The Affordable Care Act (ACA), also known as Obamacare, is a piece of legislation designed to provide affordable healthcare to all Americans. There are several different types of ACA health plans, and it is essential to understand how these plans vary. The best ACA plan for you is based on your income level, household size, and healthcare needs. Open enrollment for Nevada starts from November 1st, 2022, to January 15th, 2023.
What are the best plans on Nevada’s exchange?
The ACA offers several types of health plans grouped into different categories. The following article will explore how these plans are organized and which is most suitable for your needs.
Metal Tier Plans
The ACA organizes plans into 4 metal levels: Bronze, Silver, Gold, and Platinum. Each level varies in terms of premium and deductible cost. Still, the quality of care remains the same throughout each level. These metal tiers determine the cost-sharing between you and your insurance provider.
Here is a brief overview of each of the 4 metal levels:
- Bronze: Best for Young and Healthy People
- Silver: Best for Individuals with Low-Income
- Gold: Best for Comprehensive Coverage
- Platinum: Best for Frequent Medical Needs
Cost-Sharing of Metal Tier Plans
|Metal Level||Insurance Pays||You Pay (Deductible)||Monthly premium|
List of Available Plans on Nevada’s ACA Exchange
The following table lists all the available plans from Nevada’s ACA exchange in 2023. They are ordered from lowest to highest premium. Additionally, they are sorted based on metal tier, starting with Bronze and ending with Gold. Each type of tier plan is more well suited for a specific individual and their specific healthcare needs.
Plan (carrier + name)
|Health Plan of Nevada - A United Healthcare Company - Virtual HPN Bronze HMO||$267.09/month||$8700|
|aetnaCVSHealth Bronze HMO||$270.12/month||$8700|
|Ambetter from silversummit healthplan - Everyday VALUE Bronze HMO||$271.93/month||$8300|
|Health Plan of Nevada - A United Healthcare Company - MyHPN Plus Bronze 4 HMO||$285.95/month||$9000|
|Ambetter from silversummit healthplan- Everyday Bronze||$288.73/month||$8300|
|Anthem Bronze Convenient Care HMO||$295.18/month||$7500|
|HealthPlan of Nevada - A United Healthcare Company - MyHPN Plus Bronze 5 HMO||$297.21/month||$7800/$2000|
|SelectHealth Value Expanded Bronze Virtual First HMO||$299.86/month||$6900/$2500|
|SelectHealth Med Expanded Bronze - no deductible for urgent care and PCP office visits||$306.35/month||$6900/$2500|
|Ambetter from silversummit healthplan - Complete VALUE Silver HMO||$335.21/month||$6000|
|SelectHealth Silver 6500 - no deductible for office visits||$345.21/month||$6500|
|Ambetter from silversummit healthplan - Complete Silver HMO||$355.99/month||$6000|
|aetnaCVSHealth - Silver 3 HMO: Aetna network of doctors & hospital + $0 MinuteClinic + $0 Telehealth 24/7||$358.34/month||$6500|
|SelectHealth Med Silver 6500 Diabetes Support Plan HMO||$359.09/month||$6500/$2000|
|Anthem Silver Convenient Care x HMO 5500 $0 Select Drug||$364.34/month||$5500|
|SelectHealth Med Silver Medicaid Transition Plan HMO||$365.97/month||$6000/$500|
|Ambetter from silversummit healthplan - Complete Silver + Vision + Adult Dental HMO||$375.07/month||$6000|
|aetnaCVSHealth - Silver 2 HMO: Aetna network of doctors & hospital + $0 MinuteClinic + $0 Telehealth 24/7||$384.35/month||$5000|
|Health Plan of Nevada - A UnitedHealthcare Company - MyHPN Silver 12 HMO||$386.02/month||$7000/$1500|
|Health Plan of Nevada - A UnitedHealthcare Company - MyHPN Silver 10 HMO||$389.70/month||$6200/$1500|
|Health Plan of Nevada - A UnitedHealthcare Company - MyHPN Silver 5/Medicaid Transition Plan HMO||$435.49/month||$5000/$1500|
|Ambetter from silversummit healthplan - Complete Gold HMO||$439.22/month||$1450|
|Ambetter from silversummit healthplan - Elite VALUE Gold||$453.94/month||$0|
|SelectHealth Med Gold 1000 - no deductible for office visits HMO||$474.20/month||$1000/$250|
|SelectHealth Value Gold 1000 - no deductible for office visits HMO||$478.48/month||$1000/$250|
|Health Plan of Nevada - A UnitedHealthcare Company - MyHPN Select Network Gold 1 HMO||$482.46/month||$3500/$500|
|Health Plan of Nevada - A UnitedHealthcare Company - MyHPN Select Network Gold 6 HMO||$498.23/month||$1800/$500|
What should I consider when picking a health plan?
