FAQs for Individuals and Families

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, turning 26, and changes in family size through marriage, divorce or the birth of a child. Learn more: https://www.nevadahealthlink.com/reporting-life-and-income-changes/

Your log-on information is required to access your account.

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.

Once you enroll in a health or dental plan, you will pay your premiums directly to the insurance carrier — not to Nevada Health Link.

After you finish your enrollment, you must pay your first month’s premium in order for your coverage to take effect. Health and dental plans are usually offered by separate carriers and billed separately. Be sure to pay for both if applicable.

Many carriers accept online payments. To see if your carrier accepts online payments, log into your account and click the Enrollments tab to see the plan(s) you’ve enrolled in. If your carrier accepts online payments, you’ll see a payment button that links to your carrier’s payment site. If your carrier does not accept online payments, contact your carrier or visit their website to get more information about their payment process.

For purposes of the premium tax credit, your household income is your modified adjusted gross income (MAGI) plus that of every other individual in your family for whom you can properly claim a personal exemption deduction and who is required to file a federal income tax return. Modified adjusted gross income (MAGI) is the adjusted gross income on your federal income tax return plus any excluded foreign income, nontaxable Social Security benefits (including tier 1 railroad retirement benefits), and tax-exempt interest received or accrued during the taxable year. It does not include Supplemental Security Income (SSI).

The family glitch fix will be in effect as of 2023. So when families apply for coverage during the open enrollment period (November 1 – January 15), the new rules will be used to determine whether anyone in the household qualifies for a premium subsidy. If an employee must pay more than a predetermined affordability threshold of household income towards the premium for the lowest cost family plan offered by their employer, the plan is considered unaffordable, and the employee’s family members may therefore qualify for financial assistance for health coverage through Nevada Health Link. The affordability threshold for plan year 2024 is 8.39% and will be updated every year

The Nevada Health Link website was created by the state agency, the Silver State Health Insurance Exchange to help you find an affordable health insurance plan that fits your needs and your budget. Through Nevada Health Link individuals can shop for, compare, and purchase qualified health insurance plans with tax credits or subsidies that are based on your income.

Nevada Health Link connects individuals to a variety of insurance plans from different health insurance companies, as well as offers tools and resources to help you choose the plan that’s right for you. Nevada Health Link is the only health insurance resource that can provide you with federal tax credits and subsidies to help cover the cost of your insurance.

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.

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

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

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

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 https://enroll.nevadahealthlink.com/hix/. Nevada Health Link is 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.

Yes! Enroll.NevadaHealthLink.com is Nevada Health Link’s online platform where Nevadans can shop, compare and enroll in Qualified Health Plans.

Nevada Health Link facilitates and connects eligible Nevadans who are not insured by their employer, Medicaid, or Medicare to health insurance options. Individuals can purchase Affordable Care Act certified Qualified Health Plans through the Exchange and if eligible, can receive subsidy assistance to help offset their monthly premiums and out-of-pocket costs.

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.

When you fill out a health insurance application, you’ll need to estimate your expected income. Two important things to know:

• Nevada Health Link savings are based on your expected household income for the year you want coverage, not last year’s income
• Income is counted for you, your spouse, and everyone you’ll claim as a tax dependent on your federal tax return (if the dependents are required to file). Include their income even if they don’t need health coverage

Step 1. Start with your household’s adjusted gross income (AGI) from your most recent federal income tax return. You’ll find your AGI on line 7 of your last year’s IRS Form 1040.

Step 2. Add the following kinds of income, if you have any, to your AGI:

• Tax-exempt foreign income
• Tax-exempt Social Security benefits (including tier 1 railroad retirement benefits)
• Tax-exempt interest

Don’t include Supplemental Security Income (SSI).

 

Step 3. Adjust your estimate for any changes you expect.

Consider things like these for all members of your household:

• Expected raises
• New jobs or other employment changes, including changes to work schedule or self-employment income
• Changes to income from other sources, like Social Security or investments
• Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings.

Update your Nevada Health Link application as soon as possible when your income or household members change during the year.

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).

The “Family Glitch” was a hole in the Affordable Care Act (ACA) that affects low to moderate income families to not qualify for premium assistance on the health exchange. This is due to the rules that determine the “affordability” of employer offered health insurance.

The “family glitch” based eligibility for a family’s premium subsidies on whether available employer-sponsored insurance is affordable for the employee only, even if it’s not actually affordable for the whole family.

The family glitch fix is in effect as of 2023. So when families apply for coverage during the open enrollment period (November 1 – January 15), the new rules will be used to determine whether anyone in the household qualifies for a premium subsidy. If an employee must pay more than a predetermined affordability threshold of household income towards the premium for the lowest cost family plan offered by their employer, the plan is considered unaffordable, and the employee’s family members may therefore qualify for financial assistance for health coverage through Nevada Health Link. The affordability threshold for plan year 2024 is 8.39% and will be updated every year

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.”)

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).

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.

The first step of the enrollment process is to visit https://enroll.nevadahealthlink.com/hix/ provide some basic information about your income and household composition by answering a few questions using our exchange eligibility pre-screener tool. If the tool identifies potential Medicaid/CHIP eligibility, then you will be directed to submit a Medicaid application.

Or get FREE enrollment assistance from a licensed enrollment professionals near you by using our Find Local Assistance look-up tool or by calling 800-547-2927.

Nevada Health Link has a statewide network of licensed enrollment professionals who have been trained to assist you with the application and enrollment process, and their assistance is available to you at no cost. After enrolling, your assister can continue helping you throughout the year by reporting changes to your account, helping you understand important notices, walking you through the annual renewal process, and more.

Find a licensed enrollment professionals near you by using our Find Local Assistance look-up tool or by calling 800-547-2927.

 

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.

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).

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

 

If you’re a veteran without VA health care, visit the VA health care website. You may learn that you qualify for VA coverage.

If you don’t have veterans coverage

If you’re a veteran who isn’t enrolled in VA benefits or other veterans health coverage, you can get coverage through Nevada Health Link. 

Depending on your household size and income, you may be able to get lower costs on monthly premiums and out-of-pocket costs on private insurance. You also might qualify for free or low-cost coverage through Medicaid or Nevada Check Up.

Find out if you qualify for Medicaid. 

If your dependents aren’t covered

If you’re a veteran enrolled in (or are a beneficiary of) a VA health care program, you may have dependents who aren’t eligible for a VA health care program. They can get coverage through Nevada Health Link.

Depending on household size and income, they may get lower costs on monthly premiums or out-of-pocket costs. Or they could be eligible for free or low-cost coverage through Medicaid or Nevada Check Up. Find out if you qualify for Medicaid. 

Important:  TRICARE’s young adult coverage option is different from the Affordable Care Act’s under-26 rules. Eligibility ages, benefits, and other details differ.

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

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.

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.

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.

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 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