Did you know that Nevada is one of 12 states that has a state-based health insurance marketplace? Nevada is also one of nine states who are offering a special enrollment period in response to the COVID-19 outbreak. Nevada’s lawmakers and prior Governor Brian Sandoval created and put into statute the Silver State Health Insurance Exchange, known as Nevada Health Link, to reduce the number of uninsured Nevadans. Having health insurance coverage is more important now than ever. In a time when health insurance is vital, Nevada Health Link is able to provide access and give you peace of mind.
In response to Governor Sisolak’s recent Emergency Declaration, Nevada Health Link has opened a limited-time Exceptional Circumstance Special Enrollment Period (ECSEP) for qualified Nevadans who missed Open Enrollment. To better understand the ECSEP and your health coverage options, we’ve answered some questions you may have.
- What is the Exceptional Circumstance Special Enrollment period (ECSEP)?
The Exceptional Circumstance Special Enrollment Period is for qualified Nevadans who missed the Open Enrollment Period (Nov. 1 – Dec. 15). The SEP opened on March 17, 2020, and runs through May 15, 2020. You can get started by calling the Call Center at 1-800-547-2927 or by browsing plans on the SBE platform.
- Does insurance for Exceptional Circumstance Special Enrollment Period offer the same plan options as Open Enrollment?
Yes, all Nevada Health Link plans offer comprehensive coverage options, including the 10 Essential Health Benefits. You also won’t be denied coverage if you have a pre-existing condition like cancer or diabetes. Our plans are competitively priced and are designed to protect you and your family if a medical incident were to occur.
- If I get insurance through the Exceptional Circumstance Special Enrollment Period, will I have coverage for the rest of the year?
Yes, if you enrolled before April 1, your coverage start date was April 1. If you enrolled between April 2 and April 15, your coverage begins on May 1, 2020. We have extended this SEP to May 15, 2020. If you enroll on or before April 30, your coverage start date is May 1. If you enroll from May 1 – May 15, your coverage start date will be June 1, 2020. Once you enroll, your coverage lasts the entire year. It’s important to remember to pay your premium with your insurance carrier directly.
- Will health insurance from the ECSEP cover my whole family or just me?
If you are applying for you and your whole family and each of you are eligible for the SEP, all those who applied should be covered.
- Is this the only special enrollment period option available?
No, Special Enrollment Periods (SEPs) are offered year-round and during the offseason of the Open Enrollment Period. SEPs can occur even during the Open Enrollment Period – if you qualify. You’re eligible for the Special Enrollment Period if you have certain qualifying life events, like getting married, having a baby, or losing other health coverage, a job, or have an income change (certain restrictions apply). If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan.
- Do I need additional insurance to cover COVID-related issues?
No. An emergency regulation requires health insurers to cover—with no out-of-pocket costs—testing for COVID-19 and the office, urgent care center, or emergency room visit when the purpose of the visit is to be tested for COVID-19. No “out-of-pocket cost” means that you cannot be charged a copay or have to meet your deductible for the test or visit. Treatment of COVID-19 must be covered according to your insurance policy.
Health insurance plans cover medically necessary services. Treatment related to COVID-19 should be no different. Contact your health insurer for coverage details. If your insurance policy has copays and deductibles, they will apply to treatment for COVID-19. Learn more:
https://www.nevadahealthlink.com/coronavirus
- I recently lost my job. What are my coverage options?
If you lost your job for any reason and therefore lose your employer-sponsored coverage, you may be eligible for an SEP and enroll in a plan through Nevada Health Link. You may also qualify for free or low-cost coverage through Medicaid or Nevada Check-Up. Losing job-based coverage, even if you quit or get fired, qualifies you for a Special Enrollment Period, but only if you apply within 60 days of losing coverage.
- What is the best way to learn about my health coverage options?
We work with a statewide network of licensed enrollment professionals who have been trained to assist you. We recommend calling our Customer Assistance at 1-800-547-2927 to find the health plan that fits your needs or visit – https://www.nevadahealthlink.com/find-assistance/.
- I am furloughed/on unpaid leave/or on paid family medical leave. What are my coverage options?
When on leave under the Family Medical Leave Act (FMLA), you can continue coverage under your employer-sponsored plan.
- I already have coverage through Nevada Health Link, but having a hard time affording it because of loss of income. Am I eligible for extra financial help?
Yes, if your income has changed due to loss of hours and you are enrolled in a Nevada Health Link plan, you may be eligible to receive more subsidies. Be sure to report loss of income or job changes by calling us at 1-800-547-2927. You can also log into your account. If your plan is no longer affordable, you may need to transition to Medicaid in the state of Nevada. However, this is not a time to cancel your health plan. Please reach out to your carrier directly to work with them on keeping your plan and income changes. As always, we recommend working with a certified broker or navigator to get FREE enrollment assistance.
As we work through this time of crisis, we are beginning to see an increase in insurance-related fraud that involves fraudulent sales of COVID-19 specific health coverage. To safeguard yourself and avoid potential health insurance scams, it’s important to remember the following:
- Nevada Health Link insurance plans will cover COVID-19 related care. You do NOT need to purchase additional health insurance. If you have any questions regarding your plan purchased through Nevada Health Link, please call 1-800-547-2927 or email CustomerserviceNVHL@exchange.nv.gov. You can keep up-to-date here https://www.nevadahealthlink.com/coronavirus/.
- This is also true for Off-Exchange insurance plans that are ACA-compliant for which you do NOT need additional health insurance coverage.
- If you have witnessed or know someone who is telling people to purchase extra health insurance coverage for COVID-19, please file a complaint with the Nevada Division of Insurance: http://doi.nv.gov/Consumers/File-A-Complaint.
- Remember to always verify licensure of persons or companies trying to sell you insurance with the Division of Insurance. Verify a license on the Division’s website: https://di.nv.gov/ins/f?p=licensing:search.
- Additionally, there is no cost for medical services related to testing for COVID-19. For more information, please see Consumer Alert: COVID-19 and Your Health Insurance at the Division’s website: doi.nv.gov.
We’d like to remind you to work with a certified broker or navigator to enroll in coverage. These are enrollment professionals who are licensed with the state of Nevada and have been certified by Nevada Health Link. You can also call Customer Assistance at 1-800-547-2927 for any questions regarding special enrollment or if you’d like to be connected to a licensed enrollment professional.
