WITH a Government Subsidy
Health Insurance
Shop Health Insurance Plans
WITH a Subsidy
ON Exchange
(702) 898-0554
Qualifying for a Government SUBSIDY
(Financial Assistance)
If you qualify for a Health Insurance Subsidy (financial assistance), it’s kind of like getting a gift card from the Government to help you pay your health insurance premium. This “subsidy” is sent directly to the insurance company, which pays a portion of your premium, and you will be responsible to pay the remaining balance.
The only way to get a subsidy→CLICK FOR DEFINITION←is to get a health insurance plan through Nevada Health Link (we will walk you through this).
Be careful not to get TOO MUCH subsidy. At the end of the year, the IRS will adjust what you’ve received, and what you should have received, and if you ended up getting too much subsidy, you’ll have to pay it back. If you didn’t get enough subsidy, you’ll get it back on your tax return. If your income goes up or down, or you had changes to your family, you need to notify us immediately so we can make the necessary changes. We can help you with this.
Open Enrollment→CLICK FOR DEFINITION← begins November 1st
Health Insurance Agent
Health Insurance Quotes
Call for FREE Help
(702) 898-0554
We recommend you watch this video.
It’s VERY informative
Health Insurance Open Enrollment has Begun
You Can Only Buy Health Insurance During This Time
November 1st, 2024 through January 15th, 2025
{ unless you have a ‘Life Event’ }
Call today to book an appointment with a licensed agent
After 1/15/2025 you will need a "Life Event"
→CLICK FOR DEFINITION← to get an insurance plan.
Days Until the End of Open Enrollment
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Step #1
Start With Your Income
Determine your MAGI
Follow These Three Easy Steps
1). Calculate Your Income
This will determine your MAGI (Modified Adjusted Gross Income)
2). Calculate Your Estimated Subsidy
Enter your information into the subsidy calculator
3). Call Us to Select Your Health Insurance
(702) 898-0554
How To Figure Your MAGI
Step #3
Call Us
Call Us to Finish Your Enrollment
(702) 898-0554
Get Additional Financial Assistance!
Do you make less than 250% of the Federal Poverty Level?
Receive Additional Assistance!
There is additional assistance called a Cost Sharing Reduction→CLICK FOR DEFINITION← This is in addition to a Subsidy→CLICK FOR DEFINITION←
Check the subsidy chart below ⇓
If your family size and income ranks you under 250% of the Federal Poverty Level→CLICK FOR DEFINITION← you are most likely going to be eligible for additional assistance to reduce your overall out of pocket medical expenses like lower deductibles, and/or co-insurance, and/or out of pocket maximum, and/or co-pays. You must apply, and the enrollment process determines if you are eligible for the “Cost Sharing Reduction”.
This benefit is only available when you buy a “Silver” plan
2025 Health Insurance Subsidy Chart
by household size and income
⇓
The chart below lists the income numbers the IRS will use for “subsidy” eligibility.
* The annual subsidy amounts change in January of each year
* NOTE: You can buy a plan outside of the “Marketplace” that doesn’t have a subsidy
If your income is under 250% of the Federal Poverty Level, this “Cost Sharing Reduction” will cover more of your portion of the medical expenses. So in addition to getting the “Advanced Premium Tax Subsidy”, you’ll also have the “Cost Sharing Reduction” toreduce deductibles, co-pays, and/or co-insurance. If your income is under 250% of the Federal Poverty Level, this is a very important financial benefit you’ll want to take advantage of!
Sadly, we’ve seen when Nevadan’s enroll into a health insurance plan WITHOUT help from a broker/agent. They buy the cheapest health plan available, shopping for the cheapest premium possible, and remove themselves from being eligible for the “Cost Sharing Reduction”.
If they simply understood this benefit, in some instances for just a few dollars more a month, their deductible could go from around $7000 (example) down to sometimes as low as $0!
Considering there is no charge for an agents assistance, it just makes sense to use a professional.
What Does This Mean?
This means you should have us help you!Let’s say you pick a bronze plan (the cheapest plan you can find), just because you want to pay the least amount possible. Then, during the year you actually end up needing to use your insurance, like needing to have a surprise procedure. What if you got very sick and were diagnosed with a kidney stone? The hospital may and most likely will ask you to pay your (as an example) $7000 deductible→CLICK FOR DEFINITION← first, even before they perform your procedure!! Even if you were to get lucky and they are willing to bill you later, you still could owe $7,000 plus!!
Mistakes While Enrolling Into Health Insurance
Now, if you would have gotten good advice and assistance from a licensed agent, and enrolled into a SILVER plan (when you are entitled to a Cost Sharing Reduction)→CLICK FOR DEFINITION← it’s possible your deductible could have been $0, or at least lower than the $7000 deductible plan you chose.
