Introduction: The overall health insurance situation in Nevada is quite upsetting, in comparison to the health insurance situation is other American states. The Center for Disease Control conducted a survey on Nevada health insurance situation and the survey report revealed that over 18% of the total Nevada residents were uninsured for Nevada medical insurance for each year, between 2001 and 2003.
In the below mentioned article, we have talked about importance features of Nevada health insurance. Nevada health insurance regulations are discussed in this article. A brief idea about Nevada medical insurance alternative programs is also provided in the article. We hope that the people of Nevada can certainly make use of it to know the present health insurance status of their state.
Some Important Regulations for Nevada Medical Insurance
- An individual having employer Nevada medical insurance can not be refused or restricted access to Nevada medical insurance through an employer. Moreover, they can enjoy unlimited coverage.
- However, Nevada medical insurance companies can refuse or limit an individual, who has no group Nevada medical insurance coverage through an employer, to access individual Nevada medical insurance. The individual can take advantage of limited facilities, only; even if his or her policy gets approved. The insurance companies consider age and health condition as deciding factors while approving coverage.
- Certain limitations are imposed on the Nevada medial insurance companies, while deciding the premium rates. Nevertheless, the premium rates can differ, on the basis of health condition and age of the applicants.
- All Nevada medical insurance plans should have a guaranteed provision for renewal.
- Guarantee renewability provision lets an individual renew his or her existing Nevada medical insurance policy.
- The renewability provision is guaranteed, if and only if the individual has disbursed all the premiums, in time and provided no fake information during the term of existing Nevada medical insurance plan.
- All Nevada medial insurance companies can inflict pre-existing condition waiting periods and elimination riders.
- Through an elimination rider, Nevada medical insurance plans can keep away coverage for medical conditions or body systems or body parts, even permanently.
- A pre-existing medical condition may be defined as an illness for which an individual has been treated, received medical advice or otherwise diagnosed previously, before applying for new Nevada medical insurance plan.
- Nevada medical insurance companies are free to not to provide any coverage or bear the cost for a medical condition, during the tenure of waiting period.
- Nevada medical insurance companies can determine any medical condition to be pre-existing, at the time an individual files a claim, during the term of the policy. The rule is applicable even if the policy holder had not been ever diagnosed or treated earlier for that particular condition, before coverage.
- Although, according to Nevada health insurance regulations, pregnancy is considered as a pre-existing medical, but can yet get coverage; if any pregnancy-related complication arises.
- All newborns and adopted children should be covered under parent's individual Nevada medical insurance policy, if it offers dependant coverage. Newborns and adopted children should be automatically covered for the first 31 days from the day of birth or adoption. The policy should be modified, accordingly, after the period is over to provide them further accommodation.
- Disabled and handicapped children should get coverage under their parent's individual Nevada medical insurance plan, even if they cross the decided upper age limit.
- Nevada residents, who are between Nevada medical insurance policies or jobs, can enjoy the benefits of Nevada health insurance through temporary Nevada medical insurance policies offered by some of the Nevada medical insurance companies.
Nevada Health Benefit Policies
- Nevada medical insurance companies should offer at least one or two standardized plans to the HIPAA qualified Nevada individuals.
- The individuals have to choose one from either Basic health benefit plan or Standard health benefit plan.
- Basic Nevada Plan: This plan includes physician services, x-ray services, laboratory services, nursing, and rehabilitation and hospital services. Hospice facilities, emergency care and prescription drugs services are also included in this plan. All the services are offered with 50% coinsurance.
- Standard Nevada Plan: This plan covers all the services that are covered by the basic plan, but with 20% coinsurance. What is more, this plan provides coverage for maternity care and selected mental health as well as substance abuse services.
Nevada Medical Insurance Alternative Options
The Insurance Department of Nevada operates and aids some medical insurance alternative programs to let the individuals, who are otherwise considered to be “uninsurable” or not able to afford the cost of individual Nevada medical insurance, to access the benefits of Nevada health insurance. The programs are as follows:
- Nevada Medicaid: Nevada individuals, who meet all the income as well as health-related qualifying criteria, are able to avail the program.
- Nevada Check-Up: This is the state's Children Health Insurance Program that is especially created to provide the children and teens health insurance coverage. However, children from the family units, which are not qualified for Nevada Medicaid or unable to pay for Nevada medical insurance, are only eligible to access this state-aided plan.
Nevada Division of Insurance
For in-depth information on Nevada medical insurance, you can contact at the following address:
Nevada Division of Insurance
788 Fairview Drive, Suite 300
Carson City, Nevada 89701