Nevada Health Insurance Consumer Guide

In order to sign up for private health coverage through Nevada Health Link, you must:⁴

• Live in Nevada
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare⁵

By those rules, most Nevada residents qualify to use the exchange. But a bigger question for most people is financial assistance, and there are a few additional parameters to be eligible for subsidies in Nevada’s exchange. 

To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must:

• Not have access to affordable health coverage through an employer. If you have access to an employer’s plan but it seems too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies via Nevada Health Link. 
• Not be eligible for Medicaid or Check Up (CHIP).
• Not be eligible for premium-free Medicare Part A.⁶
• If married, file a joint tax return.⁷
• Not be able to be claimed by someone else as a tax dependent.⁷

Beyond those basic parameters, qualifying for Nevada Health Link subsidies depends on your household income, which is an ACA-specific calculation of MAGI.

You can sign up for an ACA-compliant individual or family health plan in Nevada between November 1 and January 15, which is the annual open enrollment period. 

For coverage to take effect on January 1, you need to complete your application by December 31.⁸ (This is later than the deadline in most states.) If you enroll between January 1 and January 15, your coverage will take effect on February 1.⁹

Outside of the annual open enrollment window, you may be eligible to enroll if you experience a qualifying life event, such as giving birth or losing other health coverage. Note that some people can enroll year-round even without a specific qualifying life event. 

Enrollment in Nevada Medicaid/Check Up (CHIP) is available year-round.

A note about off-exchange enrollment: From 2014 through 2019, Nevada law required plans sold outside the exchange to be available for purchase year-round, with a waiting period of up to 90 days before the coverage would take effect. But Section 56 of Nevada SB482, enacted in 2019,¹⁰ eliminated the requirement that health plans be available year-round outside the exchange. The law took effect October 1, 2019, bringing Nevada’s rules into line with the rest of the country: Both on-exchange and off-exchange, individual major medical plans can only be purchased outside of open enrollment if the applicant has a special enrollment period (most special enrollment periods are triggered by a qualifying life event).

To enroll in an ACA Marketplace/exchange plan in Nevada, you can: 

• Visit Nevada Health Link, which is Nevada’s health insurance exchange (another word for Marketplace). Nevada Health Link is an online platform where you can compare plans, determine whether you’re eligible for financial assistance, and enroll in the plan that best meets your needs. 
• Purchase Nevada Health Link coverage with the help of an insurance broker or navigator.¹¹

You can reach the Nevada Health Link call center by calling 1-800-547-2927, Monday to Friday, 9 am to 5 pm.

The Affordable Care Act (ACA) provides income-based subsidies that can help lower your premium payments each month. These subsidies are available to Nevada residents who meet the eligibility requirements and enroll in coverage through Nevada Health Link.

Eighty-six percent of Nevada Health Link enrollees were receiving premium subsidies as of early 2024, and these subsidies reduced their average health insurance premiums by $437/month. After subtracting subsidies, the average enrollee’s premium was about $151/month.¹²

Source: CMS.gov¹³

If your household income is no more than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR), which will reduce your deductible and other out-of-pocket expenses. These benefits are built into Silver-level plans if the applicant is eligible for them. As of 2024, nearly half of Nevada Health Link’s enrollees were receiving CSR benefits. ¹²

You can use both APTC and CSR benefits if you’re eligible for both and you select a Silver-level plan through Nevada Health Link (APTC can be used with plans at any metal level, but CSR benefits are only available on Silver plans).

Market Stabilization Program (Public Option) with reinsurance coming in 2026

Nevada S.B.420, signed into law in June 2021,¹⁴ calls for the state to create a public option health plan that will be available in the individual market as of 2026. The idea is to create premium reduction targets, similar to the approach that Colorado is using.

Gov. Lombardo, who took office in 2023, was critical of the public option approach, and worked to transform it into a “market stabilization program” instead. Under Lombardo’s plan there will still be a public option component, with a quality incentive payment program for insurers to prevent reimbursement cuts for medical providers due to the premium reduction targets. Lombardo’s plan also calls for a reinsurance program that would use federal funding to reduce premiums in the individual market.¹⁵ (Reinsurance programs are already in use in 17 states.)

