Nevada residents the time is now!

While practically the penalty for not having insurance in Nevada has now been reduced to zero, there are still many good reasons why it’s still important to have health insurance. During this crazy time in a pandemic world it is more important than ever to weigh those decisions carefully and this is to help navigate that for locals in Nevada as open enrollment swiftly approaches. Open enrollment starts on 2020 Nov. 1^st – Jan. 15^th and the only time you can enroll in a marketplace health insurance plan for 2021. There are exceptions to this window if people have certain life events but for most people this is the only window in the year to be able to enroll.

Healthcare.gov vs Nevada Health Link

In 2014 Obamacare went into effect making anyone in Nevada that wanted comprehensive coverage to enroll in health insurance via healthcare.gov this is the official government healthcare website. Started in 2015 Nevada Health Link came on to the scene to make Nevada a state-based health insurance exchange. Up until 2019 Nevada residents accessed this state-based exchange using the site healthcare.gov. In fall 2019 the hybrid of Nevada Health Link and healthcare.gov fully switched over to Nevada Health Link running the full show. Now all enrollment for residents in Nevada is done through Nevada Health Link’s own site nevadahealthlink.com which is the official site for anyone in living in Nevada. Besides a lot of confusion this website transition doesn’t change a whole lot for Nevada residents.

If you are working for a company

If you are currently employed, then as we approach open enrollment Nov. 1^st  – Jan. 15^th for plan year 2021 your decision is usually quite simple. You will have 1 or 2 options for health insurance through your employer to choose from which you can weigh out the pros and cons. While different employers subsidize different amounts of the cost of health insurance employees pay. Insurance through the workplace tends to be cheaper than if you go out on your own. If you work for a small employer that does not offer health insurance than you will also want to enroll in a marketplace health insurance plan.

Recently unemployment

It’s no news that the pandemic has had devastating effects on employment and particularly in Las Vegas. If you have moved to COBRA insurance after becoming unemployed then you will want to consider buying a Nevada exchange plan. COBRA is bridge insurance that allows you to stay insured after you lose a job. COBRA is called group health insurance, but the term is misleading. While it is often cheaper to have health insurance through work, it is often much more expensive to have COBRA insurance than a Nevada marketplace plan.

Why should you purchase through the state exchange

There are certainly other health insurance options out there that are not on Nevada Health Link. However, consumers must be leery as many of these may not be ACA compliant opening you to serious risk. Which completely cancels out why you are getting insurance in the first place, to protect yourself in case of a emergency! There may also be more expensive plan options that give more network coverage but consumers will also want to do an added layer of due diligence, so they don’t get mislead by any misleading marketing. Nevada Health Link is the only place you can get subsidies or financial assistance that help cover cost of monthly premium. All qualified health plans offered though Nevada health link must be ACA compliant and cover the 10 essential health benefits

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency Services
• Hospitalization (like surgery and overnight stays)
• Pregnancy, maternity and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services (for free) and chronic disease management
• Pediatric services, including dental and vision care (adult dental and vision is not included)

To be clear these 10 essential benefits generally have a deductible, copayment, or out-of-pocket cost to them. These are simply the benefits the government has said are important to be considered a comprehensive health plan. While the government sets limits and caps on what is considered acceptable cost for each of these services, that is where the choice and tier of what health plan is best for you becomes an important decision.

What are the options in Nevada

People living in Nevada have access to 5 different qualified health plan carriers. This is a huge positive move from last year, where there was only 3 carrier options for Nevada residents.

Nevada Qualified Health Plans

• Health Plan of Nevada
• Silver Summit
• Anthem HMO
• Friday Health Plans (New)
• SelectHealth (New)

Within each health care provider there exists different tiers Catastrophic, Bronze, Silver, Gold. As you move up in tier the premium is higher but so are the benefits.

The following dental providers are also available to Nevada residents this year.

Nevada Dental Plans

• Alpha Dental Plan
• EMI Dental Plan
• Delta Dental Plan
• Liberty Dental Plan
• Best Rocky Mountain Dental Plan

Lets talk costs

Costs of insurance is an unavoidable reality. While computers continue to plummet every year, it seems insurance is one of those costs that seems to raise every year. If insurance was free or dirt cheap why would anyone consider going without insurance or consider questionable non-comprehensive plans. Family budgets can be strapped and its easy to look towards not getting insurance. I myself, have lived on the edge in the past and skipped out on health insurance due to the cost seeming frivolous. Rather than focusing on policy reform I want to cover what immediate relief Nevada residents have to get access to health insurance making it more affordable to them. The premium tax credit is one the biggest subsidies you can get from the government for health insurance. It is based on a income range band. Income is defined as Modified Adjusted Gross Income (MAGI) plus some adjustments. You cannot find a line item labeled Modified Adjusted Gross Income (MAGI) on your tax return but you can find Adjusted Gross Income (AGI) for tax year 2019 on Form 1040 line 8b. (MAGI) and Adjusted Gross Income (AGI) tend to be very close for most people. (AGI) is calculated as follows

From Gross Income, subtract the following:

• Educator expenses
• Certain job expenses performing artists
• Unreimbursed job expenses of state & local officials paid on fee basis
• Health savings account deduction
• Moving expenses for members of Armed Forces
• 50% of self-employment taxes for Social Security and Medicare taxes
• Contributions to retirement accounts
• Amount you paid for health insurance during the year, limited to net self-employment income
• Any penalty paid on early withdrawal of money from savings account
• Alimony paid
• IRA deduction
• Student loan interest
• Tuition and fees

=  Adjusted Gross Income (AGI)

If your household income falls 138% to 400% of the Federal Poverty Level (FPL) then you will be eligible to receive a subsidy to assist in your monthly premium. Depending on your income this subsidy can greatly lessen the cost of insurance to you. There are some people that go every year without health care coverage not knowing they qualify for inexpensive insurance due to the subsidies they qualify for.

Federal Poverty Line (FPL)

For small business owners the cost of insurance is often a large expense the silver lining for small business owners here is your premiums can be eligible as a tax deduction for your business.

Working with an agent/broker

If you are very savvy, know exactly what you want, and don’t mind the inconvenience of taking time out of your day you can enroll in a plan yourself. However, for the majority many people can benefit greatly from the help of a professionally licensed health insurance agent. Fortunately, Nevada Health Link makes it as easy as possible to do so, you don’t need to figure this out alone. You can call the consumer assistance line at 1-800-547-2927 or work with a licensed Health Insurance Agent of your choice. Health insurance agents/brokers are trained and certified by Nevada Health Link and licensed by the Nevada Division of Insurance. Licensed Agents/Brokers are not employees of Nevada Health Link, our job is to connect someone to the best possible plan that we can given your budget and needs. Generally working with a agent or broker is a win win situation since there is no cost to you. Any commission payment to the broker is paid by the insurance company and the premium you pay is the same regardless if you get help or not. It is true different insurance companies pay different commissions amounts to agents. Now I don’t think many agents/brokers would have many long term repeat clients if they prioritized a commission over the best plan for consumer.

Conclusion

Plan year 2021 is quickly approaching and you want to make sure you don’t miss open enrollment from Nov. 1st – Jan. 15th. This global pandemic has created heightened risk of remaining uninsured for the coming year. Don’t sign up for a non-comprehensive plan that may leave you open to extra health risks. Nevada Health Link is the official government exchange to sign up for health insurance. You may qualify for more assistance than you think and a licensed insurance professional will be able to help you get the most in deciding what health care plan is best for you and your family. If you would like my assistance during to enroll text or call me.