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Opt out of the agency plan?
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Opting out of agency coverage

Decline the agency plan? Run the numbers first.

Some agencies pay more when you decline their health plan. Some do not. Owning your own plan can be the better deal, or a costly mistake, depending on three numbers you can get in a day.

A simple way to compare the agency plan to your own coverage, dollar for dollar
Private plans on nationwide PPO networks priced for healthy travelers
What to keep from the agency even if you decline medical
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By Erik Moran, licensed health insurance broker (NPN 20970092) · Updated October 14, 2026
The math

Three numbers decide it

Quick answer

Opting out makes sense when the extra pay for declining, plus the value of no gaps and one steady network, is worth more than the agency plan's employer contribution. Get three numbers: your weekly pay with and without agency medical, the agency plan's premium and deductible, and the monthly price of your own plan. If you are healthy, price a private nationwide PPO plan as well as the Marketplace.

  1. The opt-out difference. Ask your recruiter for the package both ways. If declining medical raises your pay, multiply the weekly difference by the weeks you actually work in a year.
  2. The real cost of the agency plan. Your premium share, the deductible that resets with each new agency, and the months you lose coverage between contracts.
  3. The cost of your own plan for 12 months. Including the gaps, because your own plan does not stop.

If the opt-out difference covers most of your own premium, owning your coverage usually wins on continuity alone.

Be careful

When to keep the agency plan

  • You have a health condition or take maintenance medication. Private plans can decline or exclude it. A group plan cannot.
  • You work back to back with one agency. Gaps are not your problem, and employer money is hard to beat.
  • The agency does not pay more for declining. Then you are giving up a benefit for nothing.
  • You are pregnant or planning to be. Group coverage and Marketplace plans cover maternity; many private plans do not.

Also note: if your agency offers you affordable coverage that meets federal standards, you generally cannot get a Marketplace tax credit for the months it is offered, even if you decline it. That rule decides a lot of opt-out math.

The plain truth about private plans: the nationwide PPO plans we quote are private, medically underwritten plans, not Marketplace plans. A nationwide network means in-network doctors and hospitals in many states; it does not mean every service is covered. You answer health questions, and the carrier can decline you or exclude a condition. These plans are not ACA-compliant: depending on the plan, prescriptions, maternity, mental health and other benefits can be limited or left out, some benefits have dollar maximums, and out-of-network care costs more. We walk through exactly what a plan pays before you apply, and if a Marketplace plan fits you better, we tell you that too.
Keep the rest

What to keep even if you decline medical

Declining medical does not mean declining everything. Dental, vision, life and disability offered by your agency can still be worth taking, and some agencies let you pick them separately. If yours does not, we also offer life and disability insurance for travelers who want coverage that does not end with a contract.

Over or under the 2027 subsidy line?

Self-employed and 1099 income is counted after expenses. Our free calculator shows which side of the 400% line you land on in about a minute, with results right away and no sign-up.

Run the subsidy cliff calculator →
Questions

Questions we hear most

Do travel nurses get paid more if they decline agency insurance?

Some agencies raise the pay package when you decline benefits and some do not. Ask your recruiter for the package both ways before deciding.

Can I get a Marketplace subsidy if I turn down my agency's plan?

Usually not for months when your agency offers coverage that is affordable and meets minimum value standards, even if you decline it. Months between contracts, when no offer is in place, are treated differently.

What kind of plan do travel nurses buy on their own?

Healthy travelers often choose private medically underwritten plans built on nationwide PPO networks. Travelers with health conditions usually choose Marketplace plans.

Sources

Checked October 14, 2026. Rules and dates change; confirm before you act.

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