Health Insurance in Las Vegas, Nevada with NO Subsidy

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Individual / Family Health Insurance

with NO Government Subsidy

“Off Exchange”

You have been directed to this page because...

You make too much money to qualify for a subsidy

You make too much money to qualify for a health insurance subsidy

or

You do not want a subsidy

You do not want a health insurance subsidy

Call For FREE Help

(702) 898-0554

If you do not want a subsidy, or make too much money to qualify for a subsidy, you can shop for health insurance Off Exchange (in the private market).  In Nevada we have HMO, EPO and PPO health insurance plan options available to enroll into.  When you buy a health insurance plan in the private market, you don’t need to disclose your income or worry about updating your account throughout the year.  You set it and forget it.

10 Essential Health Care Benefits that cover Pre-existing Conditions

These plans are Qualified Health Plans that contain the 10 Essential Health Benefits) that cover pre-existing conditions, no matter what the condition is.

Health Insurance Enrollment is only available during Open Enrollment each year, unless you have a Qualifying Life Event.  Enrolling into a health plan is fast and easy when you call our licensed and experienced health insurance agents (or click the button to quote yourself).

OPEN ENROLLMENT IS SO IMPORTANT NOW!

Please think twice about going without Health Insurance this year. If you miss Open Enrollment, you will be missing your only opportunity to get an ACA Qualified Health Plan that covers pre-existing conditions, mental health, wellness/preventative, Rx, and all the other ACA benefits you find in a “Qualified Health Plan”. Unless you have PROOF of a Qualifying Life Event ie. Marriage, Divorce, Relocation, Birth, etc., or someone in your family gets a job that has benefits through an employer, etc.

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If You Missed Open Enrollment:  November 1st, 2020 through January 15th, 2021

1). and DO NOT have a Life Event (← hover mouse).  We have options for you.  Click here.

2). or you DO have a Life Event. You have a Special Enrollment Period (← hover mouse). We can help you get enrolled.

– What Documents Will Be Required to Prove Eligibility for a Special Enrollment Period (SEP)?

+ click here to open/close ACCEPTABLE DOCUMENTS TO PROVE ELIGIBILITY

Consumers who qualify for a special enrollment period (SEP) will receive a Marketplace Eligibility Determination Notice that includes a list of acceptable documents they may provide to prove their eligibility for the SEP. Examples of acceptable documents for each type of SEP that requires documentation are listed below.

SEP for Marriage: Document to Prove the Marriage

  • Marriage certificate showing the date of the marriage
  • Marriage license showing the date of the marriage
  • An official public record of the marriage, including a foreign record of marriage
  • Affidavit or statement signed by the person who officiated the marriage
  • Affidavit or statement signed by a person who was an official witness to the marriage
  • A religious document that recognizes the marriage

SEP for Birth: Document to Prove the Child’s Date of Birth

  • Medical record from a clinic, hospital, physician, midwife, institution, or other medical provider showing the date of birth
  • Letter from hospital, clinic, physician, or other medical provider attesting the date of birth
  • Letter or other document from the health insurance company, like an Explanation of Benefits, showing that services related to birth or post-birth care were provided to either the child or the mother, including the dates of service
  • Birth certificate or application for a birth certificate for the child
  • Application for a Social Security number for the child
  • A foreign birth record showing the child’s date and place of birth
  • Military record showing the child’s date and place of birth
  • Religious record showing the child’s date and place of birth
  • Social Security card for the child

SEP for Adoption, Placement for Adoption, Placement in Foster Care, or Child Support or Other Court Order: Document to Prove the Adoption, Placement for Adoption, Placement in Foster Care, or Child Support or Other Court Order

  • Adoption letter or record showing date of adoption dated and signed by a court official
  • Government-issued or legal document showing the date that the child was placed in the home
  • Government-issued or legal document showing the date legal guardianship was established
  • Court order showing the effective date of the order
  • U.S. Department of Homeland Security immigration document for foreign adoptions
  • Medical support order
  • Foster care papers dated and signed by a court official

SEP for Permanent Move: Document(s) to Prove BOTH Previous Address and New Address

