All occupations Travel Nurses · Maryland

Health Insurance for Travel Nurses in Maryland

Most travel nurses in Maryland are paid in ways that leave them shopping for their own coverage, whether they work around Baltimore or anywhere else in the state. Most of the ones I work with choose a private plan priced on their health, not their income, that can start any month if approved. Maryland Marketplace premiums are rising 14.6% on average for 2027, so the private option is worth pricing first.

Private health insurance in Maryland

Most travel nurses I help in Maryland end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.

Why people leave the Marketplace

Premiums keep climbing. Maryland Marketplace premiums are rising 14.6% on average for 2027.
The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
Surprise tax bills. Underestimate your income and you repay the tax credit in April.
Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.

What a private plan does differently

Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Maryland too. Networks vary by plan.
Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
Approval is based on health. You answer health questions, and acceptance is not guaranteed.

With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.

Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.

Get a private plan quote

Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

Maryland health insurance in 2027

Maryland's finalized 2027 individual-market increase averages about 14.6 percent, roughly in line with the national figure, and small-group plans rise about 10.2 percent. Maryland has used a state reinsurance program for years, which keeps its premiums lower than they would otherwise be, but it could not fully absorb 2027's cost pressures.

Marketplace rates: up 14.6% on average for 2027 (final).
Benchmark silver plan, age 40: $491 a month in 2027, up from $414 in 2026.
The subsidy cliff in Maryland: earning $1 over $63,840 costs a single 60-year-old about $5,988 more a year for that plan, and $1 over $86,560 costs a 60-year-old couple about $16,178.
Where to enroll: Maryland Health Connection, the state's own exchange, which sets its own 2027 enrollment dates.

More: Maryland 2027 rate changes · 2027 subsidy cliff by state. General information, not tax advice.

How travel nurses work in Maryland

Maryland regulates the agencies that place travel and per diem nurses. Under Health-General section 19-2001, a health care staff agency must be licensed by the Office of Health Care Quality before it refers RNs, LPNs or nursing assistants to Maryland hospitals and related facilities, and the Office can inspect agencies to confirm every nurse they place is properly licensed. Nurses may be placed as employees or independent contractors. When an assignment ends and the next one has not started, agency coverage often stops, so a 1099 nurse who plans for those gaps avoids going uninsured.

Maryland licensing for travel nurses

The Maryland Board of Nursing licenses RNs and LPNs. Maryland is a Nurse Licensure Compact state and implemented the current compact on January 19, 2018, so a nurse with an active multistate license from another compact state can work here and may keep working on it while a Maryland license is processed. If your license is from a non-compact state, you apply by endorsement, with a fingerprint background check and license verification through Nursys, and must submit the application within 48 hours of fingerprinting. Endorsement applicants without a multistate license can request a 90-day temporary license.

The Maryland market for travel nurses

A workforce study prepared for the Maryland Hospital Association estimated that Maryland was already short about 5,000 full-time RNs in 2021, meeting roughly 91 percent of demand. Without action, the gap is projected to reach 13,800 RNs by 2035, leaving supply at about 80 percent of need. The LPN picture is worse, with supply expected to meet less than half of demand. Every region of the state is projected to be short of RNs by 2035 except the Central region around Baltimore, so facilities outside the Baltimore area face the steepest gaps.

Maryland coverage rules that apply to you

Leaving a job: Maryland requires insured group plans, including those of employers with fewer than 20 workers, to offer up to 18 months of continuation to Maryland residents who leave a job voluntarily or are let go for reasons other than cause after three months of coverage. You have 45 days to elect it and pay the full premium plus up to a 2 percent fee.
Short-term plans: Maryland law limits short-term plans to less than three months with no renewals, which is stricter than the federal rule, so the federal enforcement pause does not change anything in Maryland.
Where to enroll: Maryland runs its own exchange, Maryland Health Connection. Maryland Health Connection sets its own open enrollment dates; check its site for 2027 deadlines. Private, medically underwritten plans can start the first of any month if approved.
2027 rates: individual plans 14.6% on average. See the Maryland 2027 rate page.

The gap between contracts

Agency health plans usually end when an assignment ends, sometimes on the last day of that week or month. If your next contract starts three weeks later, you are uninsured in between unless you plan for it. Losing agency coverage opens a 60-day Marketplace special enrollment period, and if approved, a private plan can start the first of any month, so either can bridge the gap. Many travelers keep their own plan year-round and decline agency coverage so they never face a gap.

Keeping your own plan across states

A nurse who changes states every 13 weeks needs a plan that works where the contract is. Nationwide PPO networks travel well. A Marketplace plan is tied to your tax home, so if you work far from home you may have only emergency coverage there. Check the network for each assignment city before you sign.

Per diem and 1099 nursing

Per diem and independent contract nurses buy their own coverage and pay self-employment tax. Estimate a full year of net income for the Marketplace, including stipends only if they are taxable. General information, not tax advice — confirm with your CPA based on your specific entity structure.

When the Marketplace still makes sense

The Marketplace fits travel nurses with a significant health condition, because acceptance is guaranteed, and households whose 2027 income stays under 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four), where a tax credit lowers the price. Above that line it costs full price. The full guide for travel nurses goes deeper.

Quote for a travel nurse in Maryland

Private plans priced first, with the Marketplace alongside when it fits. No fee.

Get a quote (786) 218-2384

Questions from Maryland travel nurses

What license do travel nurses need in Maryland?

How much are Maryland health insurance premiums rising for 2027?

Individual-market premiums in Maryland are set to rise 14.6% on average for 2027. Households above 400 percent of the poverty level get no tax credit and pay the full increase.

What happens to my coverage if I leave a job in Maryland?

Maryland requires insured group plans, including those of employers with fewer than 20 workers, to offer up to 18 months of continuation to Maryland residents who leave a job voluntarily or are let go for reasons other than cause after three months of coverage. You have 45 days to elect it and pay the full premium plus up to a 2 percent fee. Losing employer coverage also opens a 60-day Marketplace special enrollment period, and if approved, a private plan can start the first of any month.

Should a travel nurse take the agency's health plan?

It can work for back-to-back contracts, but coverage usually ends with the assignment. Nurses with gaps between contracts often keep their own plan instead.

Can a travel nurse buy a plan that works in every state?

Some private plans and some Marketplace plans use national PPO networks. Many Marketplace plans are local HMOs or EPOs, so check the network before you choose.

Sources: mhaonline.org, mgaleg.maryland.gov, health.maryland.gov, www.nursecompact.com. Facts checked October 2026. See all Maryland health insurance rules.

Written by Frank Caballero, licensed health insurance agent in Maryland and 30 other states, NPN 21032307.