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Rights & Laws


 

Health insurance laws in Nevada are similar to much of the country. In several aspects they are more lenient, having a tendency to favor the consumer, especially after the Affordable Care Act was introduced. There do remain unfavorable provisions, as insurers can hold onto certain freedoms, but not many since the ACA. Though rates vary from one health insurer to another, federal and state laws apply to each. When applying for coverage, it is important to know these laws in case you experience difficulty obtaining a plan or have a condition and are unsure what to expect. Being aware of your rights and freedoms as well as the insurers’ is key.

 

Guaranteed Renewability

Nevada health insurance regulations include numerous positives for the policyholder, protecting your rights to coverage and maintaining it. This includes the state-enacted Guaranteed Renewability Provision, which enables individuals to renew their coverage despite any health issues they may experience after you purchased your insurance. Continuing your coverage is an important priority, especially once diagnosed with a condition or illness. Changing plans once you have acquired a health problem will get increasingly difficult, therefore, guaranteed renewability keeps you covered through the same plan for years to come.

 

Guaranteed Issue

The largest portion of health insurance laws used to revolve around pre-existing conditions, but under the ACA, all individuals can receive coverage regardless of health, gender, age or occupation. No one can be turned down for coverage for any reason. Prior to the health law, Nevada residents were restricted by exclusion periods, elimination riders and full declines of coverage depending on the results of medical underwriting. This is no longer permitted by federal law, as all individual and group insurers must guarantee issue of coverage.

 

Community Rating

Another piece of ACA legislation regarding nondiscrimination, insurers cannot increase rates for reasons other than location, age and tobacco use. A case could be made that increasing rates for aging is discriminatory, but the ACA only could eliminate so many insurer freedoms before the companies themselves would be paying policyholders to stay insured. Nevertheless, community rating creates equality among groups that were previously rated up in underwriting, including women, people with conditions, and those with hazardous jobs or hobbies.

 

Conversion Policies

Another guaranteed right as a health insurance policyholder in Nevada is that of the conversion policy. This is relevant when you have coverage and the person under whom you are insured dies or loses their insurance. A conversion policy buys you a window of time to have a health insurance plan with limited premium costs and a fixed set of benefits. A person applying for a conversion policy will not be discriminated against for having a pre-existing condition, and can receive coverage as long as they apply within 31 days of the date their previous plan has ended.

 

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