Nevada Individual Health Insurance

Nevada Individual Health Insurance Quotes

Health insurance is an essential precaution that allows your family to take care of basic medical needs without financial worry. For those considering Nevada individual health insurance, the possibilities are endless, as there are often literally hundreds of plans to choose from. As a Nevada resident, you should educate yourself in the state laws and regulations that affect these individual health insurance plans in Nevada.

Eligibility: How Am I Evaluated?

In Nevada, individual health insurance applicants are evaluated based on the criteria set forth by each individual insurer. Applicants can be turned down for any number of reasons, including health status. The only exception to this rule is for those who are HIPPA eligible and newborns born to covered individuals.

In response to HIPPA Group-to-Individual Portability regulations, Nevada requires that the consumer must be offered a choice between a basic or standard policy provided by the insurer, regardless of health status.

Nevada Guaranteed Benefits & Pre-Existing Conditions

The benefits covered by your individual plan will depend on what policy you choose. In Nevada, insurers are required to carry two standardized health plans, available to all consumers, that each covers specific options and benefits: a basic plan and a standard plan.

With a basic plan, you will receive 50% co-insurance coverage for :

Hospital stays
Skilled Nursing
Rehabilitation services
Hospice care
Emergency services
X-rays
Prescriptions

All with a lifetime maximum benefit of $1 million. There are things that are not included in this basic plan, such as maternity benefits, mental health services, and substance abuse services.

With a standard plan, you will receive a 80% co-insurance coverage for everything listed above, in additional to coverage for maternity benefits, mental health services, and substance abuse services.

You can choose one of these two policies or a completely different policy offered by the insurer.

In the case of pre-existing conditions, insurers can place an exclusionary period on any health condition for any length of time they see fit; however, they are only allowed a 6-month look back period to determine what conditions to include. If within the first 3 years you make a claim for a condition that was not listed as pre-existing by your provider, it can still be denied if your insurer decides that the condition should have been listed as a pre-existing condition. This is why it is important to always be truthful about any conditions that you may have.

Nevada also allows health providers to include elimination riders on health insurance policies. Unlike an exclusionary period, which usually lasts 6 to 24 months, an elimination rider will allow the insurer to exclude listed conditions from your policy forever. Only those who are HIPPA eligible or purchasing a conversion policy are protected from exclusionary periods and elimination riders.