What Individual Nevada Health Insurance Covers

What Will My Individual Health Insurance Cover?

• It depends on what you buy. If you are HIPAA eligible, Nevada insurers are required to sell you two standardized policies. You may select from either a basic or standard health benefit plan. These are standardized plans with benefits identical to those under group health plans. Standardized plans help you compare the cost of policies. You may be offered other non-standardized policies as well, but you may be charged more for that coverage
• The basic policy covers hospital, skilled nursing, rehabilitation, hospice, emergency care, physician services, laboratory and X-ray services, and prescription drugs. These services are covered with a 50% coinsurance. The lifetime maximum benefit is $1 million. The basic policy does not cover mental health services, substance abuse services, and maternity care.
• The standard policy covers everything that the basic policy covers. Those services are covered with a 20% coinsurance. In addition, the standard policy covers maternity care and limited mental health services, substance abuse services. The lifetime maximum benefit is also $1 million.
• Check with the Nevada Division of Insurance for more information about mandated benefits. You can also visit the Division's website at http://doi.state.nv.us/ for the summary of benefits for individual basic and standard health benefit plans.