Was your decision to save a few bucks worth it? Is that the insurance company’s fault? Getting a good health insurance agent is as important as getting a good accountant or attorney.
We’ve sadly seen it too many times, that someone purchases the cheapest plan they can, not understanding that they were giving away a $0 deductible plan (or much lower deductible than $7,000, depending on household income), and instead selecting a $7,000 deductible plan, only to save themselves a few dollars a month.
Get Sound Advice From a Local Health Insurance Agent
That Knows Nevada’s Plans
Call us. Our services are FREE to you, we are local, we are licensed with the State of Nevada, we study Nevada’s health insurance plan benefits, the network of doctors and hospitals, and the insurance plan formularies (drug lists on the insurance plan). You will NOT pay more for your insurance by getting help from one of our agents (the costs are all the same) whether you get help from a professional or not.
Qualified Health Plans
Qualified Health Plans→CLICK FOR DEFINITION← are certified by Nevada Health Link verifying they provide the 10 essential health benefits. These plans follow required limits on how much you the member has to pay, and how much the insurance company pays. These health insurance plans meet rigorous requirements, including covering preexisting conditions→CLICK FOR DEFINITION←with no maximum lifetime or annual limits.
QHP’s (Qualified Health Plans):
Will Cover Your Medical Costs With NO Maximum Lifetime and Annual Limits
PLATINUM | GOLD | SILVER | BRONZE
♦ Platinum covers 90% of your medical bills, up until the “out of pocket maximum”.
♦ Gold covers 80% of your medical bills, up until the “out of pocket maximum”.
♦ Silver covers 70% of your medical bills, up until the “out of pocket maximum”.
♦ Bronze covers 60% of your medical bills, up until the “out of pocket maximum”.
Open Enrollment is So Important Now
Please think twice about going without Health Insurance this year.
If you miss Open Enrollment, you will be missing your only opportunity to get an ACA Qualified Health Plan that covers pre-existing conditions, mental health, wellness/preventative, Rx, and all the other ACA benefits you find in a “Qualified Health Plan”. Unless you a Qualifying Life Event.
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#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Health Insurance Quotes
2). Online Quote
3). In Person
4260 W. Craig Road #150-A
N. Las Vegas, NV 89032
Step #4
Select Insurance Company
in Your Area
Current Active Insurance Companies in Nevada
Carrier Coverage by County
Call for FREE Help
(702) 898-0554
Health Plan of Nevada (HPN)
♦ HMO
♦ ON Exchange and OFF Exchange
♦ Serving Washoe, Clark and Nye counties
Sierra Health and Life
♦ EPO
♦ OFF Exchange only
♦ Clark County only
Ambetter from Silver Summit
♦ HMO
♦ Referrals to see a specialist are not required on the CORE plans only
♦ ON Exchange and OFF Exchange
♦ Serving ALL Nevada counties
Hometown Health
♦ Offering HMO, PPO & EPO in select counties
♦ ON Exchange and OFF Exchange
>> ON Exchange (HMO only) Carson City, Lyon, Washoe, Douglas, Storey
>> OFF Exchange (HMO, PPO, EPO) Carson City, Lyon, Washoe, Douglas, Storey
Anthem Blue Cross and Blue Shield
♦ HMO
♦ OFF Exchange - Nye and Clark County
♦ ON Exchange - Serving ALL Nevada counties
♦ PPO only available for “Catastrophic” plans (under 30 years old)
Select Health
♦ HMO
♦ ON Exchange only
♦ Serving Nye and Clark County
Aetna
♦ HMO
♦ ON Exchange only
♦ Serving Washoe, Nye, and Clark County
Imperial Health
♦ HMO
♦ ON Exchange only
♦ Serving Washoe, Nye and Clark County
Molina Healthcare
♦ HMO
♦ ON Exchange only
♦ Serving Washoe, Carson City, Douglas, Storey, Lyon, Nye and Clark County
Fast and Easy
Enrolling into a health plan is fast and easy when you call one of our licensed and experienced health insurance agents.
Get Sound Advice From a Local Health Insurance Agent
That Knows Nevada’s Plans
Call us.There is NEVER a charge for our services. Our services are always FREE to use.Plus, we are local (yes, we live in Las Vegas), we are licensed with the State of Nevada, we study Nevada’s health insurance plan benefits, we know the networks of doctors and hospitals, and we know the insurance plan formularies (drug lists on the insurance plan). You will NOT pay more for your insurance by getting help from our Agents and your premium will NOT go up!
