Nevada Health Insurance

According to the Center for Disease Control, from 2001 to 2003, an average of 18.3% of Nevada residents went uninsured for Nevada health insurance.

Nevada Health Insurance Regulations

Any individual covered under employer health insurance in Nevada cannot be denied or limited access to the employer’s provided health insurance. Individuals, however, who do not have group health insurance coverage under an employer can be denied or limited access for individual Nevada health insurance based on age, health, or any other factor. Nevada medical insurance rates have limits but can still vary based on age and health.

All Nevada health insurance policies are guaranteed renewable which means that any individual is guaranteed the right to renew an existing Nevada health insurance policy. Premium rates, however, can change with renewal.

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Pre-Existing Clauses

Nevada health insurance companies can impose elimination riders and pre-existing exclusion periods. Medical insurance policies in Nevada can permanently exclude coverage for a condition or body part. This is an elimination rider. Nevada health insurance companies can also decide not to cover any medical condition that was diagnosed or treated prior to the beginning of a health insurance policy and exclude coverage for this pre-existing condition for a set amount of time. Pre-existing exclusion periods can also be imposed on conditions claimed by the individual during policy even if the individual had never been treated or diagnosed for the condition prior to the policy if the company determines the condition existed prior to coverage.

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Pregnancy

Pregnancy can be considered a pre-existing condition but complications due to pregnancy can still be covered. A parent’s individual Nevada health insurance policies must cover newborns from birth through the first 31 days after which the policy may need to be adjusted. Disabled children may remain as dependents under a parent’s health insurance policy beyond the normal age at which children are no longer considered dependents.

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Health Benefit Plans

For Nevada residents who are HIPAA eligible, Nevada health insurance companies are required to sell one of two standardized plans. Individuals must select from either a basic or standard health benefit plan:

• Basic plan covers skilled nursing, hospital, rehabilitation, physician services, laboratory and x-ray services, hospice, emergency care and prescription drugs all with a 50% coinsurance.
• Standard policy covers all the Basic plan services but with a 20% coinsurance and also covers maternity care and limited mental health and substance abuse services.

Some Nevada health insurance companies sell temporary health insurance policies to individuals who are either between plans or between employers.

Alternative Nevada Health Insurance Options

For individuals who can not afford individual Nevada health insurance or may not qualify due to “uninsurable” status, some Nevada state programs may help:

• Nevada Medicaid is available to any qualified individual who meets the eligibility criteria.
• Nevada Check-Up is Nevada’s State Children’s Health Insurance Program and is designed to provide health insurance to children up to 19 years of age whose families do not qualify for Medicaid and who might not otherwise be able to afford Nevada health insurance.

Nevada Division of Insurance

Nevada Division of Insurance
788 Fairview Drive, Suite 300
Carson City, Nevada 89701

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For other Nevada Insurance Resources, See:

• Nevada Auto Insurance
• Nevada Home Insurance
• Nevada Health Insurance

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