  • Lease or rental agreement
  • Insurance documents, like homeowner’s, renter’s, or life insurance policy or statement
  • Mortgage deed, if it states that the owner uses the property as the primary residence
  • Mortgage or rental payment receipt
  • Mail from the Department of Motor Vehicles, like a driver’s license, vehicle registration, or change of address card
  • State ID
  • Official school documents, including school enrollment, ID cards, report cards, or housing documentation
  • Internet, cable, or other utility bill (including any public utility like a gas or water bill) or other confirmation of service (including a utility hook up or work order)
  • Telephone bill showing address (cell phone or wireless bills are acceptable)
  • Mail from a government agency to your address, like a Social Security statement, or a notice from TANF or SNAP agency
  • Mail from a financial institution, like a bank statement
  • U.S. Postal Service change of address confirmation letter
  • Pay stub showing address
  • Letter from a current or future employer showing relocation for work
  • Voter registration card showing name and address
  • Moving company contract or receipt showing address
  • If the consumer is living in the home of another person, like a family member, friend, or roommate, the consumer may send a letter/statement from that person stating that he or she lives with them and is not just temporarily visiting. This person must prove their own residency by including one of the documents listed above.
  • Document from the Department of Corrections, jail, or prison indicating recent release or parole, including an order of parole, order of release, or an address certification
  • If the consumer is homeless or in transitional housing, he or she may submit a letter or statement from another resident of the same state, stating that they know where the consumer lives and can verify that the consumer lives in the area and is not just temporarily visiting. This person must prove their own residency by including one of the documents listed above.
  • Letter from a local non-profit social services provider or government entity (including a shelter) that can verify that the consumer lives in the area and is not just visiting
  • Naturalization Papers signed and dated within the last 60 days or Green Card, Education Certificate, or VISA (if you moved to the U.S. from another country)
  • Letter of explanation providing the date of the move, the old and new address (or where the consumer is staying), and the reason the consumer cannot provide any other documents proving eligibility for an SEP. The Marketplace will take this letter into consideration.

SEP for Loss of Minimum Essential Coverage: Document(s) to Prove Loss or Planned Loss of Qualifying Health Coverage (Visit HealthCare.gov to learn more about qualifying coverage types)

  • Letter or other document from an employer stating that the employer dropped or will drop coverage or benefits for the employee or employee’s spouse or dependent family member, including the date coverage ended or will end
  • Letter or other document from an employer stating that the employer stopped or will stop contributing to the cost of coverage
  • Letter or other document from an employer stating that the employer changed or will change coverage or benefits for the employee, or for the employee’s spouse or dependent family member, so it is no longer considered qualifying health coverage
  • Letter showing an employer’s offer of Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage, or stating when the employee’s COBRA coverage ended or will end
  • Letter from health insurance company showing a coverage termination date, including a COBRA coverage termination date
  • Proof that the consumer had qualifying health coverage within the last 60 days, like a pay stub showing deductions for health insurance
  • Letter from school stating when student health coverage ended or will end
  • Letter or notice from Medicaid or the Children’s Health Insurance Program (CHIP) stating when Medicaid or CHIP coverage ended or will end
  • Letter or notice from a government program, like TRICARE, Peace Corps, AmeriCorps, or Medicare, stating when that coverage ended or will end
  • Dated copy of military discharge papers or Certificate of Release including the date that coverage ended or will end, if consumer is losing coverage because he or she is no longer active duty military
  • Divorce or annulment papers that include the date of ending responsibility for providing health coverage
  • Death certificate or public notice of death that includes proof of the date the consumer lost or will lose coverage due to the death of a spouse or other family member
  • Dated and signed copy of written verification from an agent or dated letter from the issuer, if consumer is or was enrolled in a non-calendar year plan that is ending
  • Copy of pay stubs of both current and previous hours if a reduction in work hours caused the consumer to lose coverage
  • Letter of explanation about the coverage the consumer had, why and when the consumer lost or will lose it, and the reason the consumer cannot provide any other

Buying Off Exchange simply means NOT enrolling on the Governments website.  Currently in Nevada, purchasing health insurance “Off Exchange” allows you to have more insurance plan choices from a larger group of Health Insurance companies.  In Nevada, we currently have Sierra Health and Life, Hometown Health, HPN (Health Plan of Nevada), and Anthem Blue Cross Blue Shield.

PPO Health Insurance Plans

The only PPO plan available (currently) “Off Exchange” is Hometown Health if you reside in Nye, Washoe, Clark, Lyon, Carson City, Douglas and Story counties.

You’ll have coverage all year long, provided you make your payments on time each month.  Open Enrollment is OPEN.  What this means is that you can make changes to your health insurance plan, health insurance company, change from Gold to Silver or Silver to Bronze, or any change you wish.  If you missed last year’s open enrollment, or you want off of Cobra coverage, and want to make a change, open enrollment is your one and possibly ONLY chance!  Remember starting 2020, in Nevada, you can only buy a health insurance plan during Open Enrollment unless you have a Life Event.

