Nurses nationwide are turning to freelance or contract work for greater flexibility and independence. That’s because per diem nursing, or working on an as-needed basis, can provide a nurse with one of the most valuable gifts: work-life balance.
Being your own boss is awesome. However, there is a catch: You are likely to have to find yourself private health insurance. Since you will be intervening on a per diem basis, most healthcare facilities will not provide you with employer-sponsored health insurance, so you will have to cover that on your own.
Getting your own health insurance is no easy task. A quick Google search will reveal thousands of articles, pages, and advice on how to best navigate this labyrinth of healthcare plan choices. Even so, a poll by PhRMA/Ipsos reviewed in Healthcare Finance shows that most Americans worry about insurance coverage costs.
Here’s the silver lining: As per diem contracts become more appealing to professional nurses across the country, health insurance companies are adjusting their policies to suit the needs of contract workers. This eases the headache of finding health insurance for per diem nurses.
Luckily, we've already done some legwork for you. Keep reading for a simple guide for navigating the complexities of securing health insurance as a per diem nurse.
This article is primarily based on information from HealthCare.gov, the official website of the U.S. Centers for Medicare & Medicaid Services.
Do I really need health insurance as a nurse?
Health insurance helps mitigate medical expenses and gives nurses access to essential health services. Strictly speaking, no one needs health insurance although there are many advantages to having it. Nurse employees typically get health insurance through their jobs. However, since PRN nurses are self-employed, they must get their own insurance if they wish to have it.
But I am fit as a fiddle. Why should I bother?
No one is invincible; you really never know what will happen. Even if you have next to zero medical costs on a “normal” day, accidents can and do happen. Whether for small health expenses that accumulate over time, an accident, or a medical emergency, paying out of pocket for healthcare can lead to serious financial distress.
The bottom line? Health insurance for independent contractors can protect your health and finances, allowing you to live and work more serenely, knowing that if anything happens, you are covered.
What are some important insurance terms to be aware of?
Per diem nurses typically have to pay out-of-pocket for health insurance for themselves and their families. To make the best, most informed choice, you should first ask yourself, “What is my budget?” and "What are my specific healthcare needs and preferences?" Answering these questions will help you determine the most cost-effective and suitable nurse health insurance plan for you and your family.
But before diving into all that, here are some important insurance terms to understand and be aware of:
Premiums
Health insurance premiums are regular payments made to insurance companies by individuals or employers for healthcare coverage. Usually paid monthly, these payments vary based on age, location, and chosen coverage level, among other factors.
Deductibles
Deductibles are predetermined amounts that individuals must pay before insurance coverage starts when dealing with specific medical expenses. Once individuals pay the deductibles, the insurance providers begin sharing the costs of medical expenses according to the policy terms.
Copayments
Copayments are predetermined out-of-pocket payments insured individuals must make for medical services or prescription drugs when they receive care. The insurance plans determine the amounts the insurance companies and the insured must pay. This predetermined amount is usually calculated as a percentage. For example, with your plan, you may pay 25 percent of hospital charges.
Out-of-pocket maximums
These are the annual maximums the insured must pay for eligible healthcare services. Once individuals reach this threshold, insurance companies must—and are legally bound to—pay 100 percent for covered services for the rest of the planned year.
Before choosing an insurance policy, you should have a good idea of estimated yearly costs by factoring in the abovementioned payments.
Now, on to the fun stuff: choosing the right health insurance for you.
Do PRN nurses get employer-sponsored health insurance?
No, PRN or per diem nurses do not typically receive employer-sponsored health insurance from the healthcare facilities where they pick up shifts.
In most cases, hospitals and other healthcare facilities do not formally employ PRN nurses. This work model exempts healthcare providers from offering an employer-sponsored healthcare insurance option.
As a result, some per diem nurses may choose to forgo health insurance altogether. However, going without health insurance has risks.
Why do per diem nurses need health insurance?
Health insurance for nurses who work as independent contractors is important because it provides individuals with financial protection in case of unexpected medical expenses. Even if you are “healthy as a horse,” you don’t want to risk paying out of pocket for healthcare. Without health insurance, your prescription drugs, regular doctor visits, or—even worse—a catastrophic emergency could land you with an enormous medical bill. Ah, no thanks, right?
Therefore, you should consider obtaining health insurance if you’re going to work solely on a per diem basis. Health insurance can help cover medical expenses, including routine check-ups, medications, and emergency care, ensuring that PRN nurses have access to necessary services.
What’s out there? Health insurance for PRN nurses
Advancing technology is making independent contract work more popular than ever. Consequently, more and more health insurance companies offer affordable plans that cater to the needs of these independent workers.