Please Be Careful…
So many times, we see honest, hard working people buying what they think are Qualified Health Insurance Plans, but only to find out later that their plan isn’t what they thought it was. Then, when they find themselves in the hospital, they suffer the consequences of not understanding what they purchased and being severely underinsured. Once you’ve terminated your qualified health insurance plan, if you don’t have a life event, you won’t be able to simply sign up for a new plan after having a bad experience. You will have to wait for the next “Open Enrollment” which is November 1st through January 15th unless you have a Qualifying Life Event→CLICK FOR DEFINITION←
If your plan is a limited benefit medical plan, mini-medical plan, discount plan, indemnity plan, short-term plan, or looks and appears to be “insurance”, but does not cover the 10 “Essential Healthcare Benefits” then you are most likely buying a plan that is NOT considered to be a “Qualified Health Plan”. We STRONGLY recommend you do your research on these types of plans. Do a Google search or look at Yelp reviews of companies that sell these plans.
Changes for 2024
BIG NEWS! This is HUGE!
Since November 1st, 2022…
The “Family Glitch” Has Been Removed for Family Members with Employer Sponsored Health Insurance Coverage.
If you were denied a subsidy because your spouse had employer coverage, this rule change is for you!
All additional family members may now qualify for a government subsidy.
What does this mean? Family members are NO LONGER BLOCKED from getting a government subsidy just because their spouse had health insurance coverage through their employer.
read more about the "Family Glitch" - click to open/close
The Employer “Family Glitch” has been removed!
All additional family members may now qualify for a government subsidy.
Now Get A Government SUBSIDY!
Affordable Health Insurance Within Reach for More Families
About half of the U.S. population gets their health insurance through their employer. This provides a wonderful benefit to the employee, because a minimum of ½ (50%) of the total cost of that health plan for that employee must be covered by the employer, if the employer offers group health insurance to their employees. In many cases, employers pay more than 50% of their employees’ premium, and the rest is paid by the employee.
When you combine what the employer pays, and what the employee contributes out of their paychecks, this makes the overall dollars spent on a health plan higher. This generally will give the employee a much better health insurance policy than they normally would if the employee had purchased it on their own.
Across the country, employers cover an average of 83% of the employees’ health insurance costs. Many employers, however, do NOT contribute anything towards the spouse and kids’ portion of the health insurance premium. Employers are not required to help pay for spouse and children. But because of rules, employers are required to OFFER to spouse and kids, but they are not required to PAY for spouse and kids. This makes the amount of premium the employee would have to pay to cover their spouse and kids extremely expensive! Because the spouse and kids are full price.
What Is the Family Glitch?
So, here’s the rub. Up until now, for the past few years since the Affordable Care Act was passed in 2010, if an employee was “offered” health insurance through their employer-based plan, in almost all cases, the spouse and children would be BLOCKED from qualifying for a government “subsidy” (government helps pay). It didn’t matter if the employee enrolled into the employer’s health insurance or not, they would still be blocked from a subsidy. The options for this family were: they could pay full price for their employer group plan for the spouse and kids, enroll in a private plan for spouse and kids, or enroll into a Marketplace plan for the spouse and kids (but they would be paying full price). Only a very small percentage of these Nevadan’s spouses and kids’ could qualify for a subsidy, because the employee’s plan was considered “unaffordable”. The reason they could not get a subsidy is because the employer’s health plan was considered “affordable” to the employee, and the employers affordable health plan to that employee would BLOCK their spouse and kids from qualifying for a government “subsidy”. This was the “Family Glitch”.
Time To Celebrate!
In October of 2022 the Treasury Department announced new rules to the American Rescue Plan Act, stating that starting on 1/1/2023 employees that are offered “affordable” health insurance by their employer, their family members may now qualify for a subsidy! “Affordability” is calculated in a way that the health insurance plan costs the family less than 9.12% of their household income. This household income will determine what amount of subsidy the family would qualify for, then the family can decide what health plan they’d like to enroll into. This is such a huge deal! We’ve seen so many families that desperately needed the tax subsidies, but because of this family glitch, the family members of the employee were not eligible. Many of these Nevadan’s had pre-existing conditions that really needed coverage, and this put the employee in a situation that made them think twice about their employment.
Advanced Premium Tax Credit
This subsidy is called an “Advanced Premium Tax Credit”, meaning, in advance of your premium being due on the 1st of every month, your health plan premium will be reduced in the form of a “subsidy,” which is based on factors such as your family size and income. You’ll only pay a percentage of your income for your health insurance plan. The higher the income the lower the subsidy, the lower the income the higher the subsidy. Be careful to report and state the correct and accurate income the very best you can, because you’ll have to account for your stated household income (and the overall amount of subsidy dollars you took) to the IRS, in the following year.
Who Benefits from the New Rules and gets to Celebrate?
