Curious about health care in the Silver State? According to a study by US News, Nevada has the 35th best health care in the nation. The study considers access, quality, and public health.
Health insurance options in Nevada
There are several ways for NV residents to access health care in their state.
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Nevada residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 48% | ||
| Individual or family | 5% | ||
| Medicaid | 19% | ||
| Medicare | 14% | ||
| Military | 2% | ||
| Uninsured | 11% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
11 percent of Nevada residents are uninsured, just above the national average. A high percentage of uninsured people can raise premiums for insured people.
Nevada health insurance companies
Residents have a few different options for health insurance companies. These companies offer both individual and family plans in your state:
- Friday
- Health Plan of Nevada
- HMO Nevada
- SelectHealth
- SilverSummit
Nevada health insurance costs and rate factors
NV residents spend an average of $6,714 per year on health care, less than the national average. So, what determines prices in Nevada? Prices vary from person to person, but depend on these factors:
Plan type
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. The more coverage you want, the more you’ll pay in monthly premiums.
How much should you expect to pay in NV? These are the average prices for each plan type for a middle-aged state resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $307 | $372 | $482 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Premiums for gold plans cost about 57 percent more than bronze plan premiums. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans only cover 60 percent of costs.
Residents may also qualify for a catastrophic plan, the lowest level of coverage available. Catastrophic plans have low monthly premiums, but a yearly deductible of $8,150. It may save you money to purchase a bronze or silver plan if you need to use your insurance.
Body mass index
According to the CDC, the higher your body mass, the higher your risk for serious health conditions. That’s why insurance companies analyze your BMI to determine your risk-level. A higher BMI means higher monthly premiums.
In 2018, NV had a 30.6 percent obesity rate, the 32nd highest rate in the country. Out of the many state residents who used QuoteWizard to compare health insurance plans, 29 percent have a BMI in the obese range.
Tobacco use
Smokers pay more for health insurance due to the substantial risks from tobacco use. About 16.5 percent of state residents are smokers, the 20th lowest rate in the country.
Age
According to HealthCare.gov, older people tend to pay up to three times more for health care than younger people. NV residents who used QuoteWizard to shop for health insurance are, on average, 41 years old.
Location
Your location plays a large role in your monthly premiums. That’s because every state has different rules, regulations, and providers for health insurance.
Also, providers use a community-rating to determine your insurance costs. Rates are partly based on the combined claims that everyone files. So, if your neighbors file an abnormally high number of claims, your rates could rise.
So, your state’s overall health plays role in your premiums. According to America’s Health Rankings, NV is the 37th healthiest state in the nation.
Nevada health insurance laws
The Affordable Care Act limits what insurance companies can use to determine the price of your policy.
- Pre-existing conditions: Thanks to the ACA, insurance companies can’t charge you more for pre-existing conditions. People with pre-existing conditions used to pay more for health insurance.
- Gender: Insurance companies also cannot charge men and women different premiums for the same plan. That’s good news, especially because women historically pay more for health care.
- Insurance and medical history: Insurance companies also used to charge people more for lapses in insurance and previous medical problems. Now, the ACA limits providers from using those factors to determine your prices.
There’s a limit to how much you’ll pay out-of-pocket for marketplace plans. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
NV state law requires health insurance companies to offer at least some coverage for the following services:
- Hospice coverage
- Cancer screenings
- Autism spectrum disorders
- Management and treatment of diabetes
- Drugs or devices for contraception
- Treatment for abuse of alcohol or drugs
- Complications of pregnancy
There are additional services that providers need to offer. Check out the complete list on cms.gov.
Medicare and Medicaid in Nevada
Medicare and Medicaid are both government-funded health care programs that NV residents can qualify for. Medicare covers seniors, whereas Medicaid helps low-income families and children.
Medicare
Residents 65 and older qualify for Medicare. There are several coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Programs with these income limits:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The number of uninsured Americans has seen dramatic improvement since the Affordable Care Act (ACA) was enacted in 2010. Here’s how a key component of that legislation, Medicaid expansion, helped decrease Nevada's uninsured rate over the last decade.
In 2008, 555,800 Nevada residents were uninsured. That’s 22% of the state’s population. Since the state expanded its Medicaid program in 2014, Nevada’s uninsured rate has dropped to 11% (as of 2018, the most recent year data is available). Driving this reduction was a 233% increase in Medicaid enrollment — to 574,700 Nevada residents — between 2008 and 2018.
Medicaid is meant for low-income families and children. These are the state’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Nevada Division of Insurance
- Website:
- Homepage
- Insurance Commissioner:
- Barbara Richardson
- Insurance Hotline:
- (888) 872 – 3234
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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