Before choosing a health plan, it is fundamental that you consider several factors. The healthcare plans in Nevada on the ACA exchange are organized by metal tier. You can choose the most suitable plan based on your health needs, your financial situation, how much you can afford, and how often you travel. The following chart shows the average premiums in Nevada for each metal tier in 2023.
Metal Tier Plans Prices and Recommendations
|Metal Plan||Average Price||Best Plan For|
|Bronze||$295||Best for Young and Healthy People|
|Silver||$385||Best for Individuals with Low-Income|
|Gold||$464||Best for People who need Comprehensive Coverage|
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Your health needs
Your health needs are critical when picking a health plan. People who require frequent or comprehensive medical attention or coverage should select from higher tiers. However, these tiers have a more expensive premium, and more of your coverage will end up being covered due to their lower deductible.
Here is a brief overview of each of the 4 metal levels based on your health needs.
- Bronze: Best for Young and Healthy People
- Silver: Best for Individuals with Low-Moderate Health Needs
- Gold: Best for Comprehensive Coverage
- Platinum: Best for Frequent Medical Needs
Your financial situation (how much you can pay out of pocket)
Choosing a healthcare plan depends on your financial situation or how much you can afford to pay out of pocket for healthcare. For instance, although the Bronze tier has the lowest average premium, it also has the highest deductible. You will have to pay for your healthcare needs out of pocket until you reach that deductible. As such, these plans are generally better suited for individuals who require infrequent medical attention.
On the other hand, a gold plan has a much higher premium but a lower deductible. These plans are best suited for people requiring frequent and comprehensive medical coverage as most of their healthcare will likely be covered for the year.
If you travel frequently
If you find that you travel frequently, it is crucial that you are fully covered. If you are traveling outside of the U.S., you might have to pay out-of-pocket for their services. Some health insurance plans will cover emergencies that can occur out of the U.S.; check your plan to see if these activities are covered.
If you are traveling within the U.S., consider getting a PPO plan. A PPO plan might be more pricey, but it will give you the most access to out-of-network coverage. The following chart shows the differences between the plans you can choose from.
|Type of Plan||Network flexibility?||Cost?||Primary care physician?||Referrals for specialists?|
|HMOs:||Must stay in-network, except for emergencies||$||Required||Yes|
|EPOs:||Must stay in-network, except for emergencies||$$||Required||No|
|PPOs:||Out-of-network options are available but more costly||$$$$||Not required||No|
|POS:||Out-of-network options are available but more costly||$$$||Required||Yes|
What happens if you can’t afford any plan on the exchange?
For the state of Nevada, since 2019, there has been no penalty for not having health insurance. As such, there is no need to fill out an exemption request. However, if you find that you are having difficulty affording typical ACA health plans, there are other options you can consider in addition to federal financial assistance.
Catastrophic plans are generally separate from the other four metal plans. Still, they are a low-cost option for uninsured individuals. Although you can purchase a catastrophic plan under Obamacare, these plans can also be purchased directly from an insurance company without the official ACA exchange. These plans are similar to Bronze plans in that they have the lowest premiums and the highest deductible price. Like Bronze Plans, catastrophic plans cater to young and healthy individuals who do not expect to have high medical costs.
However, it is important to note that to be eligible for a catastrophic plan, you must meet either of the following criteria:
- Under age 30
- Any age but with a hardship exemption (given to individuals who cannot afford typical health insurance due to personal or financial circumstances).
