What is Comprehensive Health Insurance?
Comprehensive health plans provide a full range of medical services for individuals and families under 65 years of age. In Nevada, plan types are HMOs and EPOs. HMO stands for Health Maintenance Organization. EPO stands for Exclusive Provider Organization. Each type has participating providers who form a network of care.
Most HMOs require a referral from a primary care physician to see specialists. With an EPO, seeing a specialist without a referral from a PCP is standard. With either plan, you can change primary care doctors up to once a month.
There are three ways to get a comprehensive plan. The first is through the Affordable Care Act (ACA). People choose ACA for federal help with premium payments and other possible discounts. In Nevada, you enroll through Nevada Health Link (www.nevadahealthlink.com). Federal assistance with premiums, and other possible discounts, are based on estimated taxable household income; household size; where you live; and your age. Insurance companies can charge higher premiums for tobacco use. You cannot be denied coverage for preexisting conditions.
The second way is through Medicaid. Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, the elderly, and people with disabilities. Medicaid is administered by the states, according to federal requirements. To determine your eligibility, you can go to a Medicaid office or fill out an application on the Nevada Health Link website. You cannot be denied coverage due to preexisting conditions.
The third way to get a plan is to pay full price. This path is for individuals and families who don’t qualify for a federal help through the Affordable Care Act or who choose not deal with the federal requirements. You can enroll in a full price plan through Nevada Health Link or directly with insurance companies that offer ‘Off Exchange’ plans. You cannot be denied coverage due to preexisting conditions.