I have Insurance, Now What?
NVPCA is concerned about our clients before and after they have obtained health insurance coverage so we have created a Health Insurance 101 to help you.
What does it all mean?
What to Expect: Post Enrollment and Beyond
Once you have finalized your enrollment by paying your first month's premium your information will be uploaded to your insurance carrier's database. You will receive information about your plan along with your medical insurance cards in the mail (typically in 5-7 business days).
If you have not chosen a Primary Care Provider (PCP), your insurance provider will require you pick one. You should try picking a PCP in your plan's provider network. Providers and hospitals in network have special contracted rates for services with your insurance carrier which could save you money. A list of in-network providers and hospitals can be found on your insurance provider's webpage or by contacting their customer service center.
When you visit your doctor's office you will need to provide your medical insurance card. During your visit you will be notified if you have a copayment. Any medical expenses you incur may go towards your deductible. Once you have met your deductible for the year, your coinsurance will kick in. You can find information about your deductibles, copayments, coinsurance and other benefit details by referring to your summary of benefits or by calling your insurance carrier's customer service.
To access our glossary of Health Insurance Terms click here
10 Essential Health Benefits Covered by all Qualified Health Plans (QHP)
All health plans must cover the 10 Essential Health Benefits (EHBs) in order to comply with the Affordable Care Act's definition of minimum essential coverage. The 10 EHBs are shown below:
- Ambulance services and care
- Emergency service
- Maternity and newborn care
- Mental health and substance abuse disorder treatment
- Prescription drugs
- Rehabilitation and habilitation services and devices
- Lab services
- Preventive and wellness services and chronic disease support
- Pediatric services, including dental and vision
All Nevada Health Link and Nevada Medicaid/CHIP plans cover these 10 EHBs. Refer to your summary of benefits for more information on how these services are covered by your insurance provider.
Maintaining Coverage and Reporting a Change
It is important to maintain insurance coverage. One sure way to maintain your coverage is to pay your premium on time (usually monthly). A lapse in payment may result in coverage cancellation.
If you lose insurance, your income increases or decreases, you get divorced, give birth/adopt or you experience some other life event contact the marketplace at 1-800-318-2596 or click here to learn more!
For more information about Qualified Health Plans go to www.nevadahealthlink.com
For information about Nevada Medicaid go to www.dwss.nv.gov
To access the glossary of Health Insurance Terms click here