Are you trying to find affordable, comprehensive health insurance in Nevada? You have plenty of options – but the abundance of options may feel a little overwhelming. You’re not alone if you feel this way. Making a decision and getting the coverage that you and your family need is easier than you might think. Below, we’re going to discuss all sorts of options – from major medical to indemnity plans and everything in between – so that you know what is available to you as a Nevada resident. With the information provided, you should be able to make a decision about you and your family health care needs in no time.
Major Medical Insurance in Nevada
Major medical coverage is a general term for any health insurance policy which adheres to the Affordable Care Act’s standards for qualifying health coverage and is sold through either a state or the federal Health Insurance Marketplace. The Health Insurance Marketplace was established shortly after the Patient Protection and Affordable Care Act (AKA Obamacare) was passed back in the spring of 2010.
Applying for coverage through the Marketplace has changed recently. As of the fall of 2019, Nevada residents are now encouraged to apply for health care coverage through your local state exchange, NevadaHealthLink.com. There is a link on their website where you can login and follow simple directions to merge the data from your old HealthCare.gov account through the Nevada Health Link website. Then again, if you’ve never applied through HealthCare.gov before, all you have to do is create a new account at the new state exchange website. After you get all of that sorted, just fill out the application online and you should receive a response that same day. If you are trying to enroll in coverage outside of the Open Enrollment period (which usually happens between November 1st and December 15th each year), there’s a chance you may qualify for a Special Enrollment Period (SEP) if you have an extenuating life circumstance. You should contact a representative from Nevada Health Link directly to find out more about Special Enrollment Periods.
There are a few important stipulations that differentiate major medical plans through the Nevada state exchange in the Health Insurance Marketplace from other coverage options. Those stipulations are: guaranteed coverage status, guaranteed health and wellness benefits, and government subsidies. Together, these three things ensure that your coverage will be available, comprehensive, and affordable, respectively. Purchasing a guaranteed coverage health insurance policy protects you from being rejected or discriminated against, price wise, based on things like pre-existing conditions. No matter what, you cannot be rejected for your coverage If you apply through a government-sponsored Health Insurance Marketplace. You also cannot be charged an expensive premium based on anything other than one or more of the following four factors:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
For optimal health and wellness over the long-term, you’ll want the most comprehensive health coverage you can get. Major medical coverage definitely falls into this category thanks to the 10 mandatory guaranteed Essential Health Benefits which come with every ACA plan. Even if you don’t end up using every single type of coverage benefit offered by such a comprehensive plan, medical experts the world over agree that these benefits are the bare minimum that the average person needs for optimal and affordable healthcare management long-term:
- Ambulatory/outpatient services
- Emergency services
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
Being both guaranteed issue and comprehensive does have a tendency to make health insurance cost more. But if you qualify for a government subsidy, you can get the best possible health care coverage at a fair and affordable monthly premium. In the state of Nevada, there are two different types of tax credits you can qualify for: cost-sharing reduction credits, and the advanced premium tax credit. The latter comes from the federal government and helps reduce the total cost of your monthly premium. The former, which is not available in all states but is available in Nevada, helps reduce the cost of things like your copay, coinsurance, and deductibles so that you have fewer out-of-pocket costs. Qualifying for one or both of these credits typically requires enrollment in a silver tier plan. And you have to make at least 138% of the federal poverty limit in order to qualify for one or both. Since your income and household size are both used to determine where you fall on the federal poverty level spectrum, you can use the chart below to figure out how likely you are to qualify.
|Household Size||Annual Income (138% of FPL)|
For anyone who falls below that 138% federal poverty limit, there’s good news: Nevada was an early adopter of the federal Medicaid expansion. This means that the state has plenty of funding to accept new applicants to Medicaid if they happen to fall below the 138% federal poverty limit. When it comes to Medicaid, however, there may be some different qualifications that you need to meet other than income and household size in order to get approved. For more information on applying for Medicaid in the state of Nevada, be sure to visit the Access Nevada website.
Short Term Health Insurance in Nevada
Nevada residents have more opportunities than most Americans to qualify for a tax credit that makes major medical coverage affordable for the average person. But that doesn’t mean everyone in the state will have a chance to purchase affordable, comprehensive healthcare. For people who are still struggling, there are other options such as short-term health insurance to consider. But short-term health insurance in Nevada works a little bit differently than in most states: plan terms can only last as long as 185 days, as opposed to 364 days. And they cannot be renewed.
But that isn’t the only reason that short-term health insurance falls short of qualifying as a legal equivalent to major medical coverage. Another reason it falls short is because none of the short-term health insurance in Nevada is guaranteed issue. This means that you will undergo medical underwriting, and you may either be rejected or charged more for coverage based on pre-existing conditions. Another thing that differentiates short-term health care coverage from major medical is that there are caps on your annual and lifetime benefits, but no caps on your total out-of-pocket costs. Many of these plans also come with very high deductibles – sometimes as much as $5,000 or more – which you must pay in out-of-pocket medical costs before your benefits kick in and you start seeing savings.
