Health Insurance for Travel Nurses in Montana
Most travel nurses in Montana are paid in ways that leave them shopping for their own coverage, whether they work around Billings 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. Montana Marketplace premiums are rising 22.6% to 23.3% on average for 2027, so the private option is worth pricing first.
Private health insurance in Montana
Most travel nurses I help in Montana 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. Montana Marketplace premiums are rising 22.6% to 23.3% 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 Montana 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 quoteLearn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace
Montana health insurance in 2027
Montana has one of the largest finalized 2027 increases among my states: about 23 percent in the individual market, with small-group plans up about 18 percent. Montana's market is also among the smallest, with just two insurers filing individual plans.
- Marketplace rates: up 22.6% to 23.3% on average for 2027 (final), with 2 insurers filing.
- Benchmark silver plan, age 40: $889 a month in 2027, up from $692 in 2026.
- The subsidy cliff in Montana: earning $1 over $63,840 costs a single 60-year-old about $16,130 more a year for that plan, and $1 over $86,560 costs a 60-year-old couple about $36,463.
- Where to enroll: HealthCare.gov. Open enrollment runs November 1, 2026 to January 15, 2027; choose by December 15 for coverage starting January 1.
More: Montana 2027 rate changes · 2027 subsidy cliff by state. General information, not tax advice.
How travel nurses work in Montana
Montana nurses are unusually ready to travel on paper: 66 percent of the state's RNs hold a multistate license, compared with 36 percent nationally, although about 80 percent of those holders say they have never used it. Nurses who take 1099 contracts directly should know Montana's rule for independent contractors. Under MCA 39-71-417, they need an Independent Contractor Exemption Certificate or their own workers' compensation coverage. Between contracts there is no employer plan, so even a few weeks off can leave a nurse uninsured unless a personal plan is already in place.
Montana licensing for travel nurses
The Montana Board of Nursing, part of the Department of Labor and Industry, served 29,716 licensees as of June 2025 and issued 4,689 new licenses that fiscal year. Montana joined the Nurse Licensure Compact on October 1, 2015 and has issued multistate licenses under the current compact since January 19, 2018. A nurse holding a multistate license from another compact state needs no Montana license but must apply within 60 days of making Montana a primary residence. Others apply by endorsement under MCA 37-1-304, which requires an active license from a state with substantially equivalent standards.
The Montana market for travel nurses
Montana's Department of Labor and Industry counted 23,000 actively licensed RNs in 2024, up from 20,000 in 2022, partly because nurses moved into the state, while licensed practical nurses fell to 2,200. RN unemployment was just 2.1 percent, and nearly a quarter of RNs plan to retire or leave the field within five years. A 2025 University of Montana workforce report found RNs lead health job postings at about 1,128 a month and said rural and frontier counties keep losing nurses to Missoula and Yellowstone counties, home to Billings.
Montana coverage rules that apply to you
- Leaving a job: Montana has no general continuation law for people who leave a small employer; its law only lets a worker whose hours drop below the plan's minimum keep group coverage for up to one year, with the employer's consent and at the group rate.
- Short-term plans: Montana does not limit the duration of short-term plans in its own law, so federal rules govern, and federal agencies are not prioritizing enforcement of the four-month federal limit.
- Where to enroll: Montana uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 22.6% to 23.3% on average. See the Montana 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 Montana
Private plans priced first, with the Marketplace alongside when it fits. No fee.
Questions from Montana travel nurses
What license do travel nurses need in Montana?
The Montana Board of Nursing, part of the Department of Labor and Industry, served 29,716 licensees as of June 2025 and issued 4,689 new licenses that fiscal year. Montana joined the Nurse Licensure Compact on October 1, 2015 and has issued multistate licenses under the current compact since January 19, 2018. A nurse holding a multistate license from another compact state needs no Montana license but must apply within 60 days of making Montana a primary residence. Others apply by endorsement under MCA 37-1-304, which requires an active license from a state with substantially equivalent standards.
How much are Montana health insurance premiums rising for 2027?
Individual-market premiums in Montana are set to rise 22.6% to 23.3% 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 Montana?
Montana has no general continuation law for people who leave a small employer; its law only lets a worker whose hours drop below the plan's minimum keep group coverage for up to one year, with the employer's consent and at the group rate. 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: lmi.mt.gov, www.umt.edu, boards.bsd.dli.mt.gov, erd.dli.mt.gov. Facts checked October 2026. See all Montana health insurance rules.
Travel Nurses in other states
Written by Frank Caballero, licensed health insurance agent in Montana and 30 other states, NPN 21032307.