Nevada Health Insurance
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Facts and Figures
-
Place in State
Health Report Card 42nd - Insured 2,080,800
- Uninsured 516,600
-
Insurance
Carriers 14 -
Number of
General Doctors 3710 -
Number of
Hospitals 35 -
Average Cost of
Health Insurance* $863
Breakdown of Insureds
- Employer-sponsored health insurance 69%
- Private plans 5%
- Medicaid 11%
- Medicare 14%
- Others 1%
Insurance Carriers
- Aetna
- Assurant Health
- Celtic
- Coventry
- Golden Rule Insurance Company
- Great American Health Insurance Company
- Health Plan of Nevada
- Humana
- John Alden Life Insurance
- Sierra Health and Life Insurance Company
- Time Insurance
- Tonik Health Insurance
- UnitedHealthOne Health Insurance
- World Insurance
State Health Report Card
While smoking has decreased from 29.0 percent to 21.3 percent of the
adult population in the last ten years, 434,000 adults still smoke in
Nevada.
In the past year, the percentage of children in poverty increased from 17.9 percent to 23.6 percent of persons under age 18.
In the past five years, diabetes increased from 7.1 percent to 8.5
percent of the adult population. There are now 173,000 Nevada adults
with diabetes.
In the past ten years, obesity increased from 17.9 percent to 23.1
percent of the adult population. There are now 470,000 obese adults in
the state.
The high school graduation rate declined in the last five years from a
reported 72.3 percent to 56.3 percent of ninth graders who graduate
within four years.
Nevada Health Insurance Laws and Regulations
Nevada health insurance plans are required to be sold with a guaranteed renewability clause. This clause allows policyholders to renew their coverage as much as they want to as long as they pay their premiums and do not violate their contracts. Health insurers are also prohibited from canceling a customer's policy because of deteriorating health. When writing new Nevada health insurance plans, insurers can exclude coverage for a pre-existing condition. This exclusion period can be permanent in some cases. The price of health coverage in Nevada can be based on factors like age, health status, family health history, and other related factors. In addition, an application can be denied according to these factors. This is why it is a good idea to get health coverage at an earlier age, while you are healthier. Small businesses (those with 2 to 50 employees) have the option to purchase a group health plan similar to group health plans being offered throughout the state. Nevada health insurance quotes for group coverage can vary owing to the differences in age, health status, and family health history among group members. In order for small companies to maintain their group plans, certain conditions must be satisfied like having a minimum number of participants and a minimum contribution by the employer. Group health plans may be cancelled if these and other requirements are not met. However, group health plans cannot be cancelled based on a group member's failing health. Self-employed individuals do not have access to group health coverage available to small businesses. However, they can opt for an individual health plan, which has the advantage of having a portion of the premiums tax deductible.
State Government Insurance Programs Offered
Pre- existing Condition Insurance Plan (PCIP) Run by U.S. Department of Health and Human Services www.PCIP.gov
866-717-5826
The Pre-Existing Condition Insurance aims to provide health insurance to those who have difficulties getting coverage because of a pre-existing condition. Coverage includes a wide range of benefits which includes hospital care, primary care, specialty care, and prescription drugs. Eligibility: 1. Must be a U.S. resident living in Nevada. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.
Medicaid dwss.nv.gov
775-684-3600
800-992-0900
Medicaid offers coverage to low-income individuals and families who cannot pay for their medical care. Applicants for this program should meet financial and other eligibility requirements. Benefits for this program include physician services, inpatient hospital, outpatient services, home health services, dental & vision, laboratory & x-ray, ambulatory surgery centers, non-emergency transportation, nursing, family planning, Healthchek (EPSDT) program services, Medicare Premium Assistance, Eligibility: 1. Must be U.S. citizens or legal residents living in Nevada. 2. Must not exceed income limits: Pregnant women: 200% of the Federal Poverty Level (FPL) children aged 0-18: 150% of the FPL. Workers with disabilities: 250% of the FPL, with an asset limit of $10,580, must be 16 to 64 years old, with disability, must be employed. Aged, blind, or disabled: Singles earning 64% of the FPL with an asset limit of $1,500; couples earning 83% of the FPL with an asset limit of $2,250.
Nevada Check Up www.nevadacheckup.state.nv.us
877-543-7669
800-360-6044 775-684-3777
Nevada Check Up program offers low-income, comprehensive health coverage to qualified children under 19 years. Services covered include: physician services, inpatient and outpatient hospital services, lab and X-ray, prescription drugs, immunizations, dental, vision, mental health, and many more. Eligibility: 1. Must be a U.S. citizen or qualified resident living in Nevada. 2. Must be under 19 years old. 3. Must not have health insurance coverage within the last six months prior to enrollment or lost coverage beyond parents' control. 4. Must not be eligible for Medicaid. 5. Income must be between 100% to 200% of the FPL.
Nevada Early Intervention Services (NEIS) health.nv.gov/BEIS.htm
800-522-0066
Nevada's Early Intervention Services aims to identify infants and toddlers who have, or who are at-risk for developmental delays; to address individual needs of children with developmental delays; and promote learning and participation in family and community life through the cooperation of families, caregivers, and other providers. Early Intervention services include medical services for diagnostic or evaluation purposes, health services, physical and occupational therapy, psychological services, audiology services, speech and languages services, and many more. Eligibility: 1. Must be a child under the age of 36 months; and a resident of Nevada. 2. Has been diagnosed with a qualified condition like autism, blindness, deafness, Down syndrome, and other conditions that can result to a developmental delay, or 3. Shows signs of developmental delays such as in speech and motor skills.
Women’s Health Connection (WHC)
888-463-8942
775-684-4285
The Women's Health Connection is a no-cost breast and cervical cancer early detection program available to eligible women in Nevada. Services include breast and cervical cancer screening services, clinical breast exams, mammograms, Pap smears, and pelvic exams. Eligibility: 1. Must be women residing in Nevada, 40 years or older. 2. Must not have health insurance, HMO coverage, Medicaid, Medicare Part B, or current health insurance does not cover the services in the program. 3. Must not exceed income limit of 250% of the federal poverty level.
Medicare www.medicare.gov
Medicare
800-633-4227
www.medicare.gov
Medicare Prescription
Drug Program
800-633-4227
Senior Rx
866-303-6323
www.dhhs.nv.gov/SeniorRx.htm
This health care system is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.
Heath Care Reform
With the new health care law, children under the age of 26 can choose to stay under their parent's Nevada health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In Nevada, 22,640 young adults have insurance coverage through this provision as of June 2011.
The new health care law allowed 24,892 Medicare policyholders in Nevada to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, 22,193 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $553 per person or a total of $12,274,764 was saved in Nevada.
Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, 579 individuals in Nevada have benefited from this new law.
When looking at Nevada health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. All private policyholders in Nevada will get greater value for their premium payments because of this 80/20 rule.
Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all Nevada health insurance with no deductibles or co-pays. In 2011, 230,891 Medicare subscribers and 477,000 individuals with private policies received such services in Nevada.
Under the new law, insurance companies are no longer allowed to impose an annual dollar limit-a cap on the yearly spending for your benefits, or a lifetime dollar limit-a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 937,000 Nevada residents have benefited from this law.
If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of Nevada received a total of $5 million.
All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In Nevada, 28 community health centers received a total of $3.7 million to fund these improvements.
In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. Nevada has already received a total of $7.5 million to support its policies, programs, and communities to help its residents lead healthier lives.