Nevada Health Insurance

Overview

If you live in Nevada and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:

  • Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
  • Compare private health plans using U.S. News & World Report's health insurance ratings for Nevada

Do I Qualify for a Tax Break on Health Insurance?

Use the calculator below to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.

What Plan Type is Right For Me?
How Many Need Coverage
Total Annual Income
 
 

You may qualify for Medicaid, a free, state-sponsored health insurance program. Call 855-768-5465 or go to the Nevada Health Link website to find out if you can enroll in Medicaid.

You qualify for a subsidy (tax credit) that will save you money if you buy a plan on Nevada's new insurance marketplace, called Nevada Health Link. Plans should be offered there starting October 1, 2013. While your subsidy will cover part of the monthly premium for any of the marketplace's plans, a plan that's in the "silver tier" probably offers the best deal. That's because you also qualify for a second subsidy that increases the value of benefits you'd get from any silver plan.

You qualify for a subsidy (tax credit) that will save you money if you buy a health plan on Nevada's new insurance marketplace, called Nevada Health Link. Plans should be offered there starting October 1, 2013. Your subsidy will cover part of the monthly premium for any of the marketplace's plans, known as Qualified Health Plans.

You don't qualify for a subsidy. You can either buy a plan on the Nevada Health Link website or click the button below to compare U.S. News-rated plans in your state's private insurance market. Plans on Nevada Health Link will generally offer more health coverage than plans in the private market, but they also tend to cost more in monthly premiums. The Nevada Health Link website should offer plans beginning October 1, 2013.

Any children in your household may be eligible for Medicaid. Call 855-768-5465 or go to the Nevada Health Link website to find out if your children are Medicaid-eligible.

See Plans

If You Qualify: Plans That Cost Less

Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Nevada. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage. 

Note: you had until March 31 to enroll for coverage for the rest of 2014 (enrolling on March 31 would cover you starting May 1). If you missed this date, with few exceptions, you will pay a penalty.

If You Don't Qualify: Private Plans

If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Nevada’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage.  What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.

Do I Have To Buy Health Insurance?

You may have heard that everyone in Nevada must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per adult plus $47.50 per child (up to $285 per family) or 1 percent of your family’s income, whichever is more. 

U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.

Where To Buy Health Insurance

Nevada's Official Marketplace

Nevada Health Link is Nevada’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Nevada Health Link, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:

  • Social security numbers for everyone in your household
  • Your employer’s name and address
  • Your most-recent pay stub or recent records of your wages
  • Information about other types of income you receive, such as alimony, unemployment benefits or a pension

 

Insurance Companies and Brokers

Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Nevada Health Link website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.

U.S. News & World Report has teamed up with eHealth.com, an online broker licensed to sell health insurance, to help you buy the health plan you want. The eHealth customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.

Qualified Plans on Nevada Health Link

Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.

You should also look at a Nevada Health Link plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Nevada Health Link plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"

Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.

Participating Companies

Anthem and the Nevada Co-Op are the only two insurers offering exchange plans statewide, reports the Elko Daily Free Press. Saint Mary’s and Health Plan of Nevada do not offer coverage in the state's rural counties.  

Anthem Blue Cross and Blue Shield. Owned by WellPoint, Anthem is Nevada’s second largest insurer, according to the Las Vegas Review-Journal. Anthem is affiliated with the Blue Cross and Blue Shield Association, the oldest U.S. health insurance system. The Blue Cross and Blue Shield Association offers coverage in all 50 states, Washington, D.C., and Puerto Rico and has 37 Blue Cross and Blue Shield companies that serve over 100 million members (one third of all Americans), according to the company. Nationally, Blue Cross and Blue Shield companies have contracts with over 96 percent of hospitals and 91 percent of providers. Nevada residents who buy an Anthem exchange plan may not have access to the entire network of doctors and hospitals.

Health Plan of Nevada. A part of United Healthcare, HPN offers health maintenance organization (HMO) and point of service (PoS) plans to over 400,000 members in Clark, Esmeralda, Lyon, Mineral, Nye and Washoe counties. A searchable provider directory is available for HMO and PoS plans. 

Nevada Health Co-Op. Sponsored by the Culinary Union Fund and the Health Services Coalition, according to Nevada Business, this new nonprofit, member-governed co-op offers Nevada residents exchange plans in every tier. A searchable provider directory is available.

Saint Mary’s Health Plans. Originally established in 1993 as a health maintenance organization (HMO) through Saint Mary’s Regional Medical Center, SMHP grew to include Saint Mary’s Preferred Health Insurance Company, Preferred Health Care Network (PHCN), CDS Group Health and HealthFirst. Its network includes 34 hospitals and more than 3,500 doctors, according to the company. 

Need More Help?

The Nevada Division of Insurance exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 888-872-3234 or emailed at cscc@doi.state.nv.us. Residents can file an insurance complaint online.

Health Insurance Guide

U.S. News offers information on how to buy health insurance and publishes plan ratings for every state. If you’re over 65, see the guide to Medicare plans. Otherwise, start by looking up the Health Insurance Guide for your state.

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2014-05-01