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Purchasing Health Coverage in Nevada 2019

Explore a variety of plans available to individuals, self employed, and small business owners

What To Consider

Hello and welcome to our page! We are here to help you navigate the world of health insurance, and specifically plans and coverage available in Nevada for 2019. We understand this topic can be boring, but we also know that this is significant investment that needs to be done right. To put it bluntly, many people are paying far too much $$, or have no coverage because they were not aware of more affordable options available to them.

Healthcare coverage is not, and should not be one size fits all. People’s healthcare needs differ, and the right healthcare coverage can depend on these factors that include, age, pre-existing conditions, family size, out-of-pocket expenses, doctor/hospitals, financial assistance, health status and more. Below we will help you explore options which you probably know about, and coverage many do not even know exists.  For example, have you heard of medical cost sharing or direct primary care doctors to help lower healthcare costs?

Below you will find an overview, it includes four ways to get healthcare coverage. Exploring each option below is a good first step. Scroll to the bottom after each category to find links to particular companies and there you can learn about each particular company that you would like to explore.

Remember we are here to help, if at any point you would like to connect, create request  by completing the contact form at the bottom of the page. In the message section you can, schedule a time to connect, request a proposal, or ask a general question.  In person appointments are also available by request. We respond quickly!

If you prefer to look at plans yourself, click on each particular company in the “links” section to explore more details or create quotes for yourself.

We invite you to use our website as your one stop resource to explore all your healthcare options available in Nevada and we hope to connect with you soon!

Health Insurance

Also known as the “Market Place” or sometimes “ObamaCare”. Each state will either use Healthcare.gov or their specific state website to allow individuals and small business consumers to shop for health insurance plans.

* In NV their are NO small business Market Place plans avilable for 2019. This is only a place for individuals and family’s to purchase coverage.

In Nevada there are also company’s and plans that can be found “off-exchange”. Simply put, “off-exchange” means that these are plans not found on healthcare.gov, but available to purchase without financial assistance. Due to one’s purchasing health insurance off-exchange they could not be eligible for financial assistance.

In Nevada, there are four companies that offer ACA compliant health insurance plans, which are: Health Plan of Nevada, AM Better, Hometown Health and Sierra Health & Life.

There are 30 plans offered by these four companies in 2019. The plans that are offered on healthcare.gov will be through AM Better and Health Plan of Nevada. There are 13 plans, and all of these plans have HMO networks. Again, they will be eligible based on being purchased at healthcare.gov for financial assistance for those that qualify.

Found off exchange will be 17 health insurance plans offered by Hometown Health (11) and Sierra Health & Life (6). You can quote and view plans, quote, or sign up for coverage from the link tab found below.

When comparing these four companies in Nevada some common factors include: , typically in-state network only, ACA compliant plans, open enrollment Nov 1st-Dec 15th.

Of these company’s Hometown Health has the only PPO network available. AM Better and Health Plan of Nevada both offer HMO networks and SHL offers an EPO network of doctors and hospitals

To sign up for coverage outside of the open enrollment (Nov 1-Dec 15th) one must have  a “qualifying event“.

These health insurance plans are typically recommened for those in need of pre-existing condition coverage or if receiving financial assistance through what is known as an Advanced Premium Tax credit.

If you find the monthly cost and out-of-pocket costs are still too high, we recommend considering medical cost sharing as a way to significantly lower these costs.

Rates on all health insurance plans are set and standardized regardless of how or where they are purchased. In other words, you CANNOT shop around for better rates. Health insurance rates between these 30 plans are only based on a few factors: zipcode, age, tobacco usage, and any financial assistance the applicant is eligible to receive.

Links

To find out of you are eligible for financial assistance or to apply follow the appropriate link.

Healthcare.gov

List Omni Insurance as your broker of record when completing your healthcare.gov application with the following information.

“NPN”-16688290

Hometown Health PPO Plans

Sierra Health & Life EPO Plans

Medical Cost Sharing

Also known by other names such as “HealthShare”, “Christian Ministry”, and “HealthShare Cost Sharing Ministry” programs. This type of health care coverage is offered and administered by non-profit organizations and NOT insurance companies. Designed for healthier individuals and families, coverage through a HealthShare will typically save members 40-60% in annual healthcare costs.

No open enrollment deadlines, enroll through out the year!

We find often this coverage is sought after by those who: are not receiving financial assistance (subsidy), live healthy lifestyles, do not use tobacco, have no pre-existing conditions in need of medical treatment, have no or minimal maintance medications, are in need of lowering out-of-pocket medical expenses, or are in need of lowering monthly healthcare coverage.

There are obvious benefits to this coverage. First, coverage can be customized.  Also, there is a large national network of doctors and hospitals across 50 states. Finally, it has a lower overall cost. Unlike traditional health insurance, medical cost sharing is universal and offered the same state by state.

