Individual Health Insurance in Nevada

Individual health insurance is available to Nevada residents who do not have access to employer sponsored plans. These residents may work for an employer that does not offer health insurance or they may be unemployed, retired or students. The Nevada Department of Health and Human Services is the state's governing authority to ensure all Nevada residents have access to quality, affordable health care.

Individual Plans

• Individual health plans are sold by private insurers. Not all Nevada residents qualify for individual insurance. Individual plans are based on health status. Health insurers may deny coverage to residents whose health status poses a high risk for the company.

  Nevada individual health insurance policies cover a variety of circumstances depending on the type of coverage bought. Nevada insurers sell a basic or standard benefit plan. Basic plans provide coverage for emergency care, hospitals, nursing homes, hospice care, rehabilitation services and prescription drugs. Standard plans cover everything a basic plan covers but also pays for maternity care, mental health and substance abuse services.

State-Sponsored Health Insurance

• The state partners with provider service and managed care networks to provide Medicare and Medicaid services to eligible low-income individuals and families. Nevada Medicaid is available to low income families with children, Social Security Income recipients, infants born to Medicaid-eligible women, some Medicare recipients and pregnant women whose household income does not exceed 133 percent of the federal poverty level. Medicaid-eligible recipients receive comprehensive medical care including doctor's visits, preventative care, pre-natal care, inpatient and outpatient surgery, emergency services and more.

  Nevada Check-up is a children's health insurance program which provides low-cost, comprehensive insurance coverage to low income uninsured children from birth to age 18. This insurance option is open to children who are not covered by private insurance and are not eligible for Medicaid.

Federal Health Insurance

• Nevada does not have a health insurance risk pool for individuals who cannot obtain insurance because of a pre-existing condition. As an alternative, Nevada residents may apply for the federal Pre-Existing Condition Insurance Plan (PCIP) offered through the U.S. Department of Health and Human Services. The PCIP covers health benefits such as specialty care, hospital care and prescription drugs. There are three plans available. Premiums vary by plan type and age. Similar to individual health plans, participants may choose from health care providers within a specific network. Participants who seek care from in-network providers receive 100 percent paid preventative care with no deductible.

Considerations

• It is important to note that regardless of the type of individual health plan purchased in Nevada, there is a limit on how much insurance companies can charge for coverage. Premiums may vary by age, gender and health status but the state places a maximum on premium amounts. This is beneficial for higher risk participants. Also, Nevada individual health insurers cannot cancel an insurance policy because of a sickness. As long as premiums are paid and participants remain within the plan area, Nevada individual health insurance policies have guaranteed renewability.