FAQ

Certain changes in an individual’s life can make them eligible for a Special Enrollment Period (SEP) and allow them to enroll at any time during the year. Examples of qualifying life events include: loss of employer-based coverage, moving or turning 26, and changes in family size through marriage, divorce or the birth of a child.

The 2018 federal court decision is still moving through the courts and may take several years.  There is no immediate impact to current coverage or coverage in a 2019 plan.

Certain changes in an individual’s life can make them eligible for a Special Enrollment Period (SEP) and allow them to enroll at any time during the year. Examples of qualifying life events include: loss of employer-based coverage, moving or turning 26, and changes in family size through marriage, divorce or the birth of a child.

No. Short-term plans do not qualify for tax subsidies under the Affordable Care Act.

No. In most cases short term limited duration plans do not cover preexisting conditions.

Short-term medical insurance, also called Temporary health insurance or Term health insurance, can provide a temporary solution to help fill gaps in coverage. Consider short-term if you’re:

•    Between jobs •    Waiting for other coverage to begin •    Waiting to be eligible for Medicare coverage •    Without health insurance, outside of Open Enrollment

Yes, the individual health mandate, or the shared responsibility payment, through the Affordable Care Act was repealed, and the payment no longer applies, putting the tax penalty at $0 for those individuals who do not have health insurance. There is no longer a tax penalty for those people who do not have health insurance. This means you will not be charged when you file your state taxes and you will not owe a fee on your federal tax return.

When determining eligibility for Advanced Premium Tax Credits (APTC’s), the Marketplace only considers the employee-only cost of coverage. The cost of coverage for other family members does not determine whether the coverage offered is affordable for the family. To be deemed affordable in 2017, the employee’s share of the annual premium for self-only coverage must not be more than 9.69% of annual household income. For plan years beginning in 2018, employee sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed 9.56% of annual household income.

The Internal Revenue Service (IRS) defines the total household income as income from everybody in the household who is required to file a tax return.

Once you enroll in a plan, you will pay your premiums directly to the insurance company — not to Nevada Health Link. After you finish your enrollment online or with your agent/broker in person, you must pay your first month’s premium in order for your coverage to take effect. You make this payment to your insurance company, not Nevada Health Link. Contact your insurance company for details. Silver Summit Health Plan at 1-844-366-2880 Health Plan of Nevada at 1-800-777-1840 Anthem at 1-866-755-2680

Your log-on information is required to access your account.  Please follow the directions Nevada Health Link's State Based Exchange platform FAQ page: https://help.nevadahealthlink.com/hc/en-us/articles/360030793411-How-to-reset-your-Nevada-Health-Link-password If you forget the password to your Nevada Health Link account, you have the ability to reset it.

1. Go to the Nevada Health Link website and click on Log In. Click on the Forgot Password? link.
2. Enter the email address associated with your NVHL account and click Continue
3. Follow the directions in your email to access your account. Be sure that you know the answer to the security question you selected when you created the account. You will be asked to provide this answer. Note: If not, you will have to contact Tech Support to get back into your account.

A premium tax credit, sometimes called subsidies or discounts, can be used to lower your monthly insurance payment (called your “premium”) when you enroll in a health insurance plan through Nevada Health Link. Your tax credit is based on the income estimate and household information you put on your Marketplace application. If your estimated income falls between 100% and 400% of the federal poverty level (FPL) for your household size, you qualify for a premium tax credit. If you were enrolled in a health plan through the Marketplace and used premium tax credits to lower your monthly payments. (Premium tax credits are sometimes called "subsidies," "discounts," or "savings.")

1. Download and complete an Indian exemption application form (PDF)

2. Gather documentation of membership in a federally recognized tribe or eligibility for services through an Indian health care provider for EACH member of your tax household. See the full list of acceptable documentation types on page 5 of the exemption application (PDF).

