Nevada Health Link Consumer Presentation


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  • The unexpected happens everyday, and if you don’t have health insurance, unexpected injury and illness can be catastrophic.[CHOOSE THE GROUP APPROPRIATE TO YOUR AUDIENCE][YOUNG FAMILIES]Take this couple for example, let’s call them Lucia and Carlos. Lucia is pregnant. They are excited for the new child but what should be a happy time in this family’s life turns into a time of worry and stress as she and Carlos wonders how they’re going to pay for her maternity care, hospital visits and the newborn’s doctors’ bills.[YOUNG MEN/INVINCIBLES]Take this young man for example, let’s call him Jose. He is 20-something years old, loves to play soccer and ride his motorcycle. He plays hard and is in excellent shape. But at his last soccer game he broke his ankle and was off work for several weeks. He realized that the unexpected can happen at anytime, to anyone, and it is important to be prepared.[SICK & WORRIED]Take this couple for example, let’s call them Gene and Barbara. Gene has a heart condition and they’re worried about how they’re going to continue to pay for his medication and medical bills on a fixed income. Gene hasn’t been able to get insurance in the past due to a pre-existing condition.
  • Health insurance helps pay for certain medical services so you don’t have to pay the entire bill. Having health insurance helps you avoid large medical bills and debt because in exchange for the amount of money you agree to pay the insurance company each month (your premium), the insurance company agrees to pay for part of your larger medical bills.
  • Health insurance protects you and your loved ones if you get sick or injured. Insurance helps to keep you and your family healthy. If you have insurance, you’ll be able to get preventive care (like regular check-ups and screenings) so you and your family will be sick less often. Preventative care also helps catch health issues or concerns before they develop into serious problems.It also protects you financially: it protects you from having to pay large medical bills that you could incur. Health insurance helps cover the cost of your medical bills, which is especially important if you have to miss work due to illness or injury. 
  • Insurance protects you and your family, and the U.S. government believes that all citizens should be protected. In 2010, the U.S. government passed the Affordable Care Act, a law that aims to cut the cost of health care and increase the number of people with insurance. This new law requires everyone to have health insurance by 2014. If you don’t have insurance by March 31, 2014, you will be fined by the IRS.
  • Nevada Health Link is here to protect you from the tax penalty, or fine, by helping you find a health insurance plan that fits your needs and your budget. With Nevada Health Link, you’ll be able to easily find an income-based plan that’s right for you.
  • In October 2013, Nevada Health Link will open its online marketplace, The online marketplace is like a mall, and all of the insurance providers are like stores in the mall. You can go to the mall for one-stop shopping. You can compare products at different stores and then decide which one is right for you. You can shop for, compare and buy your insurance all at
  • First, visit to fill out an application.Once your application is complete, will let you know if you qualify for financial assistance or subsidies. Once that is determined, will give you a list of different insurance plan options.You can compare these plans by price, coverage or provide network. All of the information about each plan will be available in clear, easy-to-understand language, so there’s no guesswork about what’s covered and how much it costs.
  • This is an example of what you’ll see after you fill out your application. You’ll be able to use this to compare the different plan options. You can narrow down your options by provider network (what doctors and hospitals are covered), insurance carrier or monthly costs. You can even calculate the yearly cost for you and your family based on how many doctors visits, prescriptions, etc. you think you’ll need for each person.
  •  As you search for and compare insurance plans, you can ask questions or find help through live online chat or by calling the call center at 855-7-NVLINK. There will also be trained Navigators, EnrollmentAssisters, and other in-person assistants to help you. They will be available to help youenroll and buy health insurance through the next few months, helpers, called Navigators, will be going out into communities around Nevada to educate people about Nevada Health Link and come October, to help them enroll. Beginning in October, Enrollment Assisters will work one-on-one with individuals and families, sitting with each enrollee and helping them enter information into the online marketplace. You will be able to easily find an Enrollment Assister or other in-person help in your area by searching on insurance agents can also help you find the plan that is right for you and your family.
  • Nevada Health Link is here to help any Nevada resident looking for health insurance, whether they already have it or not. If you already have insurance, through your employer for example, you aren’t required to enroll through Nevada Health Link but are welcome to explore new plans through Nevada Health Link if you want to. No one will be turned away for pre-existing conditions, like diabetes or cancer. The only requirement to apply for and purchase health insurance on is that you are legally present in the U.S. and a resident of the State of Nevada. Filling out an application on will not trigger an immigration investigation through INS.
  • There will be a variety of health insurance plans available at, and you will be able to compare plans by price, coverage and provider networks (for example, which doctors and hospitals are covered by the plan). All of the information about each plan will be available in clear, easy-to-understand language, so there’s no guesswork about what’s covered and how much it costs.