Federal Financial Help
Families with an income lower than 138% of the Federal Poverty Line (FPL) typically qualify for Medicaid coverage. However, families with income over 138% of the FPL may not be eligible for Medicaid. However, they may still have trouble paying for an ACA plan. For these families, financial assistance such as Premium Tax Credits (PTC) or Cost-Sharing Reduction (CSR) can lower their monthly premiums or out-of-pocket costs.
- Premium Tax Credit (PTC): a refundable tax credit that helps low-moderate income families and individuals afford their health insurance premiums.
- Cost-Sharing Reduction (CSR): a government-provided discount to help reduce out-of-pocket costs for low-moderate income families and individuals. CSRs will help to decrease your deductible, co-pay, or co-insurance fees.
For reference, in Nevada, 138% of the FPL for a family of 3 is $30,305. This threshold varies based on family size; you can view the full chart here. Whether you qualify for a PTC or a CSR will be seen on your health insurance enrollment application.
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How to enroll in an ACA plan?
Enrolling in an ACA plan can take time and effort. For Nevada specifically, individuals have to use a specific Healthcare Marketplace website that differs from the federal portal. This website is nevadahealthlink.com. This website contains all the information needed to enroll in an ACA health plan properly. We have a detailed article about how to enroll in an ACA health plan in Nevada that you can visit here.
Open enrollment for Nevada starts from November 1st, 2022, to January 15th, 2023. Here is a summary of how to apply for ACA health coverage in Nevada:
- Sign up for an account and start an application on the Nevada Health Link portal
- Use the “Find a Plan” to view different plan options based on your income, household size, and personal preferences.
- Choose a plan and enroll by paying your first premium.
If you need assistance submitting a health insurance application or enrolling in a plan, Nevada provides agents, brokers, and enrollment counselors for no charge.
Licensed agents and brokers have been trained to sell specific plans in the Nevada marketplace from certain insurance carriers. Still, they can tell you the advantages and disadvantages of each plan. Certified enrollment counselors are also trained but can not directly recommend a specific plan. However, they can help you better understand your options to make more informed decisions.
Nevada ACA Health Exchange Frequently Asked Questions (FAQs)
Understanding how to choose the best plan for you or your family is difficult. It is necessary that you carefully examine your possible options and the type of coverage you want to receive. The following questions can help you understand how Obamacare works and whether or not you are eligible.
What is the difference between Medicaid/Medicare and Obamacare?
Medicaid and Medicare are both federally funded insurance programs. Medicaid is an insurance program for low-income individuals under the age of 65. Medicare is an insurance program for people 65 and older, people with disabilities, or people with end-stage kidney disease requiring dialysis or transplant. On the other hand, Obamacare is legislation that regulates private insurance company pricing and coverage. A U.S. citizen needs to meet the requirements set by the federal government to qualify for Medicaid or Medicare. In contrast, any U.S. citizen can buy private health insurance through Obamacare.
Do I qualify for Obamacare?
People of all incomes qualify for Obamacare unless they meet the following criteria:
- Your employer offers comprehensive and affordable coverage.
- You can access coverage via a family member’s employer health insurance plan.
- You are eligible for federally funded health insurance such as Medicaid or Medicare.
- Your income is less than 100% of the federal poverty level.
- Your income is 400% above the federal poverty level.
- You are incarcerated.
What benefits are covered by ACA health plans?
The ACA requires that all health insurance plans include 10 essential health benefits. These 10 services must be covered in every state, but the extent of coverage may vary from state to state. These benefits are as follows:
- Ambulatory patient services
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services
Ultimately, choosing a healthcare plan can be very stressful and challenging. However, after you can properly understand the different options offered by Nevada and have considered your financial status and healthcare needs, you are more than well-prepared to choose a healthcare plan.
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Sophie is a 2024 Pharm D. candidate studying pharmacy at Rutgers University, New Brunswick. She has a passion for healthcare and writing and hopes to make meaningful contributions to healthcare transparency and accessibility. In her free time, she likes to take care of her houseplants, cook, and hang out with her cat.