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What Is A State Based Health Insurance Exchange?

by | Oct 16, 2024 | Health Insurance

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Nevada is a State-Based Health Insurance Exchange

Whether you’re looking for health insurance for yourself or your family, you may become familiar with the states health insurance website, Nevada Health Link. This is the only place to go where you can get a subsidy (government assistance) to help pay for your health insurance in Nevada.

IMPORTANT: You can still use a Heath Insurance Agent. Their services are available to guide you either on or off the exchange.

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What Is A State Based Health Insurance Exchange?

In most cases, when someone is talking about state-based health insurance, they’re referring to a health insurance plan that is regulated by the Department of Insurance in that state. These plans are sold through state health insurance exchanges. Another viable option is enrolling directly with the health insurance carriers without getting a government subsidy with the help of brokers and agents.

 

State-Based Health Insurance Exchanges And The Affordable Care Act

In 2010, when the Affordable Care Act was signed into law, states were given the option of choosing whether they wanted to establish their own state-based health insurance exchanges or whether residents would instead obtain health insurance through the federally run platform, known as HealthCare.gov.

Some states already had their own exchanges and decided to simply continue making health insurance accessible to residents that way. While others switched from their own exchange to the federal exchange.

State-based health insurance exchanges come with a lot of benefits to residents. For example, in some states, insurers have to meet coverage and rate requirements for their plans to be sold on the state exchange, ensuring that residents have access to better coverage. In some cases, states may even give priority to health insurance companies that offer benefits that align with the overall health needs of the state. Using the federal portal Healthcare.gov is more expensive than using our own State Based Exchange too.

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The Difference Between The Two Exchanges

While both on-exchange and off-exchange health insurance plans can provide great coverage, there are some key differences between the two.

On-exchange health insurance plans are purchased through government-created marketplaces online. Off-exchange health insurance plans, on the other hand, are purchased from a health insurance company. They can be purchased directly from the company or they can be purchased through an agency like Nevada Insurance Enrollment.

Having a broker is a huge benefit! At no additional cost to you, an insurance agent can provide you with the information about all the different health insurance companies and their plans as well as assist you with policy questions year round.

 

3 Reasons to Consider Purchasing an Off-Exchange Plan

More Choices for Health Insurance

On-exchange health insurance are usually HMO plans which limit the freedom to see any provider you are wanting to see. They can only be purchased during “open enrollment” or anytime with a provable “life event” such as, permanent move to NV, loss of coverage from employer, birth of baby, marriage, etc. By purchasing an off-exchange plan through Nevada Insurance Enrollment, you may have greater access to more plans like EPO’s and PPO’s which allow you to see providers without referrals. However, you cannot receive a Government subsidy when buying off-exchange.

Larger Provider Networks

Buying an off-exchange PPO plan gives you the option of selecting a plan that will cover your current doctor, in or out of the network. Most on-exchange plans generally have smaller provider networks, requiring that you pick a primary doctor that is in their network.

Affordability

Our agents are available for in-person visits. All of our agents are licensed, experienced and want to help you get the best plan at the lowest price you are entitled to, whether it is an on-exchange or off-exchange plan.​

 

Reach Out To Nevada Insurance Enrollment

With so many options available, finding great health insurance coverage can be a challenge. At Nevada Insurance Enrollment, our health insurance agents are here to help you make sense of your options to find coverage that will fit your needs and budget.

What Are Association Health Insurance Plans?

What Are Association Health Insurance Plans?

Most people have never heard of association health plans; however, these health insurance plans have been around for decades. Association Health Plans may have fewer benefits but will most likely have lower premiums, making them an attractive option for those who are young, healthy, and on a budget.

How To Spot Health Insurance Scams

How To Spot Health Insurance Scams

There are numerous health insurance options and navigating the system can feel a little daunting. Unfortunately, scammers take advantage of people’s confusion by pretending to offer cheap, hassle-free help with obtaining health insurance coverage.

Short Term Health Insurance for Nevadans

Short Term Health Insurance for Nevadans

Short-term health insurance is a special policy designed to provide coverage during times of transition when traditional health insurance coverage may be impractical or unavailable.

 

By page visits (this month)

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog

#5) Request a Quote

By page visits (this month)

 

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog Posts

#5) Request a Quote

Telemedicine Benefits

Telemedicine puts healthcare within reach of those who would otherwise have a difficult time visiting a doctor. If you have a severe sinus infection, the last thing you want to do is spend the afternoon in the doctor’s office.

What Happens If You Forget To Pay Your Premium By The Due Date?

Life happens, and while you should make every effort to pay your health insurance premium on time, health insurance plans generally will have grace periods. You may have a grace period of 30 days, or if your insurance plan is through Nevada Health Link (on-exchange), it may be up to 90 days.

Medical Loss Ratio

This Medical Loss Ratio states that when a family or individual buys a medical plan, 80% of every dollar collected and paid to an insurance company MUST pay medical claims/research. So that leaves the insurance company to pay ALL of their expenses with the remaining 20%. .20 cents on the dollar for their employees, buildings, broker costs, etc.

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