3. Mail the signed and completed application with supporting documentation to: Health Insurance Marketplace – Exemption Processing 465 Industrial Blvd. London, KY 40741

4. The Marketplace will send you an eligibility determination letter in the mail after we process your exemption application. If you qualify for this exemption, we’ll give you an Exemption Certificate Number (ECN).

5. Once you have an Exemption Certificate Number, complete Part I of IRS Form 8965—Health Coverage Exemptions (PDF). Enter the name, Social Security number, and ECN for each member of your household who’s eligible for the exemption.

6. Be sure to include your completed Form 8965 when you file your tax return.

The special monthly enrollment periods and cost-sharing reductions apply only to members of a federally recognized tribe or Alaska Native Claims Settlement Act (ANCSA) Corporation shareholders. When applying through the Marketplace, you’ll need to provide documentation that you’re a member of a federally recognized tribe or an ANCSA shareholder.

• A document issued by a federally recognized tribe indicating tribal membership

• A document issued by an Alaska Native village/tribe, or an ANCSA Corporation (regional or village) indicating shareholder status

If your state uses the federal Marketplace, yes. If one family member on the application is eligible for the Special Enrollment Period (SEP), all family members who apply on the same Marketplace application are eligible. This is true even if different family members are eligible for different Marketplace plans, based on differing eligibility for lower monthly premiums or out-of-pocket costs.

The Marketplace application asks you to provide income information that’s reportable on your federal income tax return. In general, you won’t report American Indian or Alaska Native (AI/AN) income that the IRS exempts from tax (income from treaty fishing rights, for example).

The Marketplace application will ask you to report income from various sources and will determine your eligibility for Marketplace insurance plans, Medicaid, and the Children’s Health Insurance Program (CHIP).

Most AI/AN trust income and resources aren’t counted when determining eligibility for these programs. But per capita income derived from gaming is taxable and therefore counted for these programs.

By enrolling in health coverage through the Marketplace, Medicaid, or CHIP, you have better access to services that the Indian Health Service, tribal programs, or urban Indian programs (known as I/T/Us) may not provide.

If you enroll in a Marketplace health plan, Medicaid, or CHIP, you can keep getting services from your I/T/U the same way you do now. When you get services from an I/T/U, the I/T/U can bill your insurance program. This benefits the tribal community, allowing I/T/Us to provide more services to others.

Nevada Health Link is an organization created by the State of Nevada to help you find a health insurance plan that fits your needs and your budget. Through Nevada Health Link, individuals can shop for, compare and purchase health insurance plans that are income-based. Learn more about how it works here. Nevada Health Link is a supported state-based exchange. This means that NevadaHealthLink.com uses HealthCare.gov’s system to enroll Nevadans, but plans are still certified through Nevada Health Link. Plus, Nevada provides its citizens with many ways to obtain in-person assistance throughout the State.

Nevada Health Link is its own website, by Nevadans, for Nevadans, but eligibility and enrollment takes place on the state based exchange platform, powered by a company named GetInsured, at: https://enroll.nevadahealthlink.com. Nevada Health Link owns this website too, it just means that eligibility and enrollment will take place through this portal. All of the plans are still state-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain free assistance by licensed enrollment professionals throughout the State.

Nevada Health Link is powered by the technology platform, GetInsured, which is the state based exchange (SBE) platform where eligibility and enrollment takes place. All of the plans offered are still certified by Nevada Health Link, but enrollment will take place through the SBE portal. Nevada Health Link is still the only health insurance resource that can provide individuals with financial assistance (federal tax credits and subsidies) to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State. Nevada Health Link is supported by the state agency, Silver State Health Insurance Exchange and was established due to the Affordable Care Act, sometimes referred to as Obamacare.

There are many important considerations for military veterans. For more information, please click the following link: Considerations for Military Veterans

When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link. If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

Health Coverage for American Indians and Alaska Natives:

• Native Americans who are members of a federally recognized tribe are exempt from the individual mandate.
• Native Americans who earn less than 300% of the Federal Poverty Level (FPL) are exempt from cost sharing; for example, they will not have to pay copayments or deductibles when they use medical services.
• There are special provisions for the calculation of Modified Adjusted Gross Income for Native Americans, meaning that some revenue earned on reservations and from Federal Trust payments are exempt.
• Native Americans can change Qualified Health Plans (QHPs) once per month, and they are not bound to the open enrollment dates.

