Individuals

How has Nevada Health Link changed?

Nevada Health Link is now 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 still provides its citizens with many ways to obtain in-person assistance throughout the State.

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?

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.

What American Indian and Alaska Native income do I include on my application?

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.

My children and I are tribal members, but my spouse is not. Can we enroll as a family with a Special Enrollment Period?

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.

Will I need my tribal documents when applying for coverage?

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

How do I apply for the Indian exemption?

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.

How do I calculate my income?

Calculating Modified Adjusted Gross Income (MAGI):

Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Your Adjusted Gross Income (AGI) can be found on line 38 of your Form 1040; line 22 of your Form 1040A; or line 36 of your Form 1040NR.

The following items must be added to your Adjusted Gross Income (AGI) to calculate your Modified Adjusted Gross Income (MAGI):

  • Traditional IRA contributions that were deducted.
  • Student loan interest amounts deducted.
  • Tuition and fees deducted.
  • Domestic production activities deducted.
  • Foreign income or housing costs excluded on Form 2555.
  • Foreign housing deduction taken on Form 2555.
  • Savings bond interest excluded on Form 8815.
  • Adoption benefits from an employer excluded on Form 8839.

Worksheet 1-1, found on page 17 of IRS Publication 590, provides information for a step-by-step calculation of Modified Adjusted Gross Income (MAGI).

What are the options for my family if my employer offers me coverage?

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.

Who can use Nevada Health Link?

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 Americans.

What do military veterans need to know?

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

Considerations for Military Veterans

What is insurance?

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).

Why do I need insurance?

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.

What exactly is Nevada Health Link?

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.

How do I enroll?

During open enrollment you will be able to enroll by:

  • Visiting this website (NevadaHealthLink.com)
  • Calling HealthCare.gov (QHP) or Medicaid Call Centers
  • Getting help from your health insurance agent or broker
  • Meeting with a Navigator organization or certified enrollment assister.
  • Visiting with a certified enrollment assister or licensed broker or agent at a community location near you.

Learn more about the process here.

What if I need help or can’t enroll online on my own?

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 find a person who can help you by using our in-person assistant search tool or by visiting one of our Navigator organizations.

Learn more about how to find help here.

What if I qualify for a public health insurance program like Medicaid?

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. Additionally, if you are found eligible for Medicaid or Nevada Checkup through the application process on HealthCare.gov, your information will be sent to those programs to finalize enrollment.

Help with Insurance Terms

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

 

Why should I buy insurance through NevadaHealthLink.com?

Buying insurance through Nevada Health Link guarantees that you are enrolled in a Qualified Health Plan (QHP) with Essential Health Benefits.

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).

Can I buy a Qualified Health Plan (QHP) outside of Nevada Health Link?

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).

I am currently uninsured by choice. I prefer alternative and holistic medicine. I do not take any prescription medication or vaccines. I am in very good health and very concerned about this new healthcare law. I feel I will be forced into paying for something I will never use and if I don’t, then I will be penalized. What, if any, options are there for people like me?

The Supreme Court ruling issued in June of 2012 stated that the federal government could impose a tax on individuals who do not purchase health insurance. Nevada Health Link has been put in place to help Nevadans comply with the new law. There are exemptions from the individual mandate for certain religious groups, Native Americans and for people who face a financial hardship that precludes them from purchasing health insurance. If you are a member of one of the groups spelled out in the ACA, you are exempt from the individual mandate to purchase health insurance. If you don’t fall into one of the exempt classifications, the IRS will enforce a tax penalty of $95 or 1% of your income (whichever is greater) in calendar year 2014. In 2015, the penalty increases to $325 or 2% of your income (whichever is greater). The penalty will increase to $695 or 2.5% of your income (whichever is greater) in calendar year 2016.

What are the Special Provisions for Native Americans?

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?

     

How is Nevada Health Link new and different?

Nevada Health Link is now powered by HealthCare.gov. All of the plans offered are still certified by Nevada Health Link, but enrollment will now take place through HealthCare.gov. Nevada Health Link is still the only health insurance resource that can provide individuals 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.

Is Nevada Health Link HealthCare.gov?

Nevada Health Link is still its own website, by Nevadans, for Nevadans, but it is now powered by HealthCare.gov. This means that eligibility and enrollment will take place through HealthCare.gov. 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 in-person assistance throughout the State.