Overview of Nevada’s Health Insurance Exchange
When the Affordable Care Act was passed 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 site 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.
Nevada is offering plans through the following insurers: Health Plan of Nevada, Anthem, Nevada Health CO-OP, and Saint Mary’s Healthfirst. You can shop for a plan after October 1, 2013 by web portal, telephone, or in person. Help is available with the search and enrollment process from the Nevada Health Link team. Open enrollment lasts until March 1, 2014. Your plan will be effective on January 1, 2014.
Nevada Health Link allows customers to compare up to three plans at a time while looking at over 40 points of data comparison, including insurance carrier, provider network, and price.
Per the Affordable Care Act, all plans must offer the following essential services:
- Ambulatory patient services (doctor visits)
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices (Habilitative services are for people with disabilities who need speech, occupational, or physical therapy.)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
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), and Platinum (90 percent). Lower plans have lower premiums, but higher out-of-pocket costs. A catastrophic plan is available for folks under the age of 30. This plan has a high deductible.
Adults living at or below 133 percent of the federal poverty level (also known as the FPL, which is $11,490 a year in wages for one person and $23,550 a year in wages for a family of four), or pregnant women living at or below 159 percent of the FPL, can qualify for Medicaid in Nevada, based on eligibility standards that take effect January 1, 2014.
Additional federal financial protections will start in 2015 that include a maximum annual out-of-pocket cost of $6,350 for individuals and $12,700 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, so you can easily determine what your additional out-of-pocket costs will be if you elect a higher or lower plan compared to the Silver. The Affordable Care Act (ACA) was designed so the Silver Plan would be affordable to people who had to buy their own insurance, regardless of how expensive the health care rates may be where they live.
The lowest monthly premium for a Silver Plan in Nevada for a 40-year-old non-smoker is $237.13, and the second lowest premium is $238.30. The average monthly premium for a Silver Plan in Nevada for a 40-year-old non-smoker is $349.80.
People want to how much their subsidies are, but the real question is how much will you pay? Once you figure out what the maximum healthcare percentage is for your income, then you know that's the most you'll have to pay for a Silver Plan (you may pay less). For example, if your income is $32,500 (283 percent of the poverty level), the most you’ll have to pay for health insurance is nine percent of your income. This amounts to $2,926 a year, or $244 a month. The challenge is to look at the costs of Bronze, Silver, Gold, and Platinum, and decide which plan offers the best value for you. 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.
A calculator with rates for individual health insurance plans in New Mexico is available here.
To learn more about Nevada Health Link, please visit http://www.NevadaHealthLink.com, email firstname.lastname@example.org, or call 1-855-7NVLINK (1-855-768-5465).