Health insurance: Two words that can make even the most seasoned physicians and clinicians break into a sweat.
Most have spent their careers relying on employer-sponsored plans, with HR teams handling the fine print. But as a locum tenens provider, that safety net vanishes. Suddenly, you are your own HR department.
That may seem daunting, but here’s the good news: you’ve got options. Navigating health insurance as an independent contractor may seem like a paperwork nightmare, but it’s just another part of the autonomy that makes locum tenens work so appealing.
Let’s break it down and find the smartest, simplest way to get or keep you covered.
Start with the ACA Marketplace
Your first stop? Healthcare.gov. The Affordable Care Act (ACA) Marketplace was built with independent professionals in mind. It offers flexible coverage levels, income-based subsidies, and guaranteed protections like coverage for pre-existing conditions and essential health benefits.
ACA plans cover:
- Emergency care: For sudden, severe conditions.
- Hospitalization: Surgeries, inpatient treatments, and recovery care.
- Maternity and newborn care: From prenatal to postpartum.
- Prescription drugs: Chronic and acute conditions alike.
- Mental health services: Therapy, counseling, and substance use treatment.
There are four ACA coverage tiers:
- Bronze: Lowest premiums, highest deductibles; great if you rarely need care
- Silver: Moderate premiums and deductibles; eligible for extra savings if you qualify.
- Gold: Higher premiums, lower deductibles; best for frequent healthcare users.
- Platinum: Highest monthly cost but lowest out-of-pocket expenses.
Marketplace open enrollment runs from November through January each year as of today, although that timeframe could be compressed in 2026 under the new presidential administration. But if you lose coverage after wrapping an assignment, you may qualify for a special enrollment period.
Private Health Insurance: Familiar but Expensive
Private plans from commercial insurers can resemble the comprehensive coverage of traditional employer plans. These often offer:
- Larger provider networks
- Fewer hurdles to seeing specialists
- Customizable coverage options
The tradeoff is cost. According to KFF, the average annual premium in 2023 was about $8,500 for individuals and $24,000 for families. Without an employer footing part of the bill, those numbers hit hard, even for a doctor. Private coverage may be out of reach without the income to absorb it.
Association Plans: Group Buying Power
Joining a professional association could be a cost-saving move. These groups use collective membership to negotiate better insurance rates, offering broader provider networks and fewer limitations than some ACA options.
Associations offering health benefits include:
- American Medical Association: Health, life, and disability insurance for physicians.
- American Academy of Physician Associates: Group health, malpractice, and CE support for PAs.
- American Osteopathic Association: Health coverage and extras like financial planning tools for DOs.
Bonus: these associations often include travel perks, CME discounts, and networking opportunities.
Spousal Coverage: Simple, If Available
If your spouse has job-based insurance, you may be able to join their plan. Many large employers offer family plans at lower costs than ACA or private alternatives—often with better networks and lower deductibles.
However, some employers use “spousal carve-out” or surcharge policies. These either exclude spouses who can get their own coverage or add a fee to discourage it. Check the benefits guide carefully before assuming this is your best route.
Short-Term Health Insurance: Just a Bridge
Short-term plans offer temporary protection—typically lasting a few weeks to 12 months. They’re fast to enroll in and usually cover:
- Emergency services
- Some preventive care
- Select prescriptions
But be careful—these plans often:
- Exclude pre-existing conditions
- Have high deductibles and limited coverage
Consider these only when you’re between gigs or waiting for long-term coverage to kick in. A few common options:
- UnitedHealthcare: Covers visits, urgent care, and emergencies
- Pivot Health: Includes dental and vision options
- Everest: Flexible deductibles and co-pays
HSA + HDHP: A Tax-Savvy Combo
For those playing the long game, pairing a High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA) can make financial sense. HDHPs have lower premiums but higher deductibles, making them ideal if you don’t expect frequent care.
HSAs allow you to:
- Contribute pre-tax dollars
- Grow your savings tax-free
- Withdraw funds tax-free for qualified medical expenses
Unused money rolls over year to year, and after age 65, you can use it for non-medical expenses (you’ll pay taxes, but no penalties). This combo is tough to beat for independent providers looking to control costs and build a healthcare nest egg.
Take the Lead on Your Health Coverage
Going locum tenens means calling the shots—from your schedule to your assignments to your insurance. While the number of options might feel overwhelming, understanding what each offers helps you make confident, cost-effective decisions.
A little research can go a long way. Compare plans, weigh costs, and don’t hesitate to contact a health insurance broker who understands the needs of independent clinicians. With the right coverage in place, you’ll spend less time stressing about insurance and more time enjoying the freedom of the locum tenens lifestyle.
