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Nevada uses a state-run health insurance marketplace named Nevada Health Link for the sale of certified individual/family dental plans.
Not all insurers that offer medical plans through the Nevada exchange include pediatric or adult dental coverage with their health plans, but stand-alone plans are available for purchase.
For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $32 to $89 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Nevada in 2022 was $43.42.
If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the health plan has integrated pediatric dental benefits.
The stand-alone pediatric dental plans available in Nevada will comply with the ACA’s pediatric dental coverage rules. This means out-of-pocket costs for pediatric dental care will not exceed $375 per child in 2023 (or $750 for all the children on a family’s plan), and there is no cap on medically-necessary pediatric dental benefits.
As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care are guided by the state’s essential health benefits benchmark plan.
The Nevada benchmark plan includes coverage for both basic and major dental services for children.
In 2023, five insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Nevada. These are dental plans that are not included with a medical plan and must be purchased separately:
This coverage can be purchased through HealthCare.gov during open enrollment (November 1 to January 15) or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA’s rules for pediatric dental coverage.
There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in Nevada. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Nevada Division of Insurance. If you would like to purchase a non-ACA qualified dental plan, ask a dentist for recommendations or search online.
There are also various dental discount plans available in every state. Dental discount plans are not insurance, but can offer discounted rates at participating dentists. Learn about the differences between dental insurance and dental discount plans.
To find plans in your area, search online for dental discount plans and the state you are looking to buy a plan in.
Adults (21 years and older) enrolled in Medicaid in Nevada are eligible for emergency dental services only, such as extractions. Children are eligible for much more robust dental benefits through Nevada Medicaid.
Nevada Check Up, which is Nevada’s CHIP, provides dental coverage to uninsured children 18 years of age and under who live in households with income that make them ineligible for Medicaid.
Nevada now uses Nevada Health Link instead of HealthCare.gov. Seven insurers offer plans through Nevada's exchange for 2023, with an overall average rate increase of a little more than 9%. Public option legislation was enacted in 2021, with plans that will be available by 2026.
Total enrollment in Nevada's Medicaid program increased by 159% since 2013 (versus a 60% increase nationwide). Post-pandemic Medicaid disenrollments begin June 1, 2023 in Nevada, and enrollment is expected to decline somewhat over the coming year. Nevada lawmakers passed a bill in June 2017 that would allow anyone to buy into Medicaid, but Governor Sandoval vetoed it. A public option bill was enacted four years later, and public option plans are expected to become available by 2026.
For all information on Medicare in Nevada, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
