Currently, Nevada will not allow a short term plan to cover individuals/families greater than 6 months.
♦ You can apply all year round with a next day effective date
These are REAL PPO (Nationwide Coverage) Health Insurance plan Options, HOWEVER, they do NOT cover:
Wellness/preventative, Pre-existing Conditions, Prescription Rx (like a Qualified Health Plan would). These plans do not meet Minimum Essential Coverage, or in other words, they are not “Qualified Health Plans“.
Short Term Medical plans are medically underwritten and do not cover pre-existing conditions and are not Minimum Essential Coverage under the Affordable Care Act.
♦ Outpatient Services
♦ ER / Urgent Care
♦ Diagnostic Testing
♦ Medical Supplies
♦ Home Health Care
♦ Durable Medical Equipment
♦ Rx may have a discount card (see SBC’s)
♦ Dental Injuries
♦ Cancer Treatment
♦ Transplant Benefits
You will go through an underwriting process, which means these health insurance plans will look at your “pre-existing conditions”, and height and weight on all family members. These plans work best for those individuals and families that don’t have pre-existing conditions such as: currently pregnant, blood disorders, liver, kidney or heart disorders, COPD, diabetes, cancer, MS, Crohn’s, ulcerative colitis, drug or alcohol abuse/treatment, others.
♦ If you feel like you are relatively healthy, the packages above could work very well for you.
♦ If you have pre-existing conditions that you need covered by insurance, we recommend you stay with a “Qualified Health Plan” (ACA / Obamacare) health insurance plan. CLICK HERE if you want a plan that covers pre-existing conditions. Then choose the “Subsidy“ or “No Subsidy“ buttons.
These plans requires underwriting. Underwriting means the insurance company will approve or deny your application for insurance if you have certain medical conditions. National General, however, does have a “Guaranteed Issue” plan where you will get approved, but they still won’t cover the pre-existing condition. There is a “Look back” period where the insurance companies will look back in your medical history for anything “pre-existing” and your pre-existing conditions will be excluded for the life of the policy. This includes medication. A pre-existing condition is any illness, injury, or condition for which medical advice, diagnosis, care or treatment was recommended or received by a covered person before the effective date, or “symptoms” that would cause an ordinarily prudent person to seek treatment. For example, if you have Asthma, you may get approved for the insurance, but Asthma visits to the doctor/hospital won’t be covered. Click Here If You Have Pre-Existing Conditions You Need Covered.
AGE: Can be on a family plan up to age 19, on their 19th birthday, they must get their own plan. Being a Student does not change this. Up to age 64 and 11 months.
CHILDREN: No child only plans. Must be with a parent or legal guardian
NETWORK: Nationwide PPO Coverage, however there may or may not be Out-of-Network Benefits. Check your plan if you have out of network coverage.
AMBULANCE: No Air Ambulance coverage, but ground ambulance yes. Out of Country – NONE.
PREVENTATIVE: Screening mamo’s are covered, NO coverage for pap smears, PSA testing is covered, HPV shots are covered, Contraceptive coverage, NO Child Immunizations, NO Physicals are covered.
RX: Depends on the plan chosen. There may be a preferred price card, a discounted Rx, card. The customer may need to pay for the Rx at the pharmacy at the lowest discounted price, then submit a “claim form”.
EXCLUSIONS: Each plan will have a list of medical situations that will not be covered. You’ll need to read the brochure to see what benefits may be excluded.