Health Insurance Agent in Las Vegas, Nevada

Serving Las Vegas, Henderson, North Las Vegas and the entire state of Nevada

Three Ways to Enroll

1).  Apply by Phone

(702) 898-0554

2).  Apply in Person

(by appointment ONLY)

Due to Covid-19, we’ll be conducting phone appointments

3).  Online Quote

an agent will call you

Authorized Agent for Health Plan of Nevada

HMO

Nye, Washoe, Clark

Authorized Agent for ambetter - Silver Summit Health Plan

HMO

All Nevada Counties

Authorized Agent for Hometown Health

HMO and PPO

Select Counties

Authorized Agent for Friday Health Plans

EPO

All Nevada Counties

Authorized Agent for Select Health

HMO

Nye and Clark

Authorized Agent for Sierra Health and Life

EPO

Clark County only

Health Plan of Nevada:
♦ HMO available in Clark, Washoe, and Nye
Ambetter:
♦ HMO available in ALL counties
Hometown Health:
♦ HMO available in Washoe, Carson City, Storey, Lyon and Douglas
♦ PPO available in Washoe, Clark, Carson City, Douglas, Lyon and Storey
Friday Health Plans:
♦ EPO available in ALL counties
Select Health:
♦  HMO available in Nye and Clark County (1 Bronze Plan available)
Sierra Health and Life
♦ EPO available in Clark county only
Open Enrollment Health Insurance calendar

Enrolling into a Health Insurance Plan

WITHOUT a Government “Subsidy”

You should enroll into Health Insurance during “Open Enrollment”
which is November 1st through December 15th

* You can ONLY enroll year round IF you have a Qualifying Life Event ie. Marriage, Divorce, Relocation, Birth, etc.

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Ready To Begin?

Call For FREE Help

(702) 898-0554

Start Here

Follow these steps

1). Choose how you want to apply for coverage (over the phone, online, or in person)

Over the phone:  simply call (702) 898-0554 and follow the prompts for Health Insurance 

In person:  Appointment required (due to Covid-19, we’ll be conducting phone appointments)

Online:  Click Here

2). If needed, familiarize yourself with some of the common terms used (see below)

What is an HMO?

A HMO is a Health Maintenance Organization which is a type of health insurance plan that has a group of local doctors and hospitals for you to choose from. You must choose a “Primary Care Doctor” (General practice, Internal Medicine, Family Practice, OB/GYN, Pediatrician) as your primary doctor to visit, and you must see your primary and get referrals to see specialists from your primary doctor to have any tests or procedures done. A HMO usually has lower monthly premiums than a PPO. A HMO may be right for you if you’re comfortable choosing a primary doctor, also called a PCP, to coordinate all of your health care.

What is a PPO?

A PPO, is a Preferred Provider Organization. It’s a type of health plan that offers a larger network (generally speaking), so you have access to more doctors and hospitals. Your out-of-pocket costs can be higher with a PPO than with an HMO or EPO plan. You will have network doctors and hospitals (depending on the network) which are contracted with the insurance company to accept lower payments. Or, you may see providers that are out of the network, but you’ll pay more for out of network providers. You can see providers in and out of a network if you choose.

What is an EPO?

An EPO, is an Exclusive Provider Organization, which is a type of health plan that offers a local network of doctors and hospitals for you to choose from. An EPO can be described as somewhat of combination of a PPO and HMO. You don’t have to select a primary care doctor, and you may see any of the providers in the EPO network, but there are no out of network benefits. If you choose to get care outside of your plan’s network, you will pay full price, there is no coverage, unless it’s an emergency. If you’re looking for lower monthly premiums, and are okay with using local doctors and hospitals, but don’t want to have to get referrals for specialists, you may want to consider an EPO plan.

PLATINUM | GOLD | SILVER | BRONZE

All individual and family health insurance plans will have these “Metallic” names.  It gives you an easy to understand overview of how the plans will share the payment of your medical bills.

♦ Platinum covers 90% of your medical bills, up until the “out of pocket maximum”.

♦ Gold covers 80% of your medical bills, up until the “out of pocket maximum”.

♦ Silver covers 70% of your medical bills, up until the “out of pocket maximum”.

♦ Bronze covers 60% of your medical bills, up until the “out of pocket maximum”.

This percentage will not go on forever, there is always an “Out of Pocket Maximum”, so you’ll only pay your portion of the expenses until you’ve paid your out of pocket maximum.

The Out of Pocket maximums for 2021 are:

Individuals: $8,550

Families: $17,100

You’ll want to review your “Summary of Benefits and Coverage” to find out what your deductible is, your co-insurance, your out of pocket maximum, along with all of the important details of what your plan covers.

Let’s Get You Covered!

We know this is confusing, but we’re here to help you and guide you.

Choose one of the options below

Enroll over the phone

(702) 898-0554

Enroll in person – appointment required

Online Quote

(an agent will call you)

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