  • In order to make it even easier to find the plan that’s right for you, Nevada Health Link has standardized all insurance plans into four categories: bronze, silver, gold, and platinum. A plan’s monthly cost increases based on its metal tier. For example, if you purchased the bronze plan, you’d pay less each month for your premium, but more when you receive medical care. If you purchased the gold plan, which has a higher monthly premium, you’d pay less when you receive medical care.Catastrophic plans are reserved for those individuals under the age of 30.
  • Different plans work better for different people. If you have a chronic illness or have a lot of prescriptions drugs you fill regularly, you might choose to pay more each month for the gold or platinum plan, so you pay less for your care and prescriptions. If on the other hand, you are young and healthy, you might choose to pay less each month for the bronze plan and pay more when you do receive medical care.[CHOOSE SAME GROUP FROM BEGINNING OF YOUR PRESENTATION][YOUNG FAMILIES]Remember Lucia and Carlos? Knowing they want to grow their family, they might choose the Silver plan. And when Lucia gets pregnant, they’re going to be able to pay for her doctors’ visits and hospital stays without stress and without worry. And they’ll know that their children are covered for the future.[YOUNG MEN/INVINCIBLES]So, remember Jose? He’s young, healthy, and doesn’t really go to the doctor that often. He’ll probably choose the Bronze plan. He doesn’t pay much each month, so he has to pay a little more when he does get medical care. But, when he breaks his ankle, he knows he’s covered and won’t have to spend any more than his plans out of pocket maximum.[SICK & WORRIED]Remember Gene and Barbara? Gene goes to the doctor for his heart a lot, and they both have prescriptions they get filled every month. So they’re going to pay more each month for the Platinum plan, so they pay very little for all of their doctors visits and medications.
  • Under the Affordable Care Act, all qualified health insurance plans will have to cover certain Essential Health Benefits: Ambulance Services and CareEmergency ServicesHospitalizationMaternity and Newborn CareMental Health and Substance Abuse Disorder TreatmentPrescription DrugsRehabilitation and Habilitation Services and DevicesLab ServicesPreventive and Wellness Services and Chronic Disease SupportPediatric Services, Including Dental and Vision Care
  • How much you pay each month for health insurance will be based on your annual household income. This means that people who have not previously been able to afford health insurance because of cost will now be able to sign-up for high-quality health insurance plans.This sample chart shows different income levels relative to household size and the Federal Poverty Level. So, for example, if you’re a family of four in the 200% FPL group, you make around $47,100 a year.
  • If you’re that same family of four, making around $47,100 a year, you’ll be paying $247 a month for insurance for your entire family. People may be eligible for different subsidies and financial helpbased on their household income.  One of the subsidies available is called the Advanced Premium Tax Credit. Once you fill out your application on, we’ll tell you if you qualify for this credit. If you do qualify, this credit will reduce your costs right away. The money will go directly to your insurance company, so you will be paying less on your monthly bills right from the start.Remember, these credits and subsidies are only available through Nevada Health Link.
  • Some people may qualify for other government-sponsored insurance programs, like Medicaid. If you qualify for subsidies or public insurance programs (like Medicaid or Nevada Check Up), Nevada Health Link will alert you and help enroll you in those programs if you wish. If you qualify, you will not need to fill out another application.
  • Many of you have had had trouble shopping for or buying insurance in the past. Nevada Health Link is offering a new and different way of buying health insurance, and the ACA has changed the way health insurance is handled in the US.The plans offered at will be high quality and how much you pay for them will be based on your income. You can not be turned away if you have a pre-existing condition, like diabetes or cancer. And all plans will have to cover those Essential Health Benefits we went over, including prescription drugs, check-ups, maternity care and hospital visits.
  • is here now to provide education and information, but you won’t be able to use it to sign up for health insurance until October 2013. You will be able to enroll in health insurance coverage at from October 2013 through March 2014.  If you sign up for insurance by December 15, 2013 your insurance coverage will start January 1, 2014.Enrollment closes for individuals on March 31, 2014. If you don’t have health insurance, you need to choose and enroll in an insurance plan or obtain government funded health coverage before this date if you want to avoid the tax penalty.
  • Until October 2013, you can visit to find more information about what to expect when you do apply for and select health insurance. Then in October 2013, becomes the online marketplace where you can shop for and buy your new insurance plan. Help us spread the word about Nevada Health Link by telling your friends and family about the positive changes coming to health insurance in October.