There are some benefits to consider when it comes to short-term health insurance, however. For starters, if you don’t qualify for a subsidy, short-term health insurance costs up to 33% less than an unsubsidized marketplace policy. And you’ll have a decent amount of consumer protections, which means that if you ever get into a dispute with your health insurance provider, you will have legal recourse. Most short-term health insurance providers will offer you the chance to customize your coverage and purchase what you need, although most will fall short of offering all 10 of the guaranteed Essential Health Benefits that major medical policies have to. You can also combine them with things like dental, vision, and indemnity coverage for more comprehensiveness. Although you might end up with higher out-of-pocket costs when it comes to short-term health care coverage, it still beats having no insurance whatsoever – especially if an unexpected medical emergency happens.
Christian Health Plans/Health-Sharing Plans in Nevada
Up until recently, there was something that was an integral part of the ACA known as the individual mandate. The individual mandate made it a legal requirement for every tax-paying American citizen to purchase health insurance or pay a tax penalty each year in April. The individual mandate was no more as of the beginning of 2019 – so nobody is legally required to purchase health insurance any longer. However, it could be financially devastating to go without, even if you’re struggling to pay for affordable healthcare coverage right now. So it’s a good idea to look at all of your options, including a Christian health plan, in order to get yourself covered.
Christian health plans and health share plans, due to their religious status, gave individuals an exemption to the individual mandate even though they do not meet all of the rules and regulations that major medical coverage does. As a matter of fact, Christian health plans look a lot more similar to short-term health insurance than they do major medical. Look at all of the things these two healthcare options have in common:
- These plans are NOT guaranteed issue
- They have unlimited out-of-pocket costs
- They have lifetime and annual benefit caps
- They likely won’t have all of the guaranteed essential health benefits
Don’t make the mistake of thinking that just because these plans have so much in common that it means that they are identical. The truth is that these plans are actually quite different from one another. With a Christian health plan, you will have to adhere to participation guidelines in order to maintain good standing with your provider. This usually includes things like declaring allegiance to the same religious faith as your other plan members; immediately ceasing all tobacco use; and other biblically inspired beliefs and lifestyle changes. There are fewer consumer protections with a Christian health plan, so if you feel like your plan provider has unfairly denied you benefits, you will have to settle your differences with them directly and hope for the best; you cannot take them to court and you will have no legal recourse through the judicial system. Lastly, the language is a bit different. You pay a “monthly share amount” instead of a monthly premium. You also pay a shared member responsibility amount (SMRA) or an “unshared amount” instead of things like deductibles, co-pays, or coinsurance.
Fixed Indemnity Plans in Nevada
Fixed indemnity plans are popular, but not for the reasons you might think. They are rarely ever purchased as a replacement for major medical coverage; on the contrary, they work better as a supplement to major medical in order to lower out-of-pocket costs, or as a means of gaining access to medical providers outside of a restricted network (like an HMO or a PPO) for a reduced cost. A fixed indemnity plan won’t require you to stay in network in order to get care, but you may still have a little bit of trouble getting your chosen providers to agree to the payment terms of your fixed indemnity plan’s contract, so keep that in mind while you shop around.
Like the previous two options we just finished discussing, fixed indemnity plans come with annual and lifetime benefit caps and no limit to your total out-of-pocket costs. Fixed indemnity plans, whether hospital, doctor, or dental, pay out a fixed amount of the total costs and leave it up to you to pay the rest of your medical bills – as opposed to most other options which share a percentage of the total costs between you and your insurance provider. Fixed indemnity plans also pay out at a specific rate, which is usually per day, per week, per month, per incident, or per event. These plans are highly customizable and will vary depending on your specific needs, so it’s important to find a good insurance provider who’s willing to sit down with you and discuss your medical care in detail so that you can get the best possible coverage.
Discount Cards in Nevada
If you want to get a medical discount card in Nevada, you’re free to do so – just make sure you know what you’re getting yourself into before you sign any paperwork or pay any substantial fees. You need to understand that medical discount cards are not insurance, nor are they a sufficient replacement for insurance. They can help get you discounts when you purchase medical products or services, but that’s it. They don’t reimburse your costs and you don’t have to file any claims like you would with a legitimate insurance policy. But if your membership fee is as much or less than what you could potentially save on discounts, it could be a good deal.
Most medical discount cards work like an AARP or AAA membership: you pay a monthly or an annual membership fee, you get a discount card in the mail, and you present it at participating providers and establishments in order to get a modest discount on your medical costs. But sometimes these companies will exaggerate what discounts you may receive or which providers have signed a contract to work with them, so you need to do your homework and make sure you verify their claims first. As long as you find a good, reputable company who offers the discounts that you would get the most benefit from, you can save a good deal of money combining a medical discount card with other forms of coverage.