As Nevada Medicaid, the Silver State Health Insurance Exchange/Nevada Health Link, and the Division of Insurance (DOI) are preparing for the mass vaccination of Nevada residents for COVID-19, many people are asking “how will I get the vaccine?”
State agencies and medical providers will be updating communities statewide about how, where and when a COVID-19 vaccine will be available. Medicaid, the Health Exchange, and DOI have provided the information below on how each type of patient will be covered if getting the vaccine.
Privately Insured: Earlier this year, the DOI passed both an emergency and permanent regulations to ensure there would be no out-of-pocket costs to Nevadans’ covered by health insurance for COVID-19 testing and vaccinations.
This means consumers who have coverage with individual health plans, small group plans, large group plans, and catastrophic plans will be covered to receive the COVID-19 vaccine without any co-payment, co-insurance, or other form of cost-sharing, including the cost of administering the vaccine. Nevadans who are insured by entities not regulated by DOI may still be covered to receive the vaccine by federal law.
Consumers who are unsure what type of health plan they have are encouraged to contact their employer or health insurance company first. For other questions regarding health insurance coverage, contact DOI’s Consumer Services via email at cscc@doi.nv.gov or call 888-872-3234.
Insured through Nevada Health Link: The vaccine is free for the Nevadans insured through Nevada Health Link plans. Nevada Health