Finding Affordable Nevada Individual Health Insurance

It is important to protect your family during times of medical crisis and financial hardship, and health insurance is one vital way to make sure you and your family are covered. For people not receiving group health insurance through an employer, purchasing an affordable Nevada individual health insurance plan is often the best way to meet your health coverage needs.

The information below contains details regarding the laws and regulations impacting health insurance coverage in Nevada.

How is eligibility for Individual Nevada health insurance determined?

People who are applying for individual Nevada health insurance coverage can expect their application to go through a review and underwriting process. During the review, the insurers will take into consideration factors including health status, lifestyle habits and age. An insurer in Nevada may decline an application for any reason, excluding people who are HIPPA eligible and newborns dependents of covered individuals.

HIPPA's Group-to-Individual Portability Coverage regulations require insurers to offer a choice between either a basic policy or a standardized health plan through the insurer. This medical insurance coverage is guarantee basis and cannot be denied based on health status or history.

What are the Guaranteed Benefits and Pre-Existing Conditions in Nevada?

Nevada Individual health insurance benefits will vary based on the plan type chosen. The state requires insurance providers to offer two standardized health policies that are available to all consumers, covering certain benefits. Individuals have the choice to select one of these two options (basic or standard) or secure a different policy of their choice through a private insurance company.

The basic health insurance plan in Nevada offers benefits with a 50% co-insurance coverage. Benefits for this option include:

• Hospital visits
• Emergency services
• X-rays
• Hospice care
• Skilled nursing services
• Rehabilitation services
• Prescription drugs
• Lifetime maximum benefit not to exceed $1 million.
• Certain benefits such as maternity, mental health services and substance abuse counseling are not covered.

The standard Nevada health insurance plan offers benefits with a 80% coinsurance coverage, including the benefits for the basic plan in addition to:

• Maternity benefits
• Mental health services
• Substance abuse counseling and services

When it comes to pre-existing conditions, insurance providers in Nevada have the right to impose an exclusionary period of typically 6 to 24 months on any pre-existing condition, but they may only look back on the previous 6 months to identify these conditions. An individual who makes a medical claim for a condition within the first 3 years of coverage may still experience a claim denial if the insurer determines that the condition should have been labeled pre-existing.

The state of Nevada allows insurers to use elimination riders, which give the insurer the ability to exclude certain conditions from coverage for the life of the plan. People who are HIPPA eligible or are selecting to purchase a conversion coverage plan are safe from exclusionary periods or elimination riders.

What to Expect from Premiums for Individual Health Insurance in Nevada

Premium rates for Nevada individual health insurance are based on factors such as age, health history and lifestyle habits, but in Nevada there is a limit to how much an insurer can charge although the rates will likely be higher than the norm.

Insurers reserve the right to cancel coverage if they choose to no longer provide a specific health plan, but they may not cancel a policy due to changes in one's health status or an increase in medical claims. Furthermore, individuals are guaranteed to be able to renew when the plan's term comes to a close.

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