Health Insurance FAQs for Locum Tenens Clinicians
These health insurance FAQs cover what 1099 CRNAs and locum tenens physicians ask most: private PPOs, COBRA, the Marketplace, enrollment deadlines, taxes and the terms on your policy. Search, or pick a topic.
8 questions
Locum Tenens and 1099 Questions
The questions that come up when you work 1099 and no employer stands behind your coverage.
Do locum tenens agencies provide health insurance?
Usually not when you are paid on a 1099. As an independent contractor you arrange your own health coverage, the same way you handle your own taxes and retirement. Some agencies give you access to a group or association plan, and W-2 locum arrangements can include benefits, so ask which one you are being offered before you sign.
Whatever the agency offers, a policy you own stays with you when the assignment, the facility or the agency changes.
My recruiter says the agency has a health plan. Should I take it or get my own?
Look at it before you decide. Ask three things: what kind of network it uses (many agency plans are HMOs or regional networks), whether it works in the states where you take assignments, and what happens to it when the contract ends or you change agencies.
Then compare it with a plan you own. Sometimes the agency plan is the right call, and we will tell you if it is.
Going 1099 as a CRNA? Health insurance for 1099 and locum CRNAs
A facility or doctor’s office says it can’t bill my plan. What now?
It happens with private PPOs, because front-desk staff look for the handful of plan names they see every day. Start with your ID card. It shows the network your plan uses and the claims address or payer ID the billing office needs. Ask them to look up the network named on the card, and if they are still unsure, to call the provider phone number printed on it.
If you are our client, call or text us before you pay the bill yourself. Sorting out network and billing questions with the office and the carrier is part of what we do after you enroll.
Will my coverage follow me to an assignment in another state?
With a nationwide PPO, yes. You use the same network in your home state and in your assignment state. Many Marketplace plans and HMOs use local or regional networks, and outside that area they may cover emergencies only.
Two things to verify before you enroll in any plan: the hospitals and doctors near your assignments are in the network, and the plan is available where you legally live.
How do I avoid losing coverage between contracts?
If you own your policy, nothing happens between contracts. It continues as long as you pay the premium, whichever agency or facility comes next.
If your coverage is tied to a job or an agency, plan ahead. When a contract is ending, we can line up your next policy to start the day your current one ends. With proper planning you shouldn’t go a single day uninsured.
I’m leaving a W-2 job for 1099 work. When should I sort out health insurance?
Before your last day, ideally a month or two ahead. Ask HR for the exact date your employer coverage ends (often your last day or the end of that month) and for the COBRA price in writing. A private PPO application includes health questions and takes a little time to approve, and you want that answer before the old plan stops.
See the timeline: your 60-day window after employer coverage ends
I missed Open Enrollment. Can I still get health insurance?
Often, yes. ACA Marketplace plans are limited to Open Enrollment unless you have a qualifying life event, such as losing employer coverage, moving, getting married or having a baby. That opens a Special Enrollment Period, usually 60 days.
Private PPOs enroll year-round, but you have to pass a health questionnaire. Short-term plans are also sold year-round in many states.
Is a health-sharing plan the same as health insurance?
No. A health-sharing ministry or membership is not insurance. There is no policy that obligates it to pay your bills, and it isn’t regulated the way insurance is. Major-medical insurance is a contract with a licensed carrier, with a defined out-of-pocket maximum.
Sharing plans can cost less, and some people choose them knowingly. Just know which one you are buying. The private PPOs we place are insurance policies.
12 questions
Private PPO Basics
How private, medically underwritten PPO plans work, and who they fit.
What exactly is “private” health insurance?
Private health insurance is coverage you purchase for yourself — not through an employer or a government exchange. You choose the benefits, doctors, and networks, and you can usually keep the plan as your work or location changes. For people who travel, switch contracts, or work independently, this flexibility can make all the difference.
Who is private insurance really for?