Purchasing good health insurance is an investment in your present and future wellbeing. However, just as you wouldn’t buy a car or a house before researching thoroughly, selecting a PRN health insurance plan on the spur of the moment is not a wise decision.
The best course of action for a per diem nurse looking for health insurance is to begin “comparison shopping.” With this in mind, it is critical to carefully evaluate healthcare providers’ coverage, costs, and networks of medical providers when choosing health insurance.
To make things a bit easier on you, read on for a comprehensive list of different available options.
Categories of health insurance plans
Health insurance plans in the U.S. are organized into four different categories: Bronze, Silver, Gold, and Platinum. While these categories have nothing to do with the quality of the care you will receive, they represent differing costs in terms of premiums, deductibles, copayments, and maximums.
For example, Bronze plans tend to have high deductibles, while Gold and Platinum plans have lower deductibles. Catastrophic plans are a fifth category of health plans that may be accessible to those under 30 and those with lower incomes.
All of these categories fall under the Affordable Care Act (ACA), which helps consumers understand what they can expect regarding the different premiums and out-of-pocket costs for each plan. When choosing private or public health insurance as an independent contractor nurse, make sure to take into account these four levels to choose the best policy for you.
Private insurance coverage plans
Private insurance plans are marketed by private companies rather than governmental agencies. Nurse contract workers can purchase individual health insurance plans directly from providers or the Health Insurance Marketplace, the federal government’s health insurance exchange service.
These marketplaces were created in the United States as part of the Affordable Care Act to give consumers a straightforward, centralized approach to compare health insurance plans and enroll in one that fits their needs.
Private health insurance may be a good choice for the following individuals:
- Nurses who have incomes that are sufficient to cover premiums
- Nurses with pre-existing conditions
- Nurses with families
- Nurses who want complete and thorough coverage
- Nurses who are looking to avoid coverage gaps and receive high-quality care tailored to specific medical needs
Many of these plans offer coverage for medical expenses, including doctor visits, hospital stays, and prescription medications. Private health insurance costs vary depending on factors such as age, location, and coverage level, but there are no gaps in coverage.
Knowing they will be covered no matter what can reassure per diem nurses. However, some individual plans may have high deductibles and copayments. In other cases, delayed enrollment may occur due to pre-existing conditions.
The final verdict? Even though private insurance coverage plans are typically more expensive than other types of insurance, the peace of mind you will have knowing you are always covered can be well worth the price.
Agency-provided health insurance for nurses
Some PRN nurses work for staffing agencies and may have health insurance coverage through these agencies. Whether the agencies provide health insurance depends on whether they pay nurses directly or receive a commission from the healthcare facilities that contract the PRN nurses.
If you work with an agency, it's always a good idea to inquire about any available benefits and health insurance plans.
Supplemental health coverage
Did you know an X-ray alone can cost upwards of $1,000, depending on where you are and the type of scan?
If you are a nurse, you may, in fact, be aware of this. Accidents can happen, so why risk paying high costs out of pocket?
A supplemental health insurance plan is one that you can subscribe to to complement an existing plan, allowing you coverage that your plan doesn’t include. These include specific insurance for accidents, cancer treatments, or even dental insurance.
Supplemental health coverage plans may be good for nurses who meet the following criteria:
- Work in high-risk environments
- Want to add on to their already existing healthcare plans
- Want to be prepared and covered in the event of an emergency and don’t want to be responsible for paying exorbitant out-of-pocket amounts
If you are looking for a bit more coverage than what your current health insurance offers, you can always add supplemental health coverage for your specific needs.
Supplemental health coverage with Nursa and Hooray Health
At Nursa, we are aware that many nurses picking up shifts on our platform do not have health insurance or wish to have additional coverage.
To simplify things for our nurses, we have partnered with Hooray Health to offer health insurance plans that cover per diem nurses’ everyday medical needs.
Hooray Health offers plans starting at just $15 monthly, covering medications, sick visits, and accidental injuries at lower out-of-pocket costs.
Where do I sign up, you ask? Prepare for unexpected accidents and medical emergencies that may arise, and learn more about getting supplemental insurance with Nursa and Hooray Health here.
The final verdict: Life is unpredictable, and accidents happen. Supplemental insurance can enhance your private or public insurance plan and provide an extra layer of financial protection in the case of an emergency.
Short-term health insurance
Contract nurses who cannot pay most health insurance premiums may find short-term plans a good alternative. Short-term health insurance plans often offer much lower premiums than regular healthcare plans. These short-term plans typically offer coverage for only a few months to a year.
