Health insurance for Michigan travel nurses: covering contract gaps when the marketplace PPO costs more

Sam Jaber, Licensed Health Insurance Advisor · Updated October 2026
NPN 20698748 · Licensed in 31 states, Michigan among them

What to know first: Michigan's marketplace PPO is sold in every county but typically costs about a third more than the least expensive silver plan. When an agency plan ends with a contract, you get 60 days to enroll. A tax credit usually makes a marketplace plan the better buy; above the credit line, healthy nurses should price an underwritten nationwide PPO plan.

Find your section: Between contracts · Tax credit · Too much for a credit · Healthy · Steady care

Your home is in Michigan, and your contracts take you to hospitals in other states for a few months at a time. The hard part is often not the assignment itself. It is the stretch in between: a cancelled contract, a few weeks off before the next start date, or an agency plan that stops when the paychecks do.

Michigan's marketplace does sell a PPO. For 2026 the company that sells it says it remains the only insurer in Michigan offering a PPO on the marketplace, and federal plan data shows it in all 83 counties. Compare plans county by county for a 40-year-old with no credit applied, and the PPO's least expensive silver plan runs about 35% above the least costly silver plan from any insurer in the typical county, from about 9% to about 105% more depending on the county.

These are county-by-county comparisons for one age, before credits, from federal plan data. They show the size of the gap, not what you would pay in your county.

So for a Michigan nurse the questions run in this order: are you between contracts right now, and where does your income sit against the tax credit range?

If you're between contracts and coverage just stopped

An agency plan that stops with the contract counts as losing coverage, and that gives you 60 days to pick a marketplace plan without waiting for open enrollment. The window is triggered by losing the coverage, not by starting or finishing an assignment, so use it even if the next contract is already signed.

Two Michigan rules matter in a gap. First, Michigan law caps short-term plans at 185 days in any 365-day period with the same insurer, with no renewal past that, so in this state they can only bridge a short break. Second, Medicaid looks at current monthly income. If a long break leaves you with little coming in, the Healthy Michigan Plan covers adults with income up to 138% of the federal poverty level, and it is worth checking before you assume you need a full-price plan.

If your income earns you a tax credit

When your expected income falls in the federal credit range, buying on HealthCare.gov is usually the lower-cost route, since the credit works only on marketplace plans. Michigan had seven insurers on the marketplace for 2026, though which ones you can choose depends on your county.

Here Michigan differs from some other priced-out states. The step from the PPO company's own HMO to its PPO is smaller: in the typical county the PPO costs about 21% more than the HMO affiliate's least expensive silver plan, roughly $145 a month for a 40-year-old. With a credit lowering the bill, some nurses may find that step affordable for the wider network. Others may keep the lowest-cost plan they can find and book routine care for home weeks, counting on the federal rule that emergency care out of network is covered at in-network cost.

Whichever you pick, track your income through the year. The credit is reconciled on your return, and for 2026 the full excess can be owed back.

If you earn too much for a credit

The credit stops above 400% of the federal poverty level, which is $63,840 for a single person for 2027 coverage and $62,600 for 2026. Above that, every dollar of the premium is yours, and Michigan's premiums climbed this year: KFF's benchmark for a 40-year-old, the second-lowest-cost silver plan, went from $404 a month in 2025 to $523 in 2026, about 29.5%.

At full price, a PPO costing about a third more than the least expensive silver plan is a lot to pay, and an HMO built around Michigan providers covers you mostly in emergencies while you are on assignment elsewhere. Whether either one makes sense depends on your health.

If you're healthy and over the credit line

For a healthy nurse above the line, the plans to price are outside the marketplace: private, medically underwritten plans on PPO networks with doctors and hospitals across the country. They are not sold through HealthCare.gov, so the Michigan marketplace PPO's price does not carry over to them.

• The insurer reviews your health first. You fill out medical questions, and the answers decide whether you are accepted, declined, or accepted with a condition left out.
• Screening is why the price can be lower. A healthy nurse can come in under full marketplace price. A quote for your age and household is the only proof.
• Look up your assignment hospitals. Search the directory for the facilities you have worked at and the cities you keep getting offers from.
• Each plan lists its own benefits. Read them, since marketplace rules do not set them. See what medical underwriting means for how the application works.

If you need steady care for a condition

With an ongoing condition or a costly medication, stay on a marketplace plan, even at full price. Marketplace plans have to accept you and cannot raise your price because of your health. An underwritten plan might decline you or exclude that condition.

In Michigan, the marketplace PPO is sold in every county, so it is the one guaranteed-acceptance PPO you can buy here. If you see specialists who are hard to reach from home, price it against the HMO and decide whether the difference is worth it for your care.

Where do you fit?

Choose the row that sounds like your situation. Every one ends with a call, because contract dates and income are quicker to sort out together.

Michigan's other rules are laid out in the Michigan guide for self-employed buyers. Nurses based in Florida face a steeper version of the same problem, set out in our Florida travel nurse guide, and coverage between jobs goes deeper on gaps.

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