It’s a strong fit for relatively healthy people without consistent employer coverage, including 1099 CRNAs, locum tenens physicians, and small business owners. Many private plans are medically underwritten, which often means lower monthly premiums and stronger benefits for generally healthy applicants. The tradeoff: certain conditions might be excluded, or an applicant may be declined based on health history.
What makes private PPO plans different from Marketplace plans?
Marketplace (ACA) plans are typically tied to your home state and often have smaller, more restrictive networks (some states do offer PPOs on the exchange). Private PPOs usually provide nationwide access, so you can see hospitals and specialists around the country without being out of network.
Are private PPOs legitimate health insurance?
Yes. These are real insurance policies underwritten by licensed carriers. The key is working with a broker who vets reputable options — not every plan that calls itself a PPO truly operates like one.
What does “nationwide PPO” actually mean?
Nationwide Preferred Provider Organization coverage means you aren’t locked into one state or system. If you live in Texas and accept an assignment in Colorado or Florida, you can still use in-network doctors and hospitals there without paying out-of-network rates.
Why is everyone talking about nationwide PPOs right now?
Clinicians are more mobile than ever, especially 1099 CRNAs and locum tenens physicians. A nationwide PPO means your plan travels with you, delivering peace of mind wherever you practice.
Can I keep a private plan if I move?
In most cases, yes. That’s a major advantage — your coverage can travel with you, so you don’t need to restart deductibles or jump into a new state-bound plan mid-year.
Are private plans more expensive?
They can be, and sometimes they cost less. For generally healthy people who don’t qualify for a subsidy, a private PPO often compares well with COBRA or a full-price Marketplace plan once networks, deductibles, and real out-of-pocket costs are side by side. It isn’t cheaper for everyone, which is why we compare all three before recommending anything.
How fast can I start coverage?
It depends on the plan and underwriting level, but many private policies can begin within a few days. You can also select a start date to avoid gaps. Most plans, regardless of type, begin on the first of the month.
What is medical underwriting?
It means the insurance company looks at your health before it offers you a policy. You answer a health questionnaire, and the carrier can approve you, approve you at a higher price, exclude a condition, or decline.
It is how private PPOs keep premiums lower for generally healthy people. ACA Marketplace plans are not underwritten: they cannot ask health questions or turn you down.
Do private plans cover pre-existing conditions?
It depends on the plan. ACA Marketplace plans must cover pre-existing conditions. Private PPOs are medically underwritten, so a condition can be excluded, priced higher, or lead to a decline. We tell you plainly where you stand before you apply, and show you the alternatives if private coverage isn’t a fit.
What makes Norwood Health’s plans different?
We don’t just sell plans; we help you understand them. Our focus is on 1099 CRNAs and locum tenens physicians: people who are mobile, between contracts, or managing 1099 income. Every plan we recommend is something we’d feel confident putting our own family on.
13 questions
COBRA, Marketplace and Enrollment Rules
Leaving a W-2 job starts a clock. These are the rules and the deadlines.
What exactly is COBRA?
COBRA is a federal law that lets you stay on your former employer’s health plan after leaving a job — but you pay the full premium (your portion plus your employer’s). Coverage can last up to 18 months and is generally solid, but it’s often very expensive.
Why do so many people look for COBRA alternatives?
Because COBRA is a short-term bridge, and you pay the whole premium yourself: your share, the share your employer used to pay, and an administration fee of up to 2%. For many people a private PPO or a Marketplace plan costs less for similar coverage, so it is worth comparing before you elect.
What happens if I lose my job or contract and don’t elect COBRA?
You qualify for a Special Enrollment Period (SEP), which allows you to choose another plan — Marketplace or private — without waiting for Open Enrollment. You usually have 60 days from the date coverage ends.
If I miss that 60-day window, am I out of luck?
For ACA Marketplace plans, yes. You’d typically wait until the next Open Enrollment, which opens November 1 (the closing date depends on the year and your state). Depending on your health and situation, private PPOs or short-term coverage may still be available to start right away.
