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Health Plan of Nevada Individual and Family Plans

Open enrollment is happening now through January 15, 2025. Enroll or renew by December 31 for coverage January 1.

 


 

Looking for an
On Exchange plan?

 

Losing your 
Medicaid coverage?

 

Looking for an
Off Exchange plan?

 

Want to learn about
our health plans?

 

Looking for an On Exchange plan?

Health Plan of Nevada has 35+ individual and family plans that may save you money on your premium and out-of-pocket costs.

If you choose an Exchange plan, you may be able to get some help with your monthly cost. This is called an Advanced Premium Tax Credit (APTC) subsidy.

In addition to the monthly premium, people with insurance usually have to pay a copay or coinsurance when they go to the doctor or have a test. This cost can also range from being very small, like $5, to being higher. However, through an Exchange plan, you may also qualify for a different subsidy, called Cost Share Reduction or CSR.

Most insurance plans have a monthly cost. This monthly cost, or premium, can be very small, or higher depending on the insurance plan you pick. If you have dependents age 20 or under, only the oldest three will have a premium.

Silver plans qualify for both tax credits and cost sharing subsidies. They also offer the best value if you qualify for a subsidy and want to balance your monthly premium with your out-of-pocket costs.

You and your family may qualify for help paying for your health insurance if you are:

Family size Yearly income
1 $15,060 ⁠–⁠ $60,240
2 $20,440 ⁠–⁠ $81,760
3 $25,820 ⁠–⁠ $103,280
4 $31,200 ⁠–⁠ $124,800

2024 estimated amounts. Eligibility is determined by Neavada Health Link. Must not be eligible for Medicaid or other health insurance.

  • Health Plan of Nevada has the largest provider network in Nevada.
  • Many providers are only in the HPN provider network.
  • Health Plan of Nevada has been taking care of Nevadans for 40+ years and is located in Las Vegas.
  • HPN Individual On Exchange Select Plans offer HPN’s lowest monthly premium with a select network of hospitals. The Select Network does not include Dignity facilities and Dignity micro hospitals, urgent cares and physician groups.
  • Health Plan of Nevada offers more ways to get urgent care including 24/7 urgent care, urgent care that comes to you and some specialty urgent care centers.* 
  • Health Plan of Nevada offers $0 or LOW-COST benefits and services.
  • Mental health benefits with every plan (virtual and in-person visits to all members)
  • Digital health tools, including One Pass SelectTM, a subscription-based fitness and well-being program.
  • $0 cost share on many maintenance medications for chronic conditions with our Vital Medications Program.

*Restrictions apply. Not available in all areas.

If you want an On Exchange plan, before you start your enrollment, make sure to have the following information ready:

  • Social Security numbers of everyone seeking health coverage (or document numbers for any legal immigrants)
  • Employer and income information for everyone in your family (for example, from paystubs, W-2 forms, or wage and tax statements)
  • Policy numbers for any current health insurance
  • Information about your job-related health insurance available to your family

This information will be used to find out what coverage you qualify for and if you can get help paying for it.

Call Health Plan of Nevada toll-free at 1-800-873-0004, TTY 711 for help in reviewing plans. You can also shop for a plan on NevadaHealthLink.com or call your broker.

Losing your Medicaid coverage?

If you no longer qualify for Medicaid and your enrollment is being terminated, there are ways to stay covered. Losing Medicaid coverage is called a qualifying life event because it may impact your health insurance.

Most people have 3 options:

  1. A health plan through your work
  2. An individual or family plan
  3. Medicare, if you are 65 or older

Experiencing a qualifying life event means you can enroll in a new health plan right away as part of a special enrollment period. If you miss your special enrollment period, you’ll have to wait until the next annual open enrollment period to sign up for coverage. Employers set their own open enrollment timing, while Nevada Health Link enrollment typically starts Nov. 1, for a start date of Jan. 1.

Once enrolled in a new health plan due to a special enrollment period, your coverage typically starts on the first day of the month following eligibility. The special enrollment time period is limited, so if you are no longer eligible for Medicaid, be sure to take action. If you need to sign up for another health plan, the special enrollment period is typically 30 or 60 days.

Talk to your employer about a health plan through your work or call Health Plan of Nevada at 1-800-873-0004, TTY 711 to speak to a sales representative who can help you understand your coverage options, including Medicaid transition plans on the Exchange.

Looking for an Off Exchange plan?

If you have any questions, call your broker or our sales team toll-free at 1-800-873-0004, TTY 711. Off Exchange plans are a good option for individuals and families who aren’t eligible for subsidies or financial assistance.

Want to learn more about our On and Off Exchange plans?

We have many individual and family plans that fit almost every lifestyle.

Easier on the wallet, HMO plans are designed to save you money on out-of-pocket costs.

HMO members are required to choose a primary care provider (PCP) and stay within a network of providers, urgent cares, and hospitals to receive coverage under the plan. Females 14 years and older may select an OB/GYN in addition to a PCP.

To have a specialist visit covered, you must see your PCP for an initial exam. Your PCP is the leader of your care team and will give you a referral to a specialist for a more thorough diagnosis, if needed.

HPN has the largest provider network in Nevada and many doctors are only in our network.

For a complete list of providers, visit HealthPlanofNevada.com. If you need help scheduling an appointment or finding the right provider to fit your specific needs, our Member Services team can help.

Choose an HPN plan. Find out if you qualify for financial assistance with an HPN Exchange plan or shop our Off Exchange plans.

We offer Gold, Silver and Bronze HMO plans. The choice is up to you.

Plan level

Gold

Silver

Bronze

Monthly premium

Moderate $$$

Low $$

Lowest $

Cost per  visit/prescription

$$

$$

$$$

Plan pays

80%

70%

60%

You pay

20%

30%

40%

May be best if you…

Want to manage monthly premium costs and reduce out-of-pocket health expenses

Want to balance monthly premium costs with out-of-pocket health expenses

Rarely use medical services

Primary care visits (before deductible)

X

X

X

Mental health visits

(before deductible)

X

X

X

Virtual visits with NowClinic®

X

X

X

Specialty care visits (before deductible)

X

X

 

Urgent care visits (before deductible)

X

X

 

Physician extender visits

(before deductible)

X

X

 

Pharmacy tier 1 and tier 2 drugs

(before deductible)

X

X

 


This table is a snapshot of our most popular covered benefits.

*A deductible is a specific amount you must pay before your insurance coverage kicks in.

X = Member is responsible for copay before the deductible* is met on most plans.

We also offer Off Exchange EPO plans that require you to get care from a certain network of providers. EPO health plans cover out-of-network care only in emergencies or special circumstances.

You’ll likely have a higher deductible and lower monthly payments with EPO plans compared to other types of health plans. EPO plans may be a good fit for someone who enjoys the freedom of choosing their providers without referrals, while being comfortable staying within the EPO network.

Shop our Off Exchange EPO plans. For a complete list of providers in our EPO network, visit SierraHealthandLife.com.