Frequently Asked Questions:

• Why do I need health insurance coverage if I get services from the Indian Health Service, a tribal program, or an urban Indian health program?
• What American Indian and Alaska Native income do I include on my application?
• My children and I are tribal members, but my spouse is not. Can we enroll as a family with a Special Enrollment Period?
• Will I need my tribal documents when applying for coverage?
• How do I apply for the Indian exemption?  

Yes, insurance carriers that offer Qualified Health Plans (QHPs) on NevadaHealthLink.com may offer the exact same (or similar) product outside of Nevada Health Link. But, you must enroll through Nevada Health Link if you want to receive help with your premium in the form of an Advanced Premium Tax credit (APTC).

Buying insurance through Nevada Health Link guarantees that you are enrolled in a Qualified Health Plan (QHP) with all the Essential Health Benefits included. All information about the plans offered through Nevada Health Link will be presented in clear language, so there’s no guesswork about what’s covered or what it costs. Because Nevada Health Link offers a variety of plans from different private insurance companies, we don’t have any connection with one insurance carrier. This means that all of the information about the plans is presented objectively, so you can pick the plan that’s right for you.

Nevada Health Link is the only place that you can receive cost assistance in the form of an Advanced Premium Tax credit (APTC) or Cost Sharing Reductions (CSRs).

For help with any words and terms, click here to see our glossary.

If you or someone in your family appears to qualify for government health coverage programs such as Medicaid or Nevada Check Up (CHIP), through our pre-screener tool, Nevada Health Link will alert you during the screening process and direct you to the right place to enroll in those programs if you wish.

If a person doesn’t have Internet access and/or would like some help shopping for and enrolling in a health insurance plan, the Nevada Health Link team will be here to help. You can locate a licensed enrollment professional on our broker directory tool online or by calling 1-800-547-2927 through our BrokerConnect feature by inputting your zip code. Learn more on how to designate a licensed agent/broker or a certified enrollment counselor on our Find Assistance page.  

During open enrollment you will be able to enroll by:

• Visiting this website (NevadaHealthLink.com) and logging into your account on enroll.nevadahealthlink.com
• Getting help from your licensed insurance agent or broker
• Getting help from your certified enrollment counselor
• Visiting with a certified enrollment assister or licensed broker or agent at a community location near you.

Nevada Health Link is here to help any Nevadan looking for health insurance, whether you already have insurance or not. If you already have health insurance, through your employer for example, you aren’t required to enroll through Nevada Health Link but are welcome to explore new plans through the online marketplace if you like. The only requirement to apply for and purchase insurance on NevadaHealthLink.com is that you are lawfully present in the U.S. and living in the State of Nevada. Filling out an application will not trigger an immigration/ INS investigation. This program’s goal is simply to reduce the cost of health insurance and insure more Nevadans.

Health insurance helps you get the care you need, when you need it. Insurance will help keep you and your family healthy. If you have insurance, you’ll be able to get preventive care (such as regular check-ups, screenings and immunizations) so you and your family will be sick less often. Health insurance also protects you financially; you won’t have to worry about high medical bills you can’t pay. Additionally, the Affordable Care Act (ACA), a U.S. law, says everyone must have health insurance. If someone doesn’t have health insurance, he or she will incur a penalty (a fine) on his or her income taxes. Nevada Health Link is here to protect Nevadans from the tax penalty by helping them find insurance based on their budget.

Insurance is legal entitlement to payment or reimbursement for your health care costs, generally under a contract with a health insurance company, a group health plan offered in connection with employment, or a government program like Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).

