Health insurance planning becomes more complex when CRNAs move outside traditional full-time W-2 employment. PRN, locum tenens, travel, and 1099 arrangements introduce frequent transitions, variable eligibility rules, and coverage gaps that rarely exist in permanent roles. The primary objective is continuity—maintaining dependable coverage that follows you regardless of where or how you work.

For many CRNAs, health insurance becomes less about optimizing benefits and more about avoiding interruptions, unexpected costs, and network limitations during transitions.

Why Health Insurance Is Different Outside Full-Time W-2 Roles

In W-2 employment, health insurance is typically employer-sponsored and partially subsidized. Outside that structure, coverage is often tied to hours worked, assignment length, or agency-specific eligibility rules. Credentialing delays, short contracts, and gaps between assignments commonly expose weaknesses in coverage planning.

Independent planning becomes essential because coverage may end abruptly, restart unpredictably, or vary across work arrangements.

Common Health Insurance Options for CRNAs

Employer or Agency-Sponsored Plans

Some PRN, locum, or travel arrangements offer access to employer- or agency-sponsored health insurance. These plans can be cost-effective while active, but eligibility often depends on hours worked or contract length. Coverage may terminate quickly when an assignment ends, creating gaps if another role is not immediately secured.

Marketplace (ACA-Compliant) Individual Plans

ACA-compliant individual plans are commonly used by PRN and 1099 CRNAs because they are not tied to employment. These plans provide continuity through job changes, though premiums, networks, and plan options are based on the CRNA’s primary state of residence.

Spouse or Partner-Sponsored Coverage

Coverage through a spouse’s or partner’s employer can provide stability during periods of transition. This approach works well in some dual-income households but may limit network access or flexibility for CRNAs working across multiple states.

COBRA Continuation Coverage

COBRA allows continuation of a prior employer’s health plan for a limited period after leaving a W-2 role. While it preserves existing coverage, it is often expensive because the full premium cost shifts to the individual.

Short-Term Limited-Duration Insurance

Short-term plans are sometimes used to bridge brief coverage gaps. These policies are not ACA-compliant and commonly exclude pre-existing conditions or preventive services. Availability and duration vary by state.

Comparing Health Insurance Options for Mobile CRNAs

Multi-State Considerations for Travel and Locum CRNAs

Health insurance networks are typically state-based. Even plans with national branding may restrict in-network access outside specific regions. Travel and locum CRNAs should confirm emergency coverage, out-of-state network rules, and referral requirements before relying on a plan across assignments.

Common Health Coverage Gaps to Watch

• Loss of coverage between assignments or during credentialing delays
• Limited out-of-state provider networks
• High deductibles without adequate cash reserves
• Assuming agency coverage extends beyond an assignment
• Overlooking dependent coverage during transitions

Practical Planning Tips for CRNAs

• Anchor coverage to your primary state of residence, not assignment location.
• Confirm exactly when agency-sponsored coverage begins and ends.
• Maintain liquidity to manage deductibles and out-of-network expenses.
• Reassess coverage when changing work models or adding travel assignments.

This content is provided for general educational purposes only and is not intended as personalized medical, financial, or insurance advice. Health insurance rules, availability, and costs vary by state, insurer, and individual circumstances. CRNAs should review plan details and consult qualified professionals before making coverage decisions.