Short-term health plans in Nevada
- Short-term health insurance in Nevada is limited to terms of no more than 185 days with no renewal.
- Nevada’s health insurance exchange has been active in educating consumers about short-term plans.
- At least five insurers offer short-term health insurance in Nevada.
Nevada’s short-term health insurance regulations
The Nevada Division of Insurance maintains a web page with FAQs about short-term plans, and cautions consumers to fully understand the coverage options available to them.
Before the Trump Administration finalized the new regulations to expand access to short-term plans, the Nevada health insurance exchange submitted comments to HHS, strongly objecting to the proposed short-term health insurance rules and explaining how a larger pool of people in the short-term market would result in a smaller, sicker pool of insureds in the ACA-compliant market.
After the proposed rule was finalized, the Nevada health insurance exchange published a resource with details about how short-term coverage compares to ACA-compliant plans, and a reminder that state law limits short-term health insurance in Nevada to 185 days, regardless of changes at the federal level.
Short-term health plan duration in Nevada
Until October 2, 2018, federal regulations limited short-term health insurance plans to no more than three months in duration, and renewals were prohibited. The Trump administration implemented rules at that point allowing for much longer short-term plans, unless a state imposes its own restrictions.
Nevada state regulations (which have been in place since 1997) define short-term health insurance in Nevada as a plan that lasts no more than 185 days. The coverage cannot be renewed, but can be extended if the insured is hospitalized on the day that the policy would have terminated, with the extended policy period covering the remainder of the patient’s hospital stay.
The Trump administration’s new rules for short-term plans clarify that states may continue to impose tighter regulations than the new federal rules. So short-term health insurance in Nevada can have maximum term of 185 days, and is nonrenewable. (In states that don’t impose stricter limits, the new federal rules allow short-term plans to have initial terms of up to 364 days, and total duration, including renewals, of up to three years.)
Which insurers offer short-term plans in Nevada?
At least four insurance companies offer short-term health insurance plans in Nevada as of 2020:
- Golden Rule (UnitedHealthcare)
- Independence American Insurance Company
- Everest Prime
- National General
The available plans all have a maximum duration of six months and are nonrenewable, in keeping with Nevada’s rules. The insurance companies offer differing coverage in terms of the deductibles, benefit maximums, excluded services, eligibility guidelines, and provider networks. It’s important to carefully read the details of any short-term medical plan you’re considering, in order to avoid unwanted surprises later on if you have a claim.
Who can get short-term health insurance in Nevada?
Short-term health insurance in Nevada can be purchased by residents who can meet the underwriting guidelines of insurers. In general, this means being under 65 years old (some insurers put the age at 64) and in fairly good health.
Short-term health medical insurance plans typically include exclusions for pre-existing conditions, so these types of plans will not be adequate for someone in the Silver State who needs medical care for ongoing or pre-existing conditions. Short-term health insurance policies also do not have to provide coverage for essential health benefits (the most commonly excluded benefits are maternity care, mental health care, and prescription drugs), and can impose limits on the maximum amount they’ll pay for your healthcare services.
If you’re in need of health insurance in Nevada, your first step should be to see whether you’re eligible for a special enrollment period that would allow you to enroll in an ACA-compliant individual major medical plan. There are a variety of qualifying life events that will trigger a special enrollment period and allow you to purchase of a plan through the health insurance exchange/marketplace in Nevada. These plans are sold on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a couple of months before another policy kicks in.
And if your household income makes you eligible for financial assistance, you might qualify for a premium subsidy and possibly cost-sharing reductions as well. Premium subsidies make your monthly premiums more affordable — even if you only need coverage for a short while — and cost-sharing reductions reduce your out-of-pocket medical expenses if and when you need healthcare services.
It’s also important to understand that Medicaid can serve as temporary coverage for people who have lost some or all of their income. Nevada expanded Medicaid under the Affordable Care Act, and eligibility is based on monthly income (as opposed to premium subsidies in the marketplace, which are based on annual income).
When should I consider short-term health insurance in Nevada?
There are times in the Sagebrush State when short-term health insurance could be the only realistic option, such as:
- If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
- If you’ll be enrolled in Medicare in the near future, and need a policy to cover you until your Medicare takes effect. Be aware that although Medicare covers pre-existing conditions regardless of your medical and coverage history, Medigap insurers can impose a pre-existing condition waiting period if you didn’t have coverage for your pre-existing conditions prior to enrolling in Medicare.
- If you’ve become employed recently but have a waiting period before your employer’s health benefits take effect.
- If you’re losing other coverage in the middle of the month, and have to wait until the first of the next month for a new marketplace plan to take effect (note that COBRA might be an alternative fall-back option in this case as well)
- If you’re not eligible for Medicaid or a premium subsidy in the exchange, the monthly premiums for an ACA-compliant plan might simply be too costly.
People who are ineligible for premium subsidies include:
- Those earn more than 400% of the poverty level. (For 2021 coverage, that’s $51,040 for a single person. If your ACA-specific modified adjusted gross income is just a little above the subsidy-eligible threshold, there are steps you can take to reduce it).
- People snagged by the ACA’s family glitch.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.