Health Insurance for Travel Nurses in Texas
Most travel nurses in Texas are paid in ways that leave them shopping for their own coverage, whether they work around Houston 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. Texas Marketplace premiums are rising 13.1% to 14.1% on average for 2027, so the private option is worth pricing first.
Private health insurance in Texas
Most travel nurses I help in Texas 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. Texas Marketplace premiums are rising 13.1% to 14.1% 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 Texas 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
Texas health insurance in 2027
Texas' finalized 2027 increase averages about 13 to 14 percent for the individual market, slightly under the national average, while small-group plans were approved as filed at about 17 percent. Texas has one of the most crowded markets in the country, with about 15 insurers filing and two leaving.
- Marketplace rates: up 13.1% to 14.1% on average for 2027 (final), with 15 insurers filing and 2 leaving.
- Benchmark silver plan, age 40: $737 a month in 2027, up from $661 in 2026.
- The subsidy cliff in Texas: earning $1 over $63,840 costs a single 60-year-old about $12,257 more a year for that plan, and $1 over $86,560 costs a 60-year-old couple about $28,716.
- 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: Texas 2027 rate changes · 2027 subsidy cliff by state. General information, not tax advice.
How travel nurses work in Texas
Travel nurses in Texas often take assignments of about 13 weeks through a staffing agency, then line up the next contract. Per diem and 1099 nurses pick up shifts on their own terms, but they get no employer plan at all. Texas lawmakers looked at making health care staffing agencies register with the state in 2023, but that bill died after clearing a House committee, so the agency contract sets most of the terms. Agency coverage often ends with the assignment, and a few unpaid weeks between contracts can leave a nurse uninsured or restarting a deductible.
Texas licensing for travel nurses
The Texas Board of Nursing licenses RNs and LVNs. Texas joined the original Nurse Licensure Compact in 2000 and implemented the enhanced compact on January 19, 2018, so a nurse whose home state is another compact state can work in Texas on a multistate license. Nurses from non-compact states apply by endorsement, and eligible applicants receive a one-time 120-day temporary license within about 15 business days of a complete application. A permanent license also requires a fingerprint background check and a passing score on the Texas nursing jurisprudence exam. Nurses who move to Texas have 60 days to apply.
The Texas market for travel nurses
Texas is short on nurses and expects the gap to widen. The state's Center for Nursing Workforce Studies projects that registered nurse demand will outrun supply by about 56,370 full-time nurses in 2036, leaving roughly 15.6 percent of demand unmet. The same work projects shortages in every region except the Panhandle. Hospitals in Houston, Dallas-Fort Worth, San Antonio and Austin employ the most nurses, but demand is climbing fastest in nursing homes, where RN demand is projected to grow about 70 percent by 2036, compared with about 26 percent in hospitals.
Texas coverage rules that apply to you
- Leaving a job: Texas requires insured group plans to offer state continuation for up to nine months to people not eligible for COBRA, or six more months after COBRA ends, at the group rate plus 2 percent. It does not apply to self-funded employer plans.
- Short-term plans: Texas defines short-term plans by reference to the federal rules, which set a three-month initial term and four months in total; federal agencies are not prioritizing enforcement of that limit while new rules are written.
- Where to enroll: Texas 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 13.1% to 14.1% on average. See the Texas 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 Texas
Private plans priced first, with the Marketplace alongside when it fits. No fee.
Questions from Texas travel nurses
What license do travel nurses need in Texas?
The Texas Board of Nursing licenses RNs and LVNs. Texas joined the original Nurse Licensure Compact in 2000 and implemented the enhanced compact on January 19, 2018, so a nurse whose home state is another compact state can work in Texas on a multistate license. Nurses from non-compact states apply by endorsement, and eligible applicants receive a one-time 120-day temporary license within about 15 business days of a complete application. A permanent license also requires a fingerprint background check and a passing score on the Texas nursing jurisprudence exam. Nurses who move to Texas have 60 days to apply.
How much are Texas health insurance premiums rising for 2027?
Individual-market premiums in Texas are set to rise 13.1% to 14.1% 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 Texas?
Texas requires insured group plans to offer state continuation for up to nine months to people not eligible for COBRA, or six more months after COBRA ends, at the group rate plus 2 percent. It does not apply to self-funded employer plans. 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: www.dshs.texas.gov, www.bon.texas.gov, www.bon.texas.gov, capitol.texas.gov. Facts checked October 2026. See all Texas health insurance rules.
Travel Nurses in other states
Written by Frank Caballero, licensed health insurance agent in Texas and 30 other states, NPN 21032307.