Travel Nursing Pay – Medical Benefits: Part 2
In our last blog post, we provided some general information on travel nursing medical benefits as well as some specific information on company-provided medical benefits. In this blog post, we’ll discuss some of the advantages and disadvantages of securing medical benefits on your own and offer some tips on finding them.
Advantages of securing your own medical benefits as a travel nurse
Securing your own medical benefits has its advantages and disadvantages. One clear advantage is that you’ll have continuity of care. You won’t have to worry about whether or not your doctor and prescriptions are going to be covered when you switch to a new agency. This may make it easier for you to switch travel nursing agencies when new recruiters call with great job opportunities, which could lead to your taking more desirable assignments.
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Another advantage is that you’ll always know exactly what your medical coverage entails. When you switch agencies, the new medical benefits will undoubtedly have a different “Schedule of Benefits.” There will be different deductibles, coverage limits, and other variables. Yet another advantage is that you’ll get to shop for the coverage that best suits your needs. If you decide that you only need catastrophic coverage, then so be it. If you decide that you need a very high quality plan with extensive coverage, then so be it. You are able to pay more, or less, depending on your specific needs.
Disadvantages of securing your own medical benefits as a travel nurse
There are also several disadvantages to securing your own medical benefits. First, there’s a strong chance that you’ll pay more for less coverage. This is because employers tend to receive discounts for purchasing in volume. However, this may soon change with the purchasing pools created by the new Affordable Care Act which aim to give the power of volume discounts to individual insurance purchasers.
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Another disadvantage is that you risk earning less in total compensation if you secure your own medical benefits. As mentioned previously, sometimes agencies will increase your pay if you do not take their medical benefits and sometimes they do not. If you sign on with an agency that offers medical benefits but doesn’t increase your pay if you choose not to take them, then you’re essentially leaving some money on the table. Not only are you paying for your own medical benefits, but you’re essentially paying for medical benefits that you’re not receiving from the company because, as we’ve stated several times before, everything that an agency provides comes out of the bill rate.
Medical benefits, location, and travel nursing
Now, this next issue regarding medical benefits is a little complex because it pertains to both company-provided and personally secured medical benefits. Typically, medical benefits are intended for use within an individual’s home state. The reasons for this are legal in nature and we don’t need to go in to them here, we just need to understand the ramifications. Health insurance packages offer medical coverage within a network of healthcare providers established by the health insurance company.
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For all intents and purposes, these networks are composed of healthcare providers within a given state. For example, if you purchase health insurance and list Memphis, Tennessee as your home city, then the network of providers you have access to will be within the state of Tennessee, and the original list of healthcare providers you receive will be for healthcare providers within the Memphis metropolitan area. The coverage rules will differ if you want to see a healthcare provider outside your network. As a result, you’ll need to find out how the health insurance plans you’re considering will deal with the fact that you are traveling from state to state on a continual basis.
Don’t be dismayed as this may not be a very big deal. In most cases, you’ll see your primary physician when you’re back at home between travel nursing jobs so this issue will not be of impact in that regard. This is really only an issue for emergency situations. As a result, you’ll want to find an insurance plan that pays all costs regardless of where they’re incurred once you’ve paid off the maximum annual deductible. It’s probably also advisable to purchase a plan from a carrier that sells insurance on a national level, meaning that they operate in multiple states. Examples of such companies include but are not limited to Aetna, Cigna, Anthem, HealthNet, and United Healthcare. These plans may be able to offer certain advantages over plans that operate in only one state.
Again, it’s important to remember that this issue pertains to both company-provided and personally secured medical benefits. If you’re taking company-provided medical benefits, then you’ll want to find out how this is handled on their end and what the ramifications are for you. If you’re going with personally secured medical benefits, then you’ll want to factor this issue into your decision-making process.
Travel nursing medical benefits and pre-existing conditions
Finally, you’ll want to consider the issues surrounding pre-existing conditions. The issues vary depending on whether you have company-provided health coverage or have chosen to secure your own coverage. If you elect to go with company-provided coverage, then there are various protections regarding pre-existing conditions already in place. These protections come from Health Insurance Portability and Accountablility Act (HIPPA).
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HIPPA limits the ability of a new employer health plan to exclude coverage of pre-existing conditions. Specifically, if it’s been less than 63 days since your old medical benefits were terminated, then your new employer’s health plan cannot deny coverage of conditions that were covered under your old plan. If it’s been more than 63 days since your previous coverage lapsed, then the maximum time that coverage can be denied is 12 months. In addition, your new employer’s health plan will only be allowed to consider conditions that have been diagnosed or treated within the previous 6 months. This is Federal law and some states have laws that are more beneficial to the employee.
Under current law, this is an important consideration if you have pre-existing conditions. This is because some of the travel nurses I worked with routinely went more than 63 days without coverage. Again, this is the result of one of the luxuries of travel nursing. You can take extended vacations if you choose. However, if you have a pre-existing condition then you’ll want to be cognizant of the rules.
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When it comes to securing your own medical coverage, you’ll benefit from provisions in the new Affordable Care Act pertaining to pre-existing conditions. Beginning in 2014, the Affordable Care Act makes it illegal for health insurance companies to deny coverage based on pre-existing conditions. In the mean-time The Pre-Existing Condition Insurance Plan makes health coverage available to you if you have been denied health insurance due to a pre-existing condition and have been uninsured for at least 6 months. Details vary from state to state, but you can find out more at healthcare.gov.
If you decide that the advantages of securing your own medical benefits outweigh the disadvantages and elect to secure your own benefits, then you’ll need to locate a benefits package that bests suits your needs. I suggest working with a licensed broker who can answer any questions you have and recommend a medical plan that best meets your needs. The service that I typically recommended to the travel nurses I worked with was ehealthinsurance.com. They have a great website that allows you to compare the plans from various health insurance providers. They also have free telephone customer service so you can call in, ask questions and get the help you need to make the right decision.