Can I switch from COBRA to a Marketplace plan later?
When COBRA runs out, yes: that triggers a 60-day Special Enrollment Period. If you drop COBRA on your own, or stop paying for it, that does not open one, and you would wait for Open Enrollment. Always check the timing before you cancel.
Can I have COBRA and a private plan at the same time?
Technically yes, but it’s rarely practical — you’d be paying for two full policies and one would likely be secondary. Most people move from COBRA to a more affordable long-term plan instead.
What is a Marketplace plan, and how do I sign up?
Marketplace (ACA) plans are available through Healthcare.gov or your state exchange. You can enroll during Open Enrollment (it opens November 1; the closing date depends on the year and your state) or during a Special Enrollment Period for qualifying life events (losing coverage, marriage, moving, etc.).
What if I make too much to qualify for ACA subsidies?
You can still buy a Marketplace plan — you’ll just pay the full premium. That’s often when private PPOs become competitive, since you’re no longer receiving a discount and can choose from a wider range of options.
What are short-term medical plans?
They’re temporary policies designed for a few months — perfect between jobs, contracts, or major life changes. They’re usually affordable and quick to start, but they aren’t full ACA coverage and may not include benefits like maternity or preventive care. How long you can keep one, and whether they are sold at all, depends on your state.
Are short-term plans bad?
No — they just have a different purpose. They’re ideal for healthy people who need coverage while waiting for a new job, contract, or policy to begin. We’ll be clear on what they do and don’t cover.
What about joining my spouse’s plan instead of getting my own?
That’s a solid option. Losing your coverage qualifies you to join a spouse or partner’s employer plan mid-year. If the premiums and network fit your family, it can be the simplest path. There is a deadline to join, often 30 days after you lose coverage, so ask your spouse’s HR right away.
What are small-group or association health plans?
They’re programs for people who work independently or run small businesses but want access to coverage similar to larger employers. Examples include member programs like LifeX and Detego, which can deliver stronger benefits and pricing by pooling professionals.
Are small-group plans better than individual ones?
Sometimes. Group coverage can offer richer benefits and more stable pricing. Individual plans can be more flexible if you move or work solo. We’ll help you compare both for your situation.
10 questions
Business Owners, Taxes and HSAs
For clinicians with an LLC or S-Corp and for small business owners. We don’t give tax advice, so confirm the details with your CPA.
I own a small business — can I get private coverage for myself?
Yes. Whether you’re an LLC, S-Corp, or fully self-employed, you can have your own health coverage that isn’t tied to an employer. It’s a smart way to protect both your personal and professional life. That includes locum clinicians who work through their own LLC or S-Corp.
Can I offer coverage to my employees, too?
Absolutely. You can extend private or small-group coverage to your staff — even with just a few employees. It’s often more flexible and affordable than traditional group plans and shows your team you care about their well-being.
Why is private coverage good for small business owners?
Control. You aren’t stuck with rigid corporate plans, steep annual increases, or limited networks. You can choose options that match your business size, budget, and people.
Can different employees have different plans?
In some setups, yes. If employees work in different states or have different needs, we can help structure options that make sense for everyone while keeping costs predictable.
What happens if I add or lose employees mid-year?
Your plan can adjust. That’s the beauty of private coverage — it grows or shrinks with your business instead of locking you into a fixed structure.
Can my health insurance be tax-deductible?
In some cases, yes — but it depends on your situation. Many self-employed people can deduct premiums, but it’s not guaranteed. Always check with a qualified tax professional.
Does Norwood Health give tax advice?
No. We provide general education and guidance, then point you to licensed tax professionals for official advice based on your situation.
What is an HSA and why do people like them?
An HSA (Health Savings Account) lets you set aside money tax-free for qualified medical expenses. Funds roll over year to year and the account is yours to keep — it’s a popular way to manage healthcare costs more efficiently.