  • Nevada Health Link Consumer Presentation

    1. 1. Nevada Health Link
    2. 2. Agenda 1. What Is Health Insurance? 2. Why You Need It 3. Nevada Health Link 4. Plans & Eligibility 5. What’s Covered 6. Costs 7. Important Dates
    3. 3. Life Without Insurance 3
    4. 4. What is Insurance and How Can it Help You?
    5. 5. What is Insurance? • Helps you pay for certain medical services • Covers medical bills, including preventive and emergency care • Allows you to get the care you need when you need it for you and your family • Helps you to avoid big medical bills and debt 5
    6. 6. Why Do I Need Insurance? Protect Yourself and Your Loved Ones 6
    7. 7. The Affordable Care Act (ACA) • A law passed by the U.S. government in 2010 • Aims to lower cost of health care • Requires all Americans to have health insurance by 2014 • Applies a tax penalty (a fine) for those without coverage 7
    8. 8. Nevada Health Link is Here to Protect You. 8
    9. 9. Nevada Health Link
    10. 10. • Online marketplace for health insurance • Shop for, compare and buy insurance in one place • A variety of certified plans from a number of insurance carriers will be available at the marketplace 10
    11. 11. How It Works 1. Fill out an application at 2. Find out if you qualify for financial help 3. See a list of different plan options from different insurance carriers 4. Compare your options 5. Choose the plan that’s right for you 11
    12. 12. Online Marketplace Sample View
    13. 13. What If I Have Questions? • Live online chat • Toll-free call center 855-7-NVLINK (855-786-5465) • Navigators and Enrollment Assisters • Have your current health insurance agent or broker to enroll you • Search for in-person help on 13
    14. 14. Who Can Use Nevada Health Link • Any Nevada resident looking for health insurance • Don’t need to switch if you already have insurance • Can’t be turned away for pre-existing conditions • Only requirement is that you are a Nevada resident and legally present • Your application won’t trigger INS investigation 14
    15. 15. Plans
    16. 16. Health Insurance Plans • Variety of plans for you to compare • Price of the plans will be based on your income • All information in clear language, so there’s no guesswork • All plans are certified by the State of Nevada 16
    17. 17. Plan Categories • With bronze plan, pay lower monthly premium and more when you receive care • With gold plan, pay higher monthly premium and less when you receive care 17 Tier Cost Platinum Most Expensive Gold More Expensive Silver Base Bronze Less Expensive Catastrophic Least Expensive
    18. 18. Plan Categories Different plans work better for different people. 18
    19. 19. What’s Covered 19 Essential Health Benefits Ambulance Services and Care Mental Health and Substance Abuse Disorder Treatment Preventive and Wellness Services Emergency Service Prescription Drugs Chronic Disease Support Hospitalization Rehabilitation and Habilitation Services and Devices Pediatric Services Including Dental and Vision Care Maternity and Newborn Care Lab Services
    20. 20. Cost
    21. 21. Income-Based Health Insurance Annual Income at 100% of the Federal Poverty Level and Other Levels (Calendar Year 2013) 21 Family Size 138% FPL 200% FPL 300% FPL 400% FPL 1 $15,856 $22,980 $34,470 $45,960 2 $21,404 $31,020 $46,530 $62,040 3 $26,951 $39,060 $58,590 $78,120 4 $32,499 $47,100 $70,650 $94,200 5 $38,047 $55,140 $82,710 $110,280 For each additional person add $5,548 $8,040 $12,060 $16,080
    22. 22. Help Covering Costs Monthly Premiums Under the Second Least Expensive Silver Level Plan (Calendar Year 2013) 22 Family Size 138% FPL 200% FPL 300% FPL 400% FPL Percent of Income 3.29% 6.3% 9.5% 9.5% 1 $43.53 $120.65 $272.89 $363.85 2 $58.76 $162.86 $368.36 $491.15 3 $73.98 $205.07 $463.84 $618.45 4 $89.21 $247.28 $559.31 $745.75 5 $104.44 $289.49 $654.79 $873.05 For each additional person add $15.23 $42.21 $95.48 $127.30
    23. 23. Same Application, Different Results 23 Ben applied and bought insurance from the Marketplace. Alice applied and got Medicaid coverage for herself and her daughter. James applied and bought insurance from the Marketplace and qualified for the new tax credit that lowers his monthly premium right away.
    24. 24. Change is Coming
    25. 25. Why Nevada Health Link? • Income-based plans • Can’t be turned away for pre-existing conditions • Essential health benefits 25
    26. 26. How You Can Start • Sign up on starting in October • Sign up by December 15to have coverage start January 1, 2014 • Sign up before open enrollment closes on March 31, 2014 26
    27. 27. October 2013 • Visit anytime to find more information about what to expect when you enroll beginning October 2013 • Spread the word about Nevada Health Link and all of its benefits to your friends and family 27