Even with no PPO options on the Texas marketplace, you can still arrange nationwide PPO coverage. I'll explain how travel nurses who call Texas home stay covered between assignments and find in-network care while working in other states.
Hi, I'm Sam Jaber. I work with travel nurses who want health coverage of their own. I'm licensed in 36 states, so whether you're calling from your place in Houston or staying in a furnished rental in Spokane, we can handle everything by phone.
Keeping your home address in Texas creates a challenge for travel nurses. HealthCare.gov determines your available plans using your home location, but your assignments can take you anywhere. That matters because the Texas marketplace doesn't offer a single PPO plan.
Enter a Texas zip code on HealthCare.gov, and you'll find 834 individual medical plans across the HMO, EPO and POS categories. What you won't find among them is even one PPO.
A nationwide PPO is still an option in Texas, and I can help you arrange one outside the marketplace. These private policies use medical underwriting, meaning your health questionnaire helps determine the price. Their provider networks extend across state borders, making them worth considering when you're healthy and your work keeps moving you around.
HealthCare.gov explains an important difference between these plans. With HMOs and EPOs, out-of-network treatment generally isn't covered unless it's an emergency. POS plans also require referrals for specialist visits. Your Texas HMO might serve you beautifully during six weeks at home, yet leave you paying for treatment when a sinus infection hits during an Oregon assignment.
Your income matters just as much. Premium tax credit eligibility is based on your household earnings over the entire coverage year, so how many weeks you're on assignment can change the result. Let's look at which situation describes you.
Losing that coverage qualifies you for a special enrollment period, usually lasting 60 days, when you can select a marketplace policy tied to your Texas address. You may also have COBRA available. Just remember that choosing to cancel COBRA later doesn't create another enrollment opportunity.
Before settling on gap coverage, think about your next assignment's location. Staying in Texas could make a local network perfectly workable. Heading to another state next month is different, because ordinary medical visits there might not be included in your plan's network.
Next step: Contact me before you finish that last shift, and we'll work out insurance that covers your break and stays useful when your following assignment begins.
If you're traveling this much, you're exactly the kind of nurse who should consider a nationwide PPO. Paying full marketplace premiums would otherwise leave you with coverage centered mainly on Texas providers.
Here's what happens with medical underwriting. You answer questions about your health, and the insurance company decides whether to accept you, decline you, or offer coverage excluding a specific condition. With a clean health history, you may find premiums below the marketplace's full price, along with network doctors and hospitals in the states where your assignments take you. I'll explain the benefits of every policy before you make a decision. And if you have an ongoing health condition, don't automatically dismiss private coverage. The details of that condition matter, and I'll compare both routes with you.
Next step: Schedule a phone conversation with me, and we'll compare the price of a nationwide PPO against the Texas marketplace options offered where you live.
Spending several months without assignments could lower your annual household earnings enough to qualify for a premium tax credit. When that happens, marketplace coverage generally offers the better price because those credits aren't available elsewhere.
The bigger concern comes when income falls even further. Below 100% of the federal poverty level, premium tax credits generally aren't available. Texas also chose not to expand Medicaid and limits parent eligibility to 15% of that level. With very little work during the year, you could fall into the gap between those programs.
Next step: Tell me which contracts you've already completed and which ones are coming up, and we'll calculate your expected year before submitting an application.
Straight answers, no sales pitch.
No. HealthCare.gov lists 834 individual medical plans in Texas, and not one of them is a PPO. If you're in good health, I can help you purchase a nationwide PPO privately.
In most cases, emergency treatment is the exception. Routine appointments outside the network generally aren't covered by HMO or EPO policies.
Once your agency coverage ends, that loss generally gives you 60 days to enroll in a HealthCare.gov plan through a special enrollment period. You can also consider COBRA.
Probably not. Because Texas didn't expand Medicaid and limits parents to 15% of the poverty level, a year with almost no income calls for careful planning.
Send me the Texas county you call home, your contract schedule for this year, and the names of anyone else needing coverage. I'll help you find a plan suited to your assignments and compare its price with what your agency offers.
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