How Health Insurance Affects Your Travel Therapy Salary
When comparing travel therapy salaries, most therapists focus on the weekly pay number. But health insurance can swing your real compensation by $2,000–$6,000 per year depending on which path you take. Here's how to think about insurance as part of your total salary picture.
Insurance Costs Come Out of the Bill Rate
Your total compensation — including pay, stipends, benefits, and agency margin — all comes from one number: the bill rate the facility pays the agency. When an agency provides health insurance, the cost of that insurance comes out of the same bill rate before you see your pay package. More expensive insurance means less available for your weekly pay and stipends.
This is why some therapists who opt out of agency insurance and buy their own marketplace plan see a bump in their weekly pay. The agency no longer needs to allocate part of the bill rate to cover insurance premiums on your behalf.
The Real Math: Agency Plan vs. Marketplace
Consider a PT contract with a $75/hour bill rate in Texas. After the agency's margin, there's roughly $2,400/week to allocate to your compensation. If the agency's insurance costs $150/week in premium subsidy, that's $150 less available for your pay. If you opt out and buy a $300/month marketplace plan yourself, you're spending $75/week — saving $75/week, or nearly $1,000 per contract.
But this math only works if the agency actually increases your pay when you decline insurance. Ask upfront: "If I opt out of insurance, does my pay package increase? By how much?"
What to Factor Into Your Salary Comparison
When comparing pay packages between agencies, don't just look at the headline weekly pay. Calculate total compensation including: weekly gross pay minus any insurance premium deduction, plus the value of insurance coverage (or minus the cost of your own plan if opting out), plus any other benefits (401k match, CEU reimbursement, licensure coverage).
A package at $2,300/week with excellent insurance and 401k matching may deliver more total value than $2,450/week with no benefits and a bare-bones plan.
Coverage Between Contracts Matters Too
Gaps between contracts can cost you if your insurance lapses. COBRA continuation from an agency plan typically runs $600–$1,200/month. A marketplace plan maintained year-round eliminates gap anxiety entirely. Factor the cost of potential coverage gaps into your annual salary calculation.
For a full comparison of agency insurance plans, see our agency insurance comparison. For stipend and pay details, check the pay calculator.