Who qualifies for an HSA?
Only people enrolled in an HSA-qualified High-Deductible Health Plan (HDHP). Not every plan qualifies — we’ll help you identify which ones do and whether it’s a good fit for your needs.
Deductible vs. Out-of-Pocket Maximum: What’s the Difference?
The deductible is what you pay before coverage begins. The out-of-pocket maximum is the most you’ll pay in a year for covered services. Between the two, you pay only your share of each bill (coinsurance). After you hit that max, insurance covers 100% of eligible costs for the rest of the year.
| What to compare | Deductible | Out-of-pocket maximum |
|---|---|---|
| What it is | The amount you pay for covered care each year before your plan starts sharing the cost. | The most you will pay in a year for covered, in-network care. It is your worst-case number. |
| What counts toward it | What you pay for covered services. Monthly premiums don’t count, and on many plans copays don’t either. | Your deductible, your coinsurance and usually your copays. Premiums and out-of-network bills don’t count. |
| When you reach it | You and the plan split each bill. You pay your coinsurance share, the plan pays the rest. | The plan pays 100% of covered, in-network costs for the rest of the plan year. |
| Example | With a $2,000 deductible and a $5,000 surgery, you pay the first $2,000. | On the remaining $3,000 you pay your coinsurance, for example 20%, or $600. With a $4,000 out-of-pocket maximum, covered in-network bills that year can’t cost you more than $4,000 in total. |
| When it resets | Every plan year, usually January 1. | Every plan year, usually January 1. |
Example numbers only, not a quote or a plan design. Your policy’s schedule of benefits has your actual deductible, coinsurance and out-of-pocket maximum.
8 questions
Insurance Terms Explained
The words on your policy and your bills, in plain English.
What’s a deductible, and how does it actually work?
Your deductible is what you pay out of pocket before your insurance starts sharing costs. Example: with a $2,000 deductible and a $5,000 surgery, you pay the first $2,000; then insurance pays its portion of the remaining $3,000.
What is coinsurance?
Coinsurance is the percentage of costs you share with your insurer after meeting your deductible. With 80/20 coverage, insurance pays 80% and you pay 20% until you reach your out-of-pocket maximum.
What’s the difference between a copay and coinsurance?
A copay is a flat fee (e.g., $30 for a primary care visit). Coinsurance is a percentage of the cost (e.g., 20% of an MRI). Many plans use copays for routine visits and coinsurance for larger services.
What does “in-network” mean?
It means the doctor or hospital has a contract with your insurance company for discounted rates. Seeing in-network providers usually lowers your costs because prices are pre-negotiated.
What happens if I go out of network?
Your costs may be much higher or not covered at all, depending on your plan. This is why nationwide PPO access is valuable — you have more in-network options wherever you go.
What’s an EOB (Explanation of Benefits)?
An EOB is not a bill. It’s a summary from your insurer after you receive care, showing what was billed, what insurance paid, and what you may still owe. Review it before paying any medical bill.
What’s the difference between PPO, HMO, and EPO plans?
PPO (Preferred Provider Organization): See in-network doctors without a referral, and you can go out of network at a higher cost. Learn more about PPO plans on HealthCare.gov
HMO (Health Maintenance Organization): Stay in-network and get referrals from a primary doctor. Read the full HMO definition on HealthCare.gov
EPO (Exclusive Provider Organization): No referrals needed, but only covers in-network providers (except emergencies). See how EPO plans work on HealthCare.gov
What are preventive services, and are they covered?
Preventive services include routine checkups, screenings, and vaccines (e.g., annual physicals, bloodwork, mammograms). ACA-compliant plans cover preventive care at no cost when you use in-network providers. Private and short-term plans vary, so check the benefits before you enroll.
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Last reviewed September 2026. General education, not tax, legal or medical advice. Eligibility and benefits vary by carrier and state.
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