Each particular HealthShare will function quite differently from one another and it is important to read through the “member guidelines” to understand those differences.

Navigate the “links” section below to explore plans designed for self-employed or small businesses. This seems to be a great fit for many small businesses throughout Nevada. You will also find a variety of companies designed for invididual coverage.

Links

Small Business/Self-employed/1099 contractors

Step 1 choose a basehealth plan

Base Health

Step 2 choose a medical cost sharing amount

HealthShare

Step 3 dental  or vision?

For individuals- Click on each link to create a quote and explore each company.

ZionHealth.org

Medi-Share

AlieraCare

Altrua

Short-Term Medical

Short-term health insurance can provide a temporary solution to help fill gaps in coverage. Consider short-term if you are: between jobs, waiting for other coverage to begin, or waiting to be eligible for Medicare coverage. There are a variety of plans and companies to choose from and coverage will vary by state laws.

In Nevada there are a variety of plans and company’s to choose from that you will find in the links tab below. Most offer a variety of deductibles that will range from $500-$12,000 to fit any budget or need. Its important to check network providers to make sure you doctor or hospital is in-network. From these tabs you will be able to, quote covereage, see details of plans, changes rates, and sign up for coverage online. Reach out to us if you need help designing a plan.

 

Direct Primary Care

Here is a concept that so many are asking about and many do not know even exists. Are you tired of going to a primary care doctor who is stuck behind a computer screen while barely making eye contact? If so, this may be a solution for you to get a trusted relationship back with your provider.

Although these DPC’s will function differently from one practice to another, the concept is straight forward. Their patients pay a monthly subscription/fee and in return get direct access to the healthcare provider of their choice. Through most DPC’s, patients can use this service as often as needed, call for prescriptions, and most importantly have a trusted physician willing and able to spend the quality time needed with them. Many will have accesss to services such as discounted labs or imaging that are done outside the scope of their service. We have noticed that these DPC’s often times will offer services not typically rendered at primary care providers that include holistic, or naturopath medicine.

This solution, offered though DPC’s, although wonderful and much needed, is not the only piece of this health coverage puzzle. Patients do need to retain an aspect of catastrophic coverage beyond the affordable monthly cost of the DPC service. There are strategies recommended by a company called “Planstin” on this website to combine a health savings account with DPC coverage.  Typically it is recommded to retain a health insurance plan or a medical cost sharing plan in conjuction with DPC coverage. One will find that coverage with a DPC and medical cost sharing will be signficanly less in cost as it compares to health insurance coverage without any financial assistance.

These are independent practices and as stated previously they do have differnces. 

Links

Direct Primary Care

 

Recommended catastrophic coverage for indviduals:

https://zionhealth.org/

Recommended coverage for self-employed, small business, or 1099 contractors. Base Health Plan HSA

Base Health

What To Consider

When considering catastrophic healthcare coverage, there are two options: high deductible health insurance and medical cost sharing.  When deciding which is best, the first question to answer is whether a pre-existing or chronic condition is prevalent? To the left is a video that will explain these options in greater detail and provide a real-life example.  While higher in cost, a high deductible health insurance plan may be the best fit for some. Others, especially healthier individuals, may discover the lower cost alternative to health insurance, known as medical cost sharing, to be the best fit.

Catastrophic Exactly is Coverage?

 

Catastrophic health insurance plans as defined by the ACA (ObamaCare) are only eligible to those under the age of 30 and meet specific guidelines.

Although it’s commonly understood by most that someone over the age of 30 looking for “catastrophic coverage” is in fact searching for coverage with a high deductible, or coverage with higher out-of-pocket costs.

Regardless, this health coverage has similar characteristics to a “catastrophic”plan. It simply is not defined as “catastrophic” by the ACA for those over the age of 30.

High Deductible Health Insurance

Looking only at insurance plans, a high deductible health insurance plan can leverage the lowest overall cost for catastrophic coverage. This type of plan will provide coverage for pre-existing or chronic conditions after the deductible is met. For 2019, the annual out-of-pocket maximum for these plans is $7,900 for an individual, and deductibles will vary from $6,000-$7,900 depending on the plan offered in a specific area.

If eligible for financial assistance, these plans purchased on-exchange can have a lower cost for some enrollees. Determine your financial assistance eligibility HERE.

Alternative Catastrophic Coverage

Fortunately for many, there is an alternative for catastrophic coverage which is even lower in cost. Medical cost sharing can be a great way to lower overall healthcare costs and exposure to a catastrophic medical need. Medical cost sharing, while it can alleviate a financial burden for many, is not always an option for everyone and should be carefully considered.

Medical cost sharing works best for those who are healthier, do not receive financial assistance, and are willing to pay for smaller medical needs out-of-pocket. Often families, self-employed, or small businesses benefit the most from medical cost sharing. Those who determine medical cost sharing to be a good fit will find an average 40-60% savings than with a traditional high deductible health insurance plan.

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