Simple advice

[8-ball, BSN]

Hey guys I need a little advice on travel nursing, I have been a nurse for almost 5 years, 1.5 year med-surg, 2 years ICU and a little over a year in Interventional Radiology doing conscience sedation. I am working on my BSN and will be done in summer 2016, I had planned to go into CRNA school after that but after watching the forums there seems to be a problem. I dont want to be in 250K debt and not be able to find a job. So I am thinking travel may be the way for me. For me its not about the money as much as the experience and ability to travel. So here is what I have learned and hope to utilize based on reading the forums from everyones advice.

1) Have multiple agancies working for you

2) get your own insurance and maybe even housing

3) Choose assignments that are the right fit for you not just based on pay.

So here is my plan I live in Nashville TN, and my wife is a school teacher with commitments through 2016-1017 school year. So I am thinking of taking local assignments first in TN and KY (I am near the border) during that time applying for my other licences especially CA since they take so long. Once my wife finishes her school year we will travel together and she will semi retire, basically being my agent so to speak setting up contracts and dealing with agencies, housing, etc. We will be bringing are 2 small dogs, no children. Based on our combined income I will need to make $42 hour once she quits her job, prior to that we are working to pay off all debt such as car loans and credit cards, which I think I can do in that year.

So now its your turn, what I am asking is...are there any flaws in my plan? Should my wife find part time work? Does it matter that I have been out of the ICU for over a year and almost 2 years by the time I start traveling?

Thanks

[NedRN]

Until you stop taking local jobs (ones you can commute from home versus having to rent closer to the assignment), compare travel pay closely with staff pay. Staff can be better, especially when you consider insurance, sick pay, et cetera. All of your travel compensation if you work locally will be taxed, removing a large benefit to traveling. So ignore take home quotes from agencies and insist on the full details so you can calculate your own take home pay based on your tax status.

This same tax benefit I'm referring to requires a tax home when you do go traveling. Effectively, that consists of keeping your permanent residence in TN. You can get a roommate and still qualify, but don't rent it out entirely. You have lots of time to research this before you really do go traveling on such sites as PanTravelers and TravelTax. It is worth doing right. Being itinerant is OK to (without a tax home). For most travelers, the tax benefit is worth around $10,000 a year extra take home versus being itinerant. So if the cost of maintaining a tax home is more than that, you are better off being itinerant.

No income taxes in TN is not a benefit of keeping your tax home. The work state always has first claim on taxing income, so a tax home on TN is only an advantage versus a tax home in a state with income taxes, not being itinerant. TN tax home versus itinerant status will result in exactly the same tax load.

Yes, if you want to travel ICU, lack of recent experience will hinder you. However the demand for cath lab if you are willing to travel in it will make up for that and pay more in most circumstances. Knowledge of IR may get you in the door for cardiac (considering how short everyone is right now), and then your travel career will be good. If available, see if you can float to cardiac or do per diem locally at another hospital while you have this time available to you.

Personal decision about wife working. There are always sub and tutoring jobs available so that shouldn't be a problem. Insurance for two will be costly so extra money just for that would be a plus.

[8-ball, BSN]

Thanks for the reply, yes I see the tax benefit I was basically going to do that to pay off some debt while we still had 2 incomes. I really want to work in the ICU as well I kinda miss it. We currently live small below our means our mortgage is about $700 month in a 1300 sq ft home so I think we will keep the tax home thing. We will start traveling for real once she is done. perhaps I will need to travel without her in the beginning.

[NedRN]

If her health insurance covers you both at a subsidized cost, it might be worth keeping. Part time even.

[8-ball, BSN]

Thanks for the tip, as long as I can make at or more than $42/hour I will be happy.

[Argo]

she could consider being a "teacher" for one of the online schools like K-12 or Keystone. My sons teachers were all over the place even though the school is based in a particular state....

If you need $42/hr plus housing you will have to look at working in CA regularly or the rare other "hot/premium jobs" around the country that pay more but don't come up as often as CA. It is definitely doable though.

