How Health Insurance Affects Your Travel Therapy Salary
Here's how to think about insurance as part of your total salary picture.
Insurance Costs Come Out of the Contract Rate
Your total compensation — including pay, stipends, benefits, and agency margin — all comes from one number: the contract rate the facility pays the agency. When an agency provides health insurance, the cost of that insurance comes out of the same contract 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 contract rate to cover insurance premiums on your behalf.
The Real Math: Agency Plan vs. Marketplace
If you opt out and buy a marketplace plan yourself, the 2026 average benchmark premium (the second-lowest-cost silver plan) for a 40-year-old is $625 a month before any subsidy (KFF State Health Facts, read 2026-10-06).
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).
Coverage Between Contracts Matters Too
Gaps between contracts can cost you if your insurance lapses. COBRA continuation from an agency plan can cost up to 102% of the cost to the plan (U.S. Department of Labor, read 2026-10-06); KFF puts the 2025 average annual premium for single employer coverage at $9,325 (KFF Employer Health Benefits Survey 2025, read 2026-10-06). 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.