Health Insurance for Traveler's

NedRN · Apr 3, 2017

I don't think that is an easy task online. You might be able to go the insurance company's site with a specific plan and search their network (I just pick a random couple of cities that I'm likely to travel to and search for primary care providers), but that is a pain even when you already have a policy, and could be impossible without logging in.

I'd recommend picking a couple of plans you like, and calling the insurance company directly for details about their network. Indeed there has been a trend for exchange plans to not work well out of state or wide number of in-network providers to bring costs down (which it does). While that works out for the vast majority, it doesn't work as well for the tiny percentage of those who work out of state most of the time.

While you are on the phone with insurance companies, you might as well ask them about private plans not listed on the exchange. It is possible they have one with wider coverage for not much more. You can also start such insurance at any time, versus the exchange open enrollment period. Usually not a big deal for travelers as a change of employer means you can get exchange insurance without waiting.

CFrancine, BSN, RN · Apr 11, 2017

So I did some digging and wanted to give a real life exam. I'm single and no dependents, under 30, and a non smoker. I looked into Anthem Blue Cross Blue Shield because they have a national network. The agency I'm speaking with also uses them so it was easier to compare value. My recruiter crunched some numbers based on two available contracts and gave me multiple scenarios for each.

For vision, dental, and health I'm looking at $455/month out of pocket to have my own plan based on the choices I felt were best for me. There were 21 options for medical, 3 dental, and one vision. The agency will also give me $400/month to have my own insurance. This will be added to the housing stipend so it's tax free (provided it's not over the fed limit for housing in the area). Or an increased $2-3 hourly wage if taking provided housing. So we're looking at $55 out of pocket expense (maybe slightly more or less depending on taxes and overtime with the hourly rate option)

If I take agency insurance vision/dental/medical, I will pay $110, $190, or $278 per month out of pocket (pretax) depending on the medical plan (only three options here and no choice in dental and vision). Insurance starts on Day 1 as long as paperwork is submitted 5 days before assignment starts. And you're covered for 30 days between assignments (they'll charge you out of your next couple checks). BUT NOTE: Another company I looked at, you're not covered until DAY 90!! So pay attention to this. Also, I'm not how much it would cost to put these plans on COBRA but let's just add $400 to your monthly rate. So $510, $590, or $678 completely out of pocket.

The biggest differences were deductibles when you'd have to pay out of pocket for the big expenses but it really doesn't seem to matter once I crunch some numbers (I didn't do the lowest cost plan because it doesn't seem comparable to what I picked):

Personal plan - 3500 deductible, $5700 annual max, 25% coinsurance (meaning how much of the remaining bill you have to pay after deductible, up until you hit the annual max). A outpatient services bill of $2000 will cost $2000. A $1500 ER bill will cost $1500. A hospital admission costing $8000 will cost $4626

Agency plan Mid cost - $1000 deductible, $6350 annual max, 70% coinsurance (plus additional $500 copay for admission and $200 for ER visit). A outpatient services bill of $2000 will cost $1700. A $1500 ER bill will cost $1410. A hospital admission costing $8000 will cost $6050

Agency plan highest cost - $700 deductible, $6350 annual max, and 80% coinsurance (plus additional $500 copay for admission and $200 for ER visit). A outpatient services bill of $2000 will cost $1740. A $1500 ER bill will cost $1380. A hospital admission costing $8000 will actually cause you to tap out at your annual max of $6350.

I think in this case, my own plan makes more sense to me. Obviously, monthly cost could change if companies aren't offering anything in return for carry my own insurance or you change agencies and insurance often. But it's really just preference. I think I'd rather have my own insurance, not have to worry about a waiting periods if switching companies, etc. I also don't want to have to figure out a new network every couple months. Sometime the lowest cost isn't the most important thing.

But if you're looking to save money monthly, there are other cheaper options. If it looks like if you're facing paying a high deductible, crap probably hit the fan and they all start to balance out in the end. (Sorry if a number or two from my math may be off. But I think the point is clear)

NedRN · Apr 11, 2017

Thanks for all the info. A single payer scheme like every other industrialized nation would sure simplify our lives!

Two points, your agency can certainly reimburse your insurance costs with receipts without touching your housing (which you would like to max out if the agency allows it regardless of your insurance situation).

The other point is that a $1,500 bill from an ED is not $1,500. The whole point of in network plan is that the price is contracted ahead of time and is far less than the uninsured rate. Just like prescriptions and labs.

Yes, you will be responsible for that entire contracted rate until you reach your deductible.

CFrancine, BSN, RN · Apr 11, 2017

Yeah, sorry. That's what I meant, how much the bill was after the contacted rates were done. I just made up random figures.

I think she was maxing out housing as much as she could already. My hourly rate is probably as low as can be without raising eyebrows. Not even sure if I'd want to do overtime or call at that rate but I won't be greedy... The housing and per diem alone are more than my take home pay now. She quoted me for one job in Indiana. I'm from Ohio and I can't imagine anywhere would cost 2K a month unless I'm living in a luxury place in a big city. And the hourly rate went up a couple more dollars if I took the provided housing, which also makes me think she was shuffling dollars where she could.

One in Illinois had more money for housing and hourly, so I'm not sure if it's a difference in area or what the contract pays.

NedRN · Apr 12, 2017

The housing rate is based on single night hotel stays that most business travelers use, not apartments. You can check the IRS maximum stipends for the area by searching Google for GSA per diem rates.

jive turkey · Jun 14, 2018

Anyone have a useful comment? I'm also looking, I'd prefer travel. I was wondering if anyone has suggestions for finding an insurance company with national network of providers. Everything I can find on healthcare.gov is local HMOs

One issue I see not being addressed in these discussions is what the individual's wants/needs are in terms of health care coverage.

Those of you that rarely see a provider and have little to no Rx may benefit from paying out of pocket for primary care visits and having a plan that insures you in the case of major illness/injury vs paying monthly premiums for a benefit you don't use or feeling anchored to a lower paying staff job to preserve the insurance policy.