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Tax home and your health plan
Tax homeWhich stateNationwide PPO
Tax home and your plan

Your tax home, your stipends and your health plan

The same address that keeps your housing and meal stipends tax-free is usually the state where you buy health insurance. Get it right once and both work. Get it wrong and you can lose both.

How the IRS tax home rule and health insurance residency line up for travelers
Why a plan built on your tax-home state's network leaves you exposed on assignment
Nationwide PPO options for healthy travelers in any of our 30+ states
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By Erik Moran, licensed health insurance broker (NPN 20970092) · Updated October 14, 2026
The tax side

What a tax home is, in one paragraph

Quick answer

Your tax home is your regular place of business or, for travelers, the permanent residence you maintain and return to. Travel stipends are generally tax-free only if you are working away from a tax home and paying duplicate living costs. For health insurance, you buy coverage in the state where you live, which for most travelers is that same home. Keep the two consistent and choose a plan whose network works where you take contracts.

The IRS treats an assignment at one location as temporary when it is realistically expected to last a year or less. Work at one location expected to run longer than a year is indefinite, and that location can become your tax home. Travelers with no regular home they maintain are treated as itinerant, with no tax-free travel expenses at all. This is a tax question first, so confirm your situation with a tax preparer who works with travelers.

The insurance side

Why your home state's plans can strand you

Marketplace plans are certified by service area, and most are HMOs or EPOs built around that area's hospitals. A Robert Wood Johnson Foundation review of 2025 plans found PPOs were only about 14% of Marketplace plans, and 37% of Americans lived in a state with none. For a traveler, that means a plan bought at home can treat your entire 13-week assignment as out of network for anything short of an emergency.

Options that hold up on assignment:

  • An agency plan with a national network, while you are on contract with that agency.
  • A private plan built on a nationwide PPO network, if you are healthy enough to qualify.
  • A Marketplace PPO, in the states that still offer one, if you qualify for a tax credit or have a condition to cover.
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.
Stay consistent

Keep your paperwork telling one story

  • In most cases, your driver's license, voter registration, tax returns and health insurance address point to the same home state. If yours do not, get advice from a tax preparer before you apply, because the tax-home test and insurance residency are related but not identical.
  • Keep paying the costs of that home while you travel. Duplicate expenses are part of the tax-free stipend test.
  • If you move your tax home, that move can be a qualifying event for a new Marketplace plan if you had coverage before.

Over or under the 2027 subsidy line?

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Questions

Questions we hear most

Which state do travel nurses buy health insurance in?

Usually the state of their permanent residence, which for most travelers is also their tax home. Plans are sold by state and service area, even though you work elsewhere.

Does my health insurance work on a travel assignment in another state?

On Marketplace and other ACA-compliant plans, emergencies are covered anywhere. Routine care depends on the network: many Marketplace HMOs and EPOs pay nothing out of area, while plans on national PPO networks have in-network providers across the country.

Can a travel nurse without a tax home get tax-free stipends?

Generally no. The IRS treats travelers without a tax home as itinerant, and travel expenses are only tax-free when you are away from a tax home. Talk to a tax preparer who works with travelers.

Sources

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

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