Most Affordable Health Insurance Options In Nevada

In 2021, around 1 in 10 Nevadans lacked insurance, while most relied on employer-provided plans. Insufficient coverage can lead to significant out-of-pocket costs and restricted access to essential healthcare, adding financial pressure or deterring individuals from obtaining needed care.

This article reviews Nevada's most affordable health insurance options, covering choices from Nevada Health Link, Medicaid, and private insurers.

Nevada Health Link

Nevada Health Link is the state's health insurance marketplace, where residents can compare and buy qualified health plans. It provides affordable options for individuals and families who don’t have access to employer coverage, Medicare, or Medicaid.

What is Nevada Health Link?

Nevada Health Link offers ACA-compliant health insurance plans, covering essential health benefits for enrolled residents.

Through this marketplace, Nevadans can access federal subsidies that lower monthly premiums, making it a beneficial choice for low- to moderate-income families.

Nearly 90% of those enrolled qualify for financial assistance, with almost half paying $100 or less monthly for their coverage.

Types of Health Insurance Plans Available

Nevada Health Link provides three primary plan tiers: Bronze, Silver, and Gold, each differing in premium costs and coverage percentages.

1. Bronze Plans: With the lowest premiums and highest out-of-pocket expenses, these plans cover 60% of healthcare costs, leaving 40% to the enrollee. Suitable for those seeking lower monthly costs and minimal expected healthcare needs.
2. Silver Plans: Covering 70% of healthcare expenses, Silver plans balance cost and coverage. They also qualify for Cost Sharing Reduction (CSR) subsidies, which can reduce out-of-pocket expenses for eligible individuals.
3. Gold Plans: With higher premiums, Gold plans cover 80% of healthcare costs, appealing to those who anticipate regular medical care or have ongoing health needs.

Additionally, catastrophic plans are available for individuals under 30 or those with a hardship or affordability exemption. These plans cover three primary care visits yearly before the deductible and cover severe health issues, like major accidents or serious illnesses.

Financial Assistance and Subsidies

Nevada Health Link offers financial assistance through two federal subsidies: Cost Sharing Reductions (CSRs) and Advanced Premium Tax Credits (APTCs).

• CSRs: These reduce costs for deductibles, copayments, and coinsurance for individuals with incomes between 138-400% of the Federal Poverty Level (FPL).
• APTCs: These credits lower monthly premium costs by applying the tax credit directly to the insurance company.

For those with incomes below 138% of the FPL, Medicaid generally provides a more suitable coverage option, as subsidies through Nevada Health Link are unavailable at this income level.

Dental and Vision Plans

Nevada residents can also find Qualified Dental Plans and Individual Vision Plans through Nevada Health Link. These plans offer additional coverage options with full-service features for those looking to expand their health benefits without a large cost increase.

Medicaid and Nevada Check-Up

Medicaid and Nevada Check-Up provide health coverage options for low-income families and individuals in Nevada. These state-administered programs support those who cannot afford private insurance or do not meet the qualifications for Nevada Health Link plans.

Medicaid

Medicaid offers free or low-cost health insurance to Nevada residents with limited incomes, covering essential services such as doctor visits, prescriptions, dental care, and eye exams. The program supports vulnerable groups, including:

• Children
• Pregnant women
• Individuals with disabilities

Eligibility for Medicaid in Nevada depends on income, family size, and similar factors. Households with an income up to 138% of the Federal Poverty Level (FPL) can qualify, equating to an annual income of $16,753 for an individual or $34,638 for a family of four. Qualified individuals pay no monthly premiums, and out-of-pocket costs remain low, providing an affordable health coverage option for those who qualify.

Nevada Check Up

Nevada Check Up, the state’s Children’s Health Insurance Program (CHIP), offers affordable health coverage for children from birth to 18 years old. This program supports families who earn too much to qualify for Medicaid but cannot afford private insurance. Children in households with an income up to 200% of the Federal Poverty Level (FPL), or $50,200 for a family of four, may be eligible for Nevada Check Up.