Short-term health coverage plans are good for nurses who meet the following criteria:
- Are between jobs or nursing assignments
- Need quick and affordable coverage for a limited time
- Work per diem full time and don’t have access to an employer-sponsored health insurance package
Another factor to consider is that short-term healthcare plans typically offer minimal benefits. In general, short-term health plans aim to replace coverage in the event of a job change or while awaiting enrollment in an alternative health insurance plan.
The final verdict? Short-term health insurance is an option for nurses who need immediate coverage between contracts. They commonly have low premiums and can be tailored to your specific needs. However, most short-term health insurance plans do not cover individuals with pre-existing conditions or offer family coverage options.
COBRA: Consolidated Omnibus Budget Reconciliation Act
If you are a nurse and have just recently left a job where you had a health insurance plan, you may be eligible for COBRA. COBRA falls under a federal law that lets workers keep their group health insurance for a limited period via a qualifying event.
COBRA health coverage plans may be good for the following individuals:
- Nurses who have recently lost their jobs
- Nurses who want to take a medical leave of absence
- Nurses who are getting close to retirement
- Nurses who are expecting to have ongoing health issues and will need care
COBRA could be appropriate health insurance for nurses who are between jobs or have recently lost their jobs along with their job-based coverage. However, one major drawback of COBRA is that it is expensive. The average COBRA premium can cost $400 to $700 monthly per person.
Final verdict: COBRA could be an interesting short-term solution while you test the waters of per diem nursing or until you find your ideal healthcare plan; it comes at a price—literally. Short-term healthcare solutions or catastrophic insurance plans could be more appropriate for your situation.
Catastrophic insurance plans
Catastrophic insurance plans have low monthly premiums but high deductibles. These plans are designed to cover major medical events, such as car accidents or severe illnesses, rather than routine or preventive care.
Catastrophic insurance plans may be good for the following individuals:
- Nurses who want safety nets in case of major medical emergencies to help cover high out-of-pocket costs
- Nurses who are younger or generally healthy and are only looking for protection for major medical emergencies
- Nurses who want lower monthly premiums
Catastrophic plans are generally accessible to younger people who are not eligible for subsidies under the Affordable Care Act. Catastrophic insurance is typically meant for the worst-case situations and unanticipated medical emergencies that could total thousands of dollars in medical bills.
The final verdict? Catastrophic insurance plans are excellent options for young and healthy individuals without chronic conditions and who don’t need regular care. If you are a nurse contractor looking for more specific and higher-quality care, there may be a better plan for you.
Should I get malpractice insurance as a nurse?
Nursing malpractice insurance is a type of insurance coverage that essentially protects a nurse from legal action or claims related to their professional services. Malpractice insurance cannot be used interchangeably with health insurance policies.
Malpractice insurance is a type of professional liability insurance that covers legal fees for a nurse in the event that a patient files a lawsuit against them.
If you are on the fence about getting malpractice insurance, you may want to check out this article: Do I need malpractice insurance as a registered nurse?
How to find health insurance for PRN nurses in your state
To begin your health insurance coverage independent of long-term employment contracts, visit the official HealthCare.gov website. There, you can start comparison shopping and find information about available plans, subsidies, and enrollment periods.
Alternatively, you can use non-government resources to compare different private insurance options from various providers.
Finally, consider visiting your state’s Department of Insurance website to get a list of local insurance brokers or agents who can guide you through the process and provide personalized assistance in finding the right health insurance plan for your needs.
The bottom line
If you are a per diem nurse, you are probably enjoying the advantages of your PRN status, such as more flexibility in your schedule, independence, and—in many cases—higher hourly wages. These advantages have made nurses around the country find joy in nursing again. Just remember that health insurance is vital to your overall wellbeing and financial security.
While navigating health insurance for per diem nurses may feel complex, when you find a policy that fits your needs, you can breathe a big sigh of relief.
Understanding your rights and the services you will receive from a competent insurance package is the first step in protecting you against unplanned and high medical costs. After that, you can focus on what matters most: your health and that of your patients.
Are you working as an independent nurse contractor?
Register with Nursa to pick up per diem nursing gigs in your local area and make a difference in your community by helping patients in need.
Sources:
- HealthCare.gov: Your total costs for health care: Premium, deductible & out-of-pocket costs
- HealthCare.gov: How to apply and enroll
- How to get insurance through the ACA Health Insurance Marketplace
- Healthcare Finance: Those in poorer health give lower ratings for their health insurance
- KFF: Marketplace health plans and premiums