In the past few years, if employed Nevadans that had group health insurance were super lucky, (probably less than 5% of the population) where the employee’s portion of the health insurance was considered “unaffordable”, (this means that the employee’s portion of their health insurance premium must be considered unaffordable), then the spouse and kids could get a subsidy to help pay for their health insurance, but this occurrence was very rare. Under the new rules, the affordability of employer-subsidized health insurance is based on the cost of insuring the entire family, not just the employee. There are estimates that the new rules will put affordable health insurance within reach of about a million people nationwide. The new rules go into effect for families who apply for 2023 coverage during this years open enrollment period – November 1st, 2022, through January 15th 2023.
How We Help You For FREE – Nevada Insurance Enrollment
Finding health insurance coverage that fits your needs and budget can be challenging, and ever-changing rules can make it confusing to determine what you qualify for. Our agents study the different insurance companies’ health insurance plans and options each year. They know what HMO, EPO, and PPO options are available from each insurance company. They know how the plans work, how the coverage works, what coverage you’ll have outside of Nevada, can answer difficult questions, and help with situations that may need additional research.
At Nevada Insurance Enrollment, our health insurance agents are knowledgeable, patient, caring, and can help you determine whether you may benefit from the new rules regarding the family glitch, and if you can save money by purchasing health insurance through Nevada Health Link. Our services are free to our clients. We are paid by the insurance companies to assist Nevadans into health plans that work best for them, and your insurance premiums will not go up in price one cent for using our assistance. Your plan will cost you the same with or without assistance. It only makes sense to get the help you deserve from a licensed agent. Call us today at (702) 898-0554 for an appointment in person or over the phone.
In addition…
No More Subsidy Cliff
More Americans are now eligible for a Health Insurance subsidy with The American Rescue Plan Act
So Important – MUST READ!
No More Subsidy Cliff for those making over 400% of the Federal Poverty Level
Now, higher income individuals are qualifying for a Government subsidy
read more about "Subsidy Cliff" - click to open/close
Health Insurance Subsidy Cliff
No More Subsidy Cliff for those making over 400% of the Federal Poverty Level.
For the first time, many Nevadan’s (those making over 400% of the Federal Poverty Level), may now be eligible for a health insurance subsidy! Plus, for existing members, the rate you are paying will most likely decrease.
For instance, if you were a 60 and 61 year old married couple, and your income was projected to be over $68,960 in 2021 you would not have qualified for a tax credit. Now, since the changes, that same couple making $80K per year would qualify for $1007 per month. This is HUGE!
You can now get a Government subsidy to help you pay for your health insurance premiums. Before these changes, if your income was over $51,040 for a single person in tax year 2021, or $104,800 for a family of 4, you were not eligible for a tax subsidy.
Now there is no income limit to receive these subsidies. The subsidy amount gradually slopes off to be no more than 8.5% of your household income (Modified adjusted gross – for most people, their “Adjusted Gross Income”). So, for many Nevadan’s, they’ll now be eligible for tax credits!
Also in this new law (and this is ONLY for tax year 2020), if you ended up making more than you estimated for tax year 2020, you will not be required to pay back those subsidies.
FREE or NEARLY FREE Health Insurance for any employee who lost their job and collects unemployment any time in 2021. For the tax credit, no matter how much they make on unemployment or otherwise, their income won’t be counted higher than 133% of the federal poverty level. If you are collecting unemployment for 2021, it’s most likely beneficial to apply for Obamacare than Cobra. Why? Free Cobra payments are only good for 5 months, but with Obamacare, the Free to nearly Free health plans are good all year!
These changes do not apply to those Nevadan’s that have jobs that offer insurance to their employees and their families (whether they take their employer, spouses’ employer, parents insurance or not).
Call our office, we can answer your questions, assist you with any changes to your current plan, or help you apply for these new subsidies.
Reporting Changes to Your Household
It is VERY IMPORTANT to stay on top of your account when you get a subsidy from the Government. If your “Household” changes (including your income), you’ll need to update your account by contacting us.
Eligibility for a subsidy and additional help called “cost-sharing reductions” is based on annual household income and size of your household.
Do you have changes to your family size or income?
Call us to update your info.
Changes in Your Household
If your “Household” changes (family members on your tax return) like having a baby, getting a divorce, getting married, or adoption, etc. Changes to your “Income” like getting a job with benefits, lose your job with benefits, have an increase or decrease in your income… any changes to your income or changing from Part Time to Full Time or Full Time to Part Time. These “Household” changes you’ll need to update your account by contacting us as your licensed health insurance agent.
The reason for this is because when you file your taxes next year, for this year, the IRS will look back at your overall household income and family size. If you received TOO MUCH subsidy, you’ll have to pay back the overage, and if you didn’t get all the subsidy you were entitled to, you’ll get credit for having too little subsidy. It is very important to be honest and accurate when filling out your application for a subsidy.