Nevada Insurance 101 - Learn about what’s NEW in health insurance for Plan Year 2019.

Learn about what’s NEW in health insurance for Plan Year 2019

The individual health insurance market in Nevada consists of on-Exchange and off-Exchange plans. These are plans that are compliant with the Affordable Care Act (ACA) and cover all essential health benefits (EHB). EHBs are a set of health care services that must be covered with no “annual or lifetime dollar limits.” To view a general summary of Nevada EHBs visit http://doi.nv.gov/Healthcare-Reform/Individuals-Families/.

Open Enrollment is the time to actively purchase health insurance for the following year. This takes place from November 1st until December 15th. On October 2nd of every year, the Division posts on its website the plans and the rates for such plans that will be available to buy during open enrollment. So which insurance companies will be selling health insurance next year?

The Silver State Health Insurance Exchange (Exchange)

The Exchange is the state agency that oversees Nevada Health Link, the online marketplace where Nevadans in need of health insurance can “shop” online and choose a qualified health plan.

  • These plans are available to consumers who are not offered health insurance through their employers and who are not eligible for Medicare or Medicaid.
  • Consumers who purchase health insurance through the Exchange and are eligible may receive subsidies/financial assistance from the federal government that can help offset your monthly premiums for health insurance.
  • Approved rate change on the Exchange for 2019 is a decrease of .4%. This is the lowest rate change the Division of Insurance has approved since the beginning of the ACA.
Companies offering plans on the Exchange# of plans to choose fromCounties where plans are being offered
Health Plan of Nevada9Clark, Nye and Washoe
SilverSummit5State-wide
  • There will be $0 plans for consumers available again for 2019.
  • Estimate costs on Nevada Health Link’s website at https://www.nevadahealthlink.com/
  • Consumers who are not eligible for a subsidy also have the option to purchase a QHP through Nevada Health Link.
  • The Division encourages consumers who are not sure if they are eligible for a subsidy to start with Nevada Health Link first to determine their eligibility.
  • If they are not eligible, consumers are encouraged to check out all plans including those off-exchange.

What is available Off-Exchange:

Off-Exchange plans are ACA-complaint health insurance plans sold outside of the Exchange. Just like On-Exchange plans all essential health benefits as mandated by the ACA are included in these plans.

  • Since these plans are not sold on the Exchange there is no financial assistance from the federal government that can help offset monthly premiums.
  • Consumers who are eligible for a subsidy need to purchase a health insurance plan through Nevada Health Link.
  • The approved rate increase for off-Exchange plans is 2.0%.
Companies offering plans on the Exchange# of plans to choose fromCounties where plans are being offered
Health Plan of Nevada6Clark & Nye
Sierra Health & Life7Clark
Hometown Health Plan (HMO)14Carson City, Douglas, Lyon, Storey and Washoe
Hometown Health Providers (PPO)14Carson City, Clark, Douglas, Lyon, Storey and Washoe
SilverSummit1State-wide

 

RESOURCES:

Now that you know the difference between on and off-Exchange plans, you can view the approved plans and their rates by visiting the Division’s Rate Wizard Tool at http://healthrates.doi.nv.gov/Wizard.aspx

The Rate Wizard lets you compare the health insurance plans available. These rates are displayed by age, county, and are for non-smokers. The search results are displayed and then sortable by plan name, carrier name, metal tier, and whether it is offered on or off the Exchange. This allows the search to be targeted for quicker more focused results. It provides the full contracts and schedules of benefits as well.

It is important to note that these rates DO NOT REFLECT FINANCIAL ASSISTANCE offered through the federal government. To see whether you qualify, visit NevadaHealthLink.com.

If you are not sure what some insurance terms mean visit the Division’s health insurance glossary at http://doi.nv.gov/Health-Rate-Review/Glossary-of-Health-Insurance-Terms

Frequently Asked Questions

Everyone should shop for coverage...even if you already have insurance. There are new plans available each annual enrollment period so you should be sure to review your options. Even if you decide to stay with your current plan, here are some questions you should ask to be sure that you pick the plan that is best for you.

  • Does the health plan cover your preferred doctor?

  • Are your current medications covered by this plan?

  • Are you eligible for a subsidy?

  • Do you anticipate high or low medical expenses next year?

  • Is the premium affordable?

  • Is the deductible affordable?

Put all that knowledge to work. Use our Rate Wizard Tool to compare rates now.

Get Health Insurance Rates