Nevada Health Link is an organization created by the State of Nevada to help you find a health insurance plan that fits your needs and your budget. Through Nevada Health Link, individuals can shop for, compare and purchase health insurance plans that are income-based. Learn more about how it works here. Nevada Health Link is a supported state-based exchange. This means that NevadaHealthLink.com uses HealthCare.gov’s system to enroll Nevadans, but plans are still certified through Nevada Health Link. Plus, Nevada provides its citizens with many ways to obtain in-person assistance throughout the State.

Nevada Health Link is its own website, by Nevadans, for Nevadans, but eligibility and enrollment takes place on the state based exchange platform, powered by a company named GetInsured, at: https://enroll.nevadahealthlink.com. Nevada Health Link owns this website too, it just means that eligibility and enrollment will take place through this portal. All of the plans are still state-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain free assistance by licensed enrollment professionals throughout the State.

Nevada Health Link is powered by the technology platform, GetInsured, which is the state based exchange (SBE) platform where eligibility and enrollment takes place. All of the plans offered are still certified by Nevada Health Link, but enrollment will take place through the SBE portal. Nevada Health Link is still the only health insurance resource that can provide individuals with financial assistance (federal tax credits and subsidies) to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State. Nevada Health Link is supported by the state agency, Silver State Health Insurance Exchange and was established due to the Affordable Care Act, sometimes referred to as Obamacare.

Certified Enrollment Counselors, which encompass: Exchange Enrollment Facilitators (EEFs), Navigators, Certified Application Counselors, and In Person Assiters will facilitate enrollment in qualified health plans offered by the Exchange. CECs, Navigators and EEFs are hired by entities that have been awarded grants by the Exchange. The Exchange releases a Request for Application (RFA) to award Navigator and In Person Assisters in the beginning of each year. If you have interest in becoming a Navigator, you will need to respond to the RFA. If you'd like to become an Enrollment Assister, please contact our current entities HERE. If you have interest in serving as a CAC, you will need to be certified by the Nevada Division of Insurance prior to becoming appointed with the Exchange. If you are interested in becoming a CAC, please submit information HERE.  

When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link. If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

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No, Nevada Health link will not be able to pre-populate applications for non-insurance government programs such as SNAP or TANF; however, by applying through Access Nevada for Medicaid or Nevada Checkup, that system will also determine eligibility for SNAP and TANF.

After a person has filled out application pre-screener on enroll.NevadaHealthLink.com, we will be able to determine if that individual or a family member appears to be eligible for a government program, such as Nevada Check Up (CHIP) or Medicaid. If one person in the family qualifies for Medicaid, that person can be enrolled in Medicaid and the rest of the family will be able to enroll in a health insurance plan or plans through Nevada Health Link.

Yes, part of the data migration from healthcare.gov, in addition to consumer application and enrollment data, will be NPN numbers. NPN data will be synced with consumer data so that Agents/Brokers will be able to see their entire book of business. But it is important to note that the matching will only be as successful as the accuracy of the NPN data that is in healthcare.gov

Yes, Agents/Brokers will be able to enroll consumers in a plan with any carrier selling qualified health plans (QHPs) and stand alone dental plans (SADPs on the GetInsured system.

We do not have plans to build a copy of the Federal Facilitated Marketplace (FFM) Help On Demand functionality. However, we will have the Broker Distribution tool that will immediately connect callers looking for assistance to an available enrollment professional in their area. This should provide participating brokers with a good source of leads. We'll also have the web-based broker directory that will be available directly from within the consumer's shopping and application experience.

This question could have multiple answers depending on the intent, but in best trying to answer this we wanted to point out that consumers can access their accounts and applications via the web portal, and agents can access the accounts and applications of their clients via the web portal. What is not available (and currently not supported by any state based exchange (SBM) is the ability for web brokers to build their own front-end experiences using web service APIs made available by the Exchange.

The GetInsured single streamlined application process (SSAP) is consumer facing and therefore has questions distributed over a larger number of pages, which include the explanatory text, etc. Questions are not asked multiple times.

Yes, we will have a broker-specific phone line that goes to Tier 2 agents.

Yes, stand alone dental plans will be offered in 2020.