Think about doing the RV travel thing too. You can save some extra cash with that. Look at them with your wife before you discount the idea, they are very nice these days and you don't have to pack up every 3 months.

[NedRN]

Thanks for the tip, as long as I can make at or more than $42/hour I will be happy.

Are you aware of what health insurance really costs? You are probably looking at between $800 to $1,600 a month for insurance that covers both of you, with a $5,000 annual deductible.

[8-ball, BSN]

ARgo I have considered the RV thing, I think we will have to save some money first before something like that but its an option. NedRN no I wasn't aware of that kind of cost I will have to check into that. I am fine with getting insurance through the agency but then are you not tied to just one agency? Also with Obama care what if there is a gap in coverage between assignments isn't that a problem now?

[NedRN]

No, you are not tied to one agency. But most agencies have crappy insurance and many to most don't have to provide insurance that meets ACA standards.

For an eye opener, ask your the benefits person of your current employers what the COBRA cost of your insurance is. That is the real cost. You can maintain that insurance after you leave employment for up to 18 months at that price, and do the same thing with agency insurance (if they are large enough where COBRA is required - 20 plus employees) and you like it. But you are probably better off getting insurance on the exchange. The cost does vary quite a bit from state to state - if TN has their own exchange, it will cost less than the federal exchange - and you have to make sure you have decent coverage outside of TN too, policies vary a lot on that.

Theoretically, you cannot really have gaps per the COBRA law if your gaps between employment is less than 90 days or so. You have to take the right steps to make this so, and there are caveats, such as an agency being subject to COBRA in the first place. You'd be surprised how many agencies have less than 20 FTEs or have managed otherwise to wiggle out of the law. That won't be an issue with a large agency, and they should also be covered by the ACA and are required to supply insurance (but may be grandfathered in and not have to meet ACA standards - which doesn't make it bad insurance necessarily).

[8-ball, BSN]

So I just talked to my recruiter she said its about $1850 biweekly for me but to add my wife in there it will cost an additional $190 so we are looking at $210 every 2 weeks or $420 a month, that's half my mortgage. WOW I didn't see your post about the COBRA before calling her so I didn't ask that but I may need to. I wonder if my wife can get some sort of unemployed insurance since she will probably not be working. She is about to be 50yr so I dont think she qualifies for early retirement stuff yet.

[NedRN]

So I'm not sure you are really getting this insurance thing. As a staff employee, both you and your wife are getting heavily subsidized insurance as a benefit. The true cost if you ask your employer(s) for the COBRA cost (which represents the real cost they are paying plus a 2% administration fee) is going to shock you. It will not be less than $400 a month each for group health, and may be more than double that.

So for most employees, the cost of health insurance is hidden. Becoming a contract employee, it becomes much more clear that (just like a staff employee), insurance is really part of your pay. This is because of the way your pay is generated. Unlike your permanent employer, an agency only can pay you from what they bill a hospital per hour for your work. That is a limited pot of money. If you get good insurance, your hourly or housing compensation will suffer in direct proportion.

Your agency did not actually quote you insurance cost, rather they told you what your estimated gross pay will be. So the insurance cost is hidden but it sounds like it is $400 (less than good insurance usually costs) - yes, you can ask about COBRA costs with the agency too if they are not revealing the cost to you. If insurance is important to you and you want to use agency insurance rather than getting your own, you would do well to get a copy of the policy before committing to the job.

You would also do well to shop around for other agencies. Your summary in post one implies that you are onboard with this, but it sounds like you only have info from one agency. Besides pay, you also shop for service, assignments, communication, logistics, and in your case, perhaps insurance too. That is a lot of eggs to put in one basket.

[8-ball, BSN]

Thanks Ned, There was a typo in that post it should have said $18.50 not $1850...Either way I agree I haven't talked to other agencies yet and yes I plan to do that. I still have time as I will not be taking an assignment till well after the new year. If you don't mind me asking what do you do for insurance? I am a healthy person and don't plan on really using it but you never know. I am one of those people that plan and think way ahead of time, I just want to have all my bases covered before I start.