En español | Most Nevada residents are eligible to buy health insurance through Nevada Health Link, Nevada’s Affordable Care Act (ACA) marketplace. And you might be able to save money on premiums, thanks to expanded federal tax credits in the March coronavirus relief bill. Nevada Health Link’s open enrollment period begins Nov. 1 and runs through Jan. 15, but you may be able to switch to a marketplace plan at any time if you get married, have a baby or experience another qualifying life event.
Most people already enrolled in ACA marketplace plans will also see their premiums go down this year because the recently enacted American Rescue Plan increases tax credits for insurance premiums and expands the number of households that qualify for them. Every household that pays more than 8.5 percent of its household income now qualifies for federal tax credits to help it afford health insurance. Prior to the new law, such tax credits were only available to people making up to 400 percent of the federal poverty level (around $51,000 for one person).
The average American with a marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will only be available in 2021 and 2022.
Who is eligible?
- Most Nevadans are eligible to buy health insurance through Nevada Health Link regardless of whether they are currently insured. Non-U.S. citizens with work or student visas and those who are incarcerated are not eligible.
- You may also qualify for Medicaid, which offers free or low-cost coverage to low-income people and families, to some residents of skilled nursing facilities, to people with certain disabilities and to qualifying immigrants. You can determine your eligibility online at the Nevada Division of Welfare and Supportive Services or by calling the department toll-free at 800-992-0900.
- Nevada Check Up is the state’s health insurance program for low-income children 0 to 18 years of age and pregnant women who are not covered by private insurance or Medicaid. Also known as CHIP (Child’s Health Insurance Program), it’s designed for families that earn too much money to qualify for Medicaid.
When can I enroll?
- Nevada Health Link’s open enrollment runs from Nov. 1 through Jan. 15. To ensure your coverage starts Jan. 1, 2022, you must enroll by the end of this year.
- You can enroll at any time if you experience a qualifying life event, but you only have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances.
- You can also enroll at any time for Medicaid or for CHIP, the child health insurance program. Year-round enrollment is open to American Indians or members of an Alaskan Native tribe.
How do I sign up?
You apply for coverage and choose your plan at the same time. Make sure to pay your first premium directly to your insurance carrier. After your first payment, your carrier will bill you. To apply and enroll:
- Online: Go to the Nevada Health Link website and click the Get Started button in the upper-right-hand corner. You can also request assistance via email at CustomerServiceNVHL@exchange.nv.gov.
- By phone: Nevada Health Link’s call center can be reached Monday through Saturday, from 9 a.m. to 5 p.m., at 800-547-2927. Multi-language options are available. If you’re hearing-impaired, dial 711 for TTY-enabled service.
- In person: “Assisters” are available at no cost to help you navigate the application and enrollment process, either in person or via Zoom for those concerned about exposure to COVID-19. You can request an in-person assister on the Nevada Health Link website or by phone at 800-547-2927. You can work with two types of assisters: an agent-broker or a certified enrollment counselor (a description of their roles is available on the Nevada Health Link website).
What is covered, and how much will it cost?
Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family.
If you qualify for Medicaid, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All Nevada Health Link plans cover 10 “essential” benefits , including:
- Emergency services and hospitalization
- Pregnancy, maternity and newborn care
- Mental health services (including counseling)
- Chronic disease management and pediatric care
- Prescription drugs
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
All Nevada Health Link plans cover basic dental services for children, including cleanings and exams. But adults who want dental coverage must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.
What about new federal assistance for premiums?
Every eligible household that pays insurance premiums that exceed 8.5 percent of their annual income now qualifies for federal tax credits for insurance premiums.
For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.
Is there any other financial assistance available?
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for out-of-pocket expenses such as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.
If you’ve collected unemployment benefits this year, even for just one week, you may qualify for an almost $0/month premium health coverage option, thanks to the American Rescue Plan. This subsidy goes into effect upon enrollment into a Nevada Health Link plan. If you’ve already received unemployment benefits this year while enrolled in a marketplace plan, you’ll be able to claim the additional subsidies for the months before July when you file your 2021 tax returns. This extra financial help will expire at the end of 2021.
What plans are available?
Nevada Health Link plans are organized into four categories:
- Bronze plans have the lowest monthly premiums and the highest deductibles and copays, and cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury.
- Silver plans have moderate monthly premiums, deductibles and copays. They cover between 70 and 94 percent of care costs, depending on whether you qualify for a basic plan or an Enhanced Silver plan for lower-income households. They’re the only plans eligible for cost-sharing subsidies.
- Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays, and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.
- Catastrophic plans, designed to cover excessive bills due to a medical emergency, are available for applicants under age 30. Catastrophic health insurance plans have low monthly premiums and very high deductibles.
Nevada Health Link’s comparison tool allows you to estimate costs and benefits of plans and to check whether you may qualify for financial assistance.
What if I already have health insurance?
If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to Nevada Health Link. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.83 percent of your household income for individual coverage or more than 8.27 percent for family coverage in order for you to qualify for the tax credits.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), the Nevada Health Link will allow consumers who lose access to their COBRA plan and/or COBRA premium assistance (which ends on the last day of Sept. 2021) to qualify for a Special Enrollment Period on Nevada Health Link for the duration of the plan year 2021. When you apply, be sure to select a qualifying life event in the Loss of Minimum Essential Coverage section of your application. If you’re not sure about whether making this switch makes sense for you, you can ask for free advice from a certified insurance broker.
Will I need to get a new doctor?
That depends. Major insurance providers, including Health Plan of Nevada , Silver Summit Health Plan and Anthem , offer Nevada Health Link plans, but not all doctors accept them. The insurance company websites provide links, so you can search to see if your doctor is within the network. Or talk with your physician’s office directly to see whether the practice will accept a particular marketplace plan.
Will my family members qualify for the same health plan that I do?
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs, depending on age, income and disability, or caregiver status. Such families may choose to enroll as “mixed-program families” and still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.