies offer the best overall value for travel nurses with moderate taxable income.
• Use Special Enrollment Periods to enroll outside open enrollment. Losing agency coverage triggers a 60-day window to sign up.
• Always estimate income slightly conservatively to avoid repaying subsidies at tax time. Update your estimate when your situation changes.

Related Resources

• Travel Nurse Health Insurance: Complete Guide
• COBRA for Travel Nurses: Is It Worth the Cost?
• HSA vs. FSA for Travel Nurses: Which One Works?
• How to Cover Insurance Gaps Between Assignments
• Travel Nurse Tax Deductions
• How to Become a Travel Nurse

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Affiliate Placement Notes

• ACA income estimation calculator widget after Income section
• Plan comparison tool after Choosing the Right Tier section
• Enrollment assistance service link after Step-by-Step section
• Sidebar widget for “Check your ACA subsidy eligibility” CTA