Nevada is working with CMS to secure a 1332 waiver for the reinsurance program and the Market Stabilization Program plans (Battle Born State Plans) both of which are still expected to debut for the 2026 plan year.¹⁶ CMS was considering the 1332 waiver proposal but Nevada asked CMS to pause that process in March 2024, while the state amends its application due to new actuarial assumptions and evolving design of the program. Review of the 1332 waiver proposal will resume after that information is submitted.¹⁷

Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Medicaid or Check Up (Nevada’s CHIP). You can learn more about whether you might meet the criteria for Medicaid in Nevada.

Eight carriers will continue to offer Marketplace plans in Nevada in 2025.³

The same eight carriers offered 2024 coverage, with coverage areas that vary from one insurer to another.¹⁸ They included two carriers that were new for 2024: Imperial Insurance Companies and Molina Healthcare of Nevada.¹⁹

For 2025 coverage, the following average rate changes have been approved for Nevada’s Marketplace insurers,²⁰ amounting to a weighted average rate increase of 7.3%²¹ before any subsidies are applied.

Source: Nevada Division of Insurance²⁰

Three additional carriers offer individual market coverage only outside the exchange in Nevada. We have not included their premium changes in the chart above, since they don’t offer coverage in the Marketplace. But you can see details here.

It’s important to remember that these proposed average rate increases are for full-price plans, and most enrollees do not pay full price: As of 2024, 86% of Nevada Health Link enrollees were receiving premium subsidies that reduced their monthly payments.²²

The subsidy amount is different for each enrollee and changes each year depending on the cost of the second-lowest-cost Silver plan relative to the enrollee’s household income. As a result of the American Rescue Plan and the Inflation Reduction Act, subsidies are larger and more widely available than they were in the past, and that will continue to be true at least through 2025.²³

Changes in full-price premiums depend on the insurer and the plan (premium changes vary across the plans that each insurer offers), as well as the enrollee’s age and zip code.

For people who receive premium tax credits – which includes the vast majority of Nevada Health Link enrollees – the net premium change also depends on how much the subsidy amount changes from one year to the next. 

Here’s an overview of how average full-price premiums have changed over the years in Nevada’s individual/family market:

• 2015: Average increase of 4%.²⁴
• 2016: Average increase of 9.6%.²⁵
• 2017: Average increase of 10.6%.²⁶
• 2018: Average increase of 38.2%.²⁷
• 2019: Average increase of 0.4%.²⁸
• 2020: Average increase of 1.7%.²⁹
• 2021: Average increase of 4.9%.³⁰
• 2022: Average increase of 4.1%.³¹
• 2023: Average increase of 9.2%.³²
• 2024: Average increase increase of 2.8% (3.6% including off-exchange plans).²

According to Centers for Medicare & Medicaid Services (CMS) data, 99,312 people selected private plans through Nevada Health Link during the open enrollment period for 2024 coverage.³³

Effectuated enrollment is always a little lower than the number of people who select plans during open enrollment. CMS reported that effectuated enrollment through Nevada Health Link stood at 96,947 people as of early 2024.²²

Source: 2014,³⁴ 2015,³⁵ 2016,³⁶ 2017,³⁷ 2018,³⁸ 2019,³⁹ 2020,⁴⁰ 2021,⁴¹ 2022,⁴² 2023,⁴³ 2024⁴⁴

Nevada Health Link: This is Nevada’s Marketplace, used to enroll in individual/family health plans and receive income-based subsidies. You can contact Nevada Health Link at 800-547-2927.

Nevada Department of Health and Human Services: The Nevada Department of Health and Human Services (DHHS) administers Medicaid and Check Up (CHIP), as well as other social services programs. You can reach Nevada DHHS by phone at (775) 684-4000 or by email at [email protected]

Nevada Division of Insurance: Regulates Nevada’s insurance industry, and assists consumers and businesses with insurance-related questions and concerns.  

Nevada State Health Insurance Assistance Program: A local service for Medicare beneficiaries and their caregivers. Provides information and assistance with questions related to Medicare eligibility, enrollment, and claims.