Health Insurance 101 – Knowing the Basics

Jun 5, 2019

Who needs health insurance? The answer is easy; everyone! No matter your age, gender or shoe size, you need health insurance. Just like you need car insurance to protect your automobile, health insurance will cover you if you become sick or suffer an injury. Not only will it protect you in an accident or emergency, health insurance also covers things like preventative care, vaccines and screenings — which could essentially prevent you from becoming sick later on.

While everyone needs health insurance, if knowing the ins, outs, “whys” and “hows” of health insurance seem like a foreign language to you, you’re not alone! If you are wondering “how do I get health insurance in Nevada,” learn first about the common terms used in the health insurance enrollment process. We’ve taken some of the most commonly used terms and are pulling back the curtain on what they really mean:


deductible is the amount of money that you are required to pay for covered services out-of-pocket before you can use the benefits from your health insurance plan. For example, if your deductible is $2,000, you will have to pay $2,000 in medical expenses on your own or “out-of-pocket.” Once you have reached your deductible you will either pay nothing for future medical expenses, or you will have to pay a copayment for covered services. Your insurance will then cover the remaining costs. It is important to note that deductibles vary from plan to plan. Your deductible amount and what is exempt from the deductible will be outlined in your insurance plan language, so you will know what your annual deductible is before you choose a plan.


Often referred to as “copay,” this term describes a fixed amount of money, set by your insurance provider that you pay for covered medical services. Copayments are one of the ways that health insurers will split costs with you after you hit your deductible. For example, if you break your arm and go to a clinic to have it set, you may be told your copay for service is $50. If you have met your deductible and your copay is $50, you will pay $50 and your insurance should cover the rest of the bill. As with deductibles, something to keep in mind is that copayments can vary in cost based on different services such as doctor visits, emergency room visits, filling prescriptions or lab tests.


It’s easy to think of your premium as your monthly bill. Each month, you will pay a set amount of money for your health insurance coverage directly to your insurance carrier. Keep in mind that a low monthly premium may cost you more in out-of-pocket expenses. How much you pay for your monthly premium does not equate to how much you will pay for healthcare services. Get Insured also states that an insurance plan with a slightly higher premium, but a lower deductible could save you a lot of money in the long run.

In-Network and Out-of-Network

Just like your circle of friends and colleagues, in-network providers, suppliers and facilities have been contracted by the insurer to provide approved health care services. Insured individuals will likely pay less when using an in-network provider versus an out-of-network provider. Going “out-of-network,” or getting services through a provider or facility that hasn’t been approved by your insurer may result in the insurer paying a smaller percentage of what would have been paid if you had stayed in-network. Going out-of-network could also result in your insurance provider making no payment at all, leaving you responsible to pay the entire fee on your own.

How do you find affordable health insurance?

This is where we come in. Nevada Health Link is designed to help you find an insurance plan that fits your needs, as well as your budget, and answer all of your insurance questions. Just like shopping at the mall, Nevada Health Link allows you to compare and purchase health insurance plans through our online marketplace. We are also the only health insurance resource that can provide you with federal tax credits and subsidies to help pay for all or part of your insurance. Nevada Health Link partners with licensed enrollment professionals to assist you through the enrollment process. Call the experts now and make an appointment for this upcoming Open Enrollment period.

When should you buy health insurance?

Nevada Health Link opened a Special Enrollment Period (SEP) for Nevadans, starting February 15 through August 15, 2021. The SEP is in accordance with the Executive Order issued by President Biden, in response to the ongoing national emergency presented by COVID-19. This year, open enrollment will begin on November 1 and end on January 15

What if I miss Open Enrollment?

There is one exception to missing the Open Enrollment deadline and that is called a Special Enrollment Period (SEP). As part of a Qualifying Life Event (QLE) you could be eligible for an SEP. These QLE’s are determined on a case-by-case basis, for example, things such as marriage, birth, adoption or moving to a new location, are often life changes that could make you eligible for a Special Enrollment Period.

Our staff is your number one resource for all things health insurance in Nevada. If you currently do not have health insurance, discover whether you are eligible for a Special Enrollment PeriodTo learn more or receive answers to additional questions that you may have, call Nevada Health Link at 1-800-547-2927.