Nevada’s Response to Coronavirus
The Centers for Disease Control and Prevention (CDC) and the Silver State Health Insurance Exchange (SSHIX, also known as Nevada Health Link), Nevada Division of Insurance (DOI), the Governor’s Office and the Nevada Division of Public & Behavioral Health (DPBH) are closely monitoring the outbreak of respiratory illness caused by the 2019 novel coronavirus (COVID-19), first identified in Wuhan, Hubei Province, China.
For the most up-to-date information, please see the links and resources below:
Special Enrollment Period (SEP)
Nevadans who have lost their job due to COVID19 (or due to other circumstances) or experience a Qualifying Life Event (QLE) can newly enroll in a health plan through Nevada Health Link even outside the open enrollment period (Nov. 1 – Dec. 15). Currently, enrolled members who experience life changes can make changes to their health insurance or choose a new plan. This is known as a Special Enrollment period (SEP). Learn more: Special Enrollment Period
- SSHIX Extended Press Release April 13, 2020
- SSHIX March 17,2020 Press Release
- FAQs on this SEP
- Self Attestation of No Prior Plan Year 2020 Coverage
- Exceptional Circumstance SEP Emergency Regulation NAC Updated
- Special Enrollment Period Information
- Watch the full press briefing: https://twitter.com/GovSisolak/status/1238265289512386560
- The Governor’s office also announced the creation of the new “Nevada Health Response” website, created in coordination with the NV Dept. of Health and Human Services. Access the website: https://nvhealthresponse.nv.gov/
- Roadmap to Recovery- Phase One Initial Guidance
- April 8, 2020 Press Briefing
- Governor’s Directives and Declarations
- Press Releases in Response to COVID-19 in NV
- Nevada Health Response website adds testing locator map
- How Coronavirus stimulus compensation affects eligibility: The CARES Act
Note: Testing and treatment for the COVID-19 virus will NOT count as a Public Charge. Public Charge has been an impediment to providing services and access. In addition, the rule does not restrict access to vaccines for children or adults to prevent vaccine-preventable disease. Learn more on Public Charge.
The Division of Insurance Statements for March 30, 2020 on the treatment of COVID-19 issues under the Nevada insurance statutes and regulations:
The three (3) statements are linked to the Division’s website and can be found through the COVID-19 Section on the front page of our website, direct links are below:
The Silver State Health Insurance Exchange is the state agency that oversees and connects Nevada residents to qualified health and dental plans through the online marketplace known as Nevada Health Link. Nevada Health Link is where Nevadans can shop and apply for comprehensive, Affordable Care Act (ACA) compliant plans.
Rules of prevention apply to your day to day at work, at home, or while traveling:
- Avoid contact with sick people.
- Avoid touching your eyes, nose, or mouth with unwashed hands.
- WASH YOUR HANDS – with soap and water for at least 20 seconds.
- Use an alcohol-based hand sanitizer with 60-95% alcohol if you are unable to wash your hands in a sink.
Under the ACA, most health plans must cover preventive services with no out-of-pocket costs to you. This means you won’t have a copay or coinsurance for certain medical services, such as immunizations or blood pressure screenings, as long as they’re delivered by a medical provider in your plan’s network.
The Centers for Medicare & Medicaid Services – Resources
The Centers for Medicare & Medicaid Services (CMS) FAQs on Essential Health Benefits (EHBs) Coverage in response to the 2019 Novel Coronavirus outbreak. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure the all Americans – particularly those at high-risk of complications – have access to the health benefits that can help keep them healthy while helping to contain the spread of disease.
What Health Insurance Plans Must Cover
The ACA requires every health insurance company, upon your request, to give you a Summary of Benefits and Coverage that explains your benefits and coverage limits in easy-to-understand language. Although some health plans offer additional benefits, state and federal laws require plans to provide the following 10 essential health benefits:
Note: Most health plans are not allowed to have annual benefit limits, and no plans are allowed to have lifetime benefit limits.
- Ambulatory Services and Care: Cover outpatient treatment without being admitted to a hospital, including hospice and home health services.
- Emergency Medical Services in Emergency Department: An emergency service is care that could lead to disability or death if not immediately treated. This often involves an emergency room and/or transport by an ambulance. It does not matter if you are out of network because you cannot be penalized for any emergency service.
- Hospitalization: Hospital coverage that includes surgeries, transplants, overnight stays, skilled nursing facilities. Some plans may limit your facility coverage to no more than 45 days.
- Maternity and Newborn Care: Services you receive throughout pregnancy, delivery and post delivery are covered, including care for newborn babies.
- Mental Health and Substance Abuse Disorder Services: Behavioral health inpatient and outpatient services and substance abuse disorder services are covered. Examples include behavioral health treatment, counseling and psychotherapy.
- Prescription Drugs: At least one medication for each category and classification of federally-approved drugs must be covered under your health insurance. Some prescription drugs may be excluded or only generic drugs may be covered. When a cheaper and equally effective medicine is available, the insurance may decline coverage. Out-of-pocket drug expenses under the ACA count toward your deductible.
- Rehabilitation or Habilitation Services and Devices: Rehabilitative services, habilitative services and devices help you gain or recover mental and physical skills lost to injury are included in coverage. This coverage extends to rehab after a stroke or speech therapy for children, for example. Plans must provide 30 visits each year for speech therapy and 30 visits for cardiac or pulmonary rehab.
- Lab Services: Screenings, blood draws, or urinalysis that a medical provider orders to help the doctor determine an injury or condition, are covered.
- Preventative or Wellness Services and Chronic Disease Support: Preventative services such as shots and screening tests, at no cost to the patient when a medical provider from the plan’s network delivers the service. Care for many chronic conditions such as asthma and diabetes falls under this category. Counseling, physicals, immunizations, and cancer screenings are covered under your insurance plan.
- Pediatric Services, Including Dental and Vision: Health care for children and infants from birth to age 19 are covered. This includes dental and vision coverage: two routine dental exams, one eye exam, and corrective lenses each year.
Note: While all qualified health plans must offer these ten essential health benefits, the scope of each plan may differ slightly. Pay attention to your premiums and decide what plan is best for you.
If you have questions about what your specific health plan covers, we recommend that you contact your insurance carrier directly.
For information on the benefits health plans must cover under Nevada State Law and the rate review process, please visit the Nevada Division of Insurance website to learn more.
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