En español | Most Nevada residents are eligible to buy health insurance through Nevada Health Link, Nevada’s Affordable Care Act (ACA) marketplace, during open enrollment, which begins Nov. 1 and runs through Jan. 15, 2023.
Residents who experience a qualifying life event, such as a marriage, divorce, the birth of a child, a move or lost health insurance, may be eligible to buy or change coverage under special enrollment, which operates outside the usual open enrollment period.
Most people already enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households who qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help them afford health insurance. These enhanced subsidies are now available through 2025.
Prior to the 2021 law, such tax credits were only available to people earning less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.
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:
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:
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.
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income qualifies for federal tax credits for insurance premiums through 2025. According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have already seen average annual savings of over $950.
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.
Nevada Health Link plans are organized into four categories:
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.
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 9.12 percent of your household income for individual coverage.
If you lose your COBRA coverage, you may be able to sign up for a Nevada Health Link plan during a 60-day special enrollment window. Try to apply and select your plan through Nevada Health Link before your COBRA coverage ends to make sure there's no gap in coverage.
If you already have a marketplace plan and want to adjust your coverage, you’ll need to wait until the next open enrollment period, unless you experience a qualifying life event.
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.
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.
This guide was updated on Sept. 13, 2022 with information about Nevada’s special enrollment period.
This story is provided by AARP Nevada. Visit the AARP Nevada page for more news, events, and programs affecting retirement, health care, and more.
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