When the Affordable Care Act (ACA) was enacted in 2010, states gained the opportunity to build health insurance marketplaces called exchanges. Nevada launched an exchange called Nevada Health Link in October 2013. The website is a marketplace that allows both individuals and small businesses to find, compare, and purchase income-based health insurance plans that work for their health needs and income levels.
In 2015, Nevada created a new process for citizens to enroll in healthcare. First, you’ll be asked to complete a pre-screen process. After the pre-screen, you’ll be directed to either healthcare.gov to shop for income-based insurance plans or Access Nevada for Medicaid and Nevada Check Up. Nevada Health Link can help you with the search and enrollment process.
Nevada is offering plans through the following insurance companies:
- Health Plan of Nevada
- Nevada Health CO-OP
- Saint Mary’s Healthfirst
With Nevada Health Link, you can compare up to three plans at a time and look at over 40 points of data, including insurance carrier, provider network, and price.
All plans must offer the following essential services:
- doctor visits
- emergency services
- inpatient hospital services
- maternity care
- newborn care
- mental healthcare
- prescription medications
- rehabilitative care
- laboratory services
- preventive care
- chronic disease management
- pediatric care
- substance abuse rehabilitative services
There are four basic plans available with varying levels of coverage:
- bronze (60 percent of expenses paid by plan)
- silver (70 percent)
- gold (80 percent)
- platinum (90 percent)
Lower plans have lower premiums, but higher out-of-pocket costs. A catastrophic plan, with a high deductible, is available for those under the age of 30.
Many people will want to know how much of a subsidy they qualify for, but the real question is, how much will you pay? Your ultimate decision should be based on your income versus how often you might need to use the coverage. For example, if your annual income is $32,500 (273 percent of the poverty level), the most you’ll have to pay for health insurance is 9 percent of your income. This amounts to $2,592 a year, or $216 a month.
A helpful calculator offered by the Kaiser Family Foundation provides an estimate of your subsidy eligibility and how much you should expect to spend on health insurance.
Depending on your income, you may qualify for financial aid to help offset the costs of coverage. This may come in the form of:
- Medicaid coverage
- tax credits
Adults living at or below 133 percent of the federal poverty level (FPL) may qualify for Medicaid in Nevada. Pregnant women living at or below 160 percent of the FPL may also qualify. The FPL for 2015, according to the Health Insurance Marketplace, is:
- $11,770 in individual annual wages
- $15,930 for those in families of two
- $24,250 for a family of four
- $40,890 for a family of eight
As of 2015, the annual maximum out-of-pocket is $6,600 for individuals. It’s $13,200 for families. Capping out-of-pocket costs will help consumers pay medical bills that aren’t covered by insurance, reducing the chances of bankruptcy.
Tax credits are based on the silver plan. This helps you determine any extra out-of-pocket costs if you elect a higher or lower plan. The ACA was designed so the silver plan is more affordable for individuals buying their own insurance. This is regardless of how expensive the healthcare rates are where you live.
Open enrollment for individuals begins November 1, 2015, and ends on January 31, 2016. Businesses can enroll throughout the year.
Getting the right health insurance plan is important for you and your family’s health. Start researching your options before the enrollment period to ensure that you sign up for the best plan.