Comprehensive coverage for children includes:

• Preventive care
• Doctor visits
• Hospital stays
• Dental care
• Vision services

Nevada Check Up eliminates copayments and deductibles, easing financial strain by instead charging a quarterly premium based on income and family size.

Transitioning from Medicaid to Other Health Coverage

With recent changes to the federal continuous coverage requirement related to COVID-19, many Medicaid recipients will need to renew their coverage or move to other health insurance options. Those losing Medicaid coverage can access a special enrollment period through Nevada Health Link to sign up for a Qualified Health Plan.

Medicaid and Nevada Check Up accept enrollments year-round, so qualifying individuals or families can join anytime. Updating life changes like income or family size ensures eligibility and accurate coverage for those transitioning to a Nevada Health Link plan.

Private Health Insurance Providers in Nevada

Private health insurance provides another option for those not qualifying for Medicaid or Nevada Check Up. In Nevada, multiple private insurers offer a range of plans with different benefits, coverage levels, and costs, allowing residents to find healthcare that matches their needs and budget.

Top Health Insurance Providers in Nevada

Nevada has multiple private insurance carriers offering plans both through Nevada Health Link and as off-exchange options. In 2024, residents can access four insurance companies with up to 220 plan choices. Here is a look at some of the top health insurance providers in the state:

1. Aetna Health

Aetna Health provides individual and family plans in select Nevada counties, including Clark, Nye, and Washoe. Known for accessible options, Aetna offers $0 copays for telehealth visits and convenient access to services at CVS locations, including MinuteClinic® and HealthHUB™. The range of bronze, silver, and gold plans combines affordability with comprehensive coverage.

Contact Information:

For general inquiries, reach out to their corporate contact center. While they cannot access individual member account information, they can provide contact options for Aetna Member Services.

• Phone: 1-800-872-3862 (TTY: 711)
• Hours: Monday to Friday, 8 AM to 6 PM ET

General Mailing Address: Aetna Inc., 151 Farmington Avenue, Hartford, CT 06156, USA

2. Ambetter (SilverSummit Healthplan)

Ambetter, the largest marketplace carrier in the country, offers a range of plans in Nevada through SilverSummit Healthplan. These plans feature low premiums and include $0 copays for virtual care, urgent care, and mental health services. Ambetter’s rewards program allows members to earn up to $500 for maintaining healthy habits.

Contact Information:

• Phone: 1-800-442-1623 (TTY 711)
• Hours: 8 am-8 pm CST

General Mailing Address: Ambetter from SilverSummit Healthplan, 2500 North Buffalo Drive, Las Vegas, NV 89128

3. Hometown Health

Hometown Health, affiliated with Renown Health, serves counties like Douglas, Lyon, Storey, Washoe, and Carson City. Members can access Renown Health's network, which includes primary care facilities, urgent care centers, and hospitals. Hometown Health offers various plans, some with $0 deductibles, appealing to residents in northern Nevada.

Contact Information:

• Phone: 775-982-3232
• Hours: Monday – Friday, 8 AM to 5 PM

General Mailing Address: 10315 Professional Cir, Reno, NV 89521, USA

4. SelectHealth

SelectHealth, a non-profit insurer, provides coverage for residents in Clark and Nye counties. Known for its wellness focus, SelectHealth offers perks like gym reimbursements and discounts on services not covered, such as LASIK surgery and cosmetic dermatology. It also features specialized options, including the Diabetes Support Plan and the Virtual First Plan, tailored to meet specific healthcare needs.

Contact Information:

• Phone: +1 800-538-5038
• Hours: 7:00 AM to 8:00 PM

General Mailing Address: 5381 S Green St, Murray, UT 84123, United States

Short-Term Health Insurance Plans in Nevada

Short-term health insurance plans offer a temporary coverage option for Nevadans, typically serving individuals between jobs, awaiting other coverage to start, or seeking a short-term solution.

What Are Short-Term Health Insurance Plans?

Short-term health insurance plans offer limited coverage for a brief period, usually ranging from a few months to a year. These plans are exempt from ACA regulations, so they do not include the ten essential health benefits, such as:

• Mental health care
• Maternity care
• Prescription drugs

Although they come with lower premiums, short-term plans can leave consumers financially vulnerable if a serious health issue occurs.

Top Short-Term Health Insurance Plans

Short-term health insurance provides quick, flexible coverage for temporary needs. Here’s a look at the top options from Pivot Health and Everest.

1. Pivot Health

Pivot Health offers short-term health insurance plans for individuals and families, providing flexible options for temporary coverage. The Epic Base plan is affordable, featuring a 0% coinsurance option, where all covered costs are paid once the deductible is met. Pivot Health also includes an option for prescription drug coverage, uncommon among short-term plans. Eligible applicants can receive quick approval, often within five minutes.

Coverage Options:

• Coverage Maximums: $500,000 or $1 million
• Deductible Options: $5,000, $10,000, $15,000, $20,000

Contact Information:

• Phone: 877-246-0106
• Hours: Monday to Friday, 9 AM to 6 PM

General Mailing Address: 3311 S Rainbow Blvd #146, Las Vegas, NV 89146, USA

2. Everest

Everest provides short-term health insurance plans with coverage maximums and deductible options. The Flex Term Health Insurance plan is known for its affordability and flexibility, offering up to $1.5 million in coverage with various coinsurance options. Everest offers accessible temporary health coverage for those in need.

Coverage Options:

• Coverage Maximums: $250,000, $750,000, $1 million, $1.5 million
• Deductible Options: $1,000, $2,500, $5,000, $7,500, $10,000

Contact Information:

• Phone: +1 (800) 269-6660

General Mailing Address: U.S. Headquarters, 100 Everest Way, Warren, NJ 07059

Risks of Choosing Short-Term Plans

Short-term health insurance often lacks coverage for pre-existing conditions. Without ACA regulation, these plans may deny coverage for pre-existing issues or charge higher premiums based on health history. Many short-term plans also come with high deductibles and out-of-pocket costs, so while premiums are lower, substantial expenses can arise when medical care is needed.

According to the US Department of Health and Human Services, short-term plans can exclude individuals with pre-existing conditions and typically don’t provide essential benefits. This can result in unexpected costs, especially during emergencies or for ongoing care. Nevadans may want to evaluate if a short-term plan aligns with their healthcare needs, particularly for managing chronic conditions, or if extensive care is anticipated.

Wrap Up

Resources such as Nevada Health Link help residents compare plans, apply for financial assistance, and find coverage that suits their healthcare needs and budget.

Programs like APTC and CSR make healthcare accessible for lower-income households, while Medicaid and Nevada Check-Up provide comprehensive coverage for low-income families and children.

FAQs on Health Insurance Options in Nevada

What are Health Savings Accounts (HSAs), and which plans in Nevada offer them?

A Health Savings Account (HSA) is a tax-advantaged account that can be used to pay for qualified medical expenses. Hometown Health offers several HSA-eligible plans in Nevada, including the Silver HSA HMO and Bronze HSA HMO. These plans allow individuals to save money tax-free to cover deductibles, copayments, and other medical expenses.

How do I apply for Medicaid in Nevada?

To apply for Medicaid in Nevada, individuals must visit Access Nevada, where they can apply online. A pre-screening tool is available to help determine eligibility. Paper applications are also available under the "Applications and Forms" section on the Division of Welfare and Supportive Services (DWSS) website, and these can be mailed to the address provided on the form.

Are there any penalties for employers who do not provide health insurance to their employees?

Yes, employers with 50 or more employees face penalties if they don't provide insurance to at least 95% of full-time workers.