Health insurance for locum tenens physicians (& CRNAs)

Ryan Michalek, Licensed Health & Life Insurance Agent · NPN 21043091 · Last updated September 15, 2026

Why 1099 locum work changes the coverage question

Working locum tenens means you're an independent contractor, not an employee — 1099, not W-2 — and that one fact changes everything about coverage. The staffing agency places you and pays you, but it isn't your employer in the benefits sense; there's no company plan behind you between assignments. What you get instead is a plan you own outright — on the individual market, in your name, not tied to any single facility or contract. That can feel like a step down from hospital benefits the first time you look at it. It isn't. It means your coverage doesn't end the day an assignment does, and it carries straight from one placement to the next. The mechanics here are the same as they are for any self-employed professional; the self-employed health insurance guide is the full walkthrough of options, subsidies, and the tax deduction. This page is about the parts that are specifically a locum provider's story.

Coverage that continues between assignments

The wrinkle that catches locum providers isn't a busy month — it's the quiet stretch between placements, when nothing is scheduled and it's tempting to let coverage lapse to save the premium. That's the one instinct worth resisting. A plan you own is built for exactly the in-between: it doesn't care which facility signs the next contract, it doesn't reset when an assignment ends, and it carries through the gap instead of leaving you exposed the moment you can least afford a surprise. Because your work can move you across state lines, it's also worth matching a plan's network to where you actually live and get care, not just where the current placement is. If a real break is coming — a stretch off, a transition — there are better levers than going uninsured, and mapping those before the gap opens is part of what I'm here for.

One of my travel-nurse clients sent a friend my way who was in almost the exact spot she'd been in. Her friend is a physician working locum tenens, moving between agencies — and every time she switched, she had to decide all over again whether to take the agency's coverage or pass on it. After a while she was just tired of it: new job, new plan, new paperwork, every single time. What she wanted was one plan that stayed put no matter which agency she was with, and went with her wherever the next assignment took her. So that's what we set up. She's switched agencies a couple of times since. Her plan hasn't.

1099 locum tenens options and what drives the price

As a locum provider you generally have two routes worth pricing side by side: a marketplace plan, which may come with an income-based subsidy, and a private under-65 plan bought directly. Here's the honest wrinkle for this field: locum work pays well, and a strong year of placements often puts a household past the point where a marketplace subsidy applies at all. That isn't a rate claim — it's just the fork in the road that quietly decides what fits. When you're paying full freight either way, the real question becomes which plan gives you the most for it, and what you'd actually pay turns on your household, your state, and how you and your family use care rather than any one advertised number. Knowing which side of that subsidy line you're on is the first thing to settle — and getting a clear, specific quote for your situation is exactly what an honest call is for.

The deduction — and where your CPA comes in

A lot of locum providers don't realize the premiums they pay themselves may be deductible — it's an above-the-line deduction the self-employed can often take. Two things shape it in locum work specifically. The deduction is capped at your net self-employment income, which swings from one assignment to the next, and it can't apply to a month you were eligible for coverage through a hospital, an agency, or a spouse. How you're incorporated matters too — many locums run through a PLLC or an S-corp. All of that is genuinely your CPA's department, and it should be; nothing here is tax advice, and I route the specifics to your accountant. My job is getting the coverage itself right, so there's something worth deducting. The self-employed guide breaks the deduction down in more detail.

CRNAs and other independent providers

This isn't only a physician's situation. CRNAs, nurse practitioners, physician assistants, and other clinicians who take independent or 1099 contract work are in the same spot: no employer group plan, income that can arrive in blocks, and a need for coverage that continues between engagements. The path is the same one every self-employed professional walks — your own individual or private under-65 plan, kept in your name regardless of which facility you're contracting with this quarter. And it's not only about you: you can cover a spouse and kids on the same plan, just as a hospital plan would have, with the fit leaning on your income and how your household actually uses care. If you're an independent provider of any stripe, the coverage question is workable, and a short call is the fastest way to sort it.

Ready to see your options?

If you're working locum tenens and not sure whether you're overpaying — or even covered the right way through the gaps — start with the coverage cost estimator to see the landscape, then book a quick consultation when you want a real person to walk your specific situation with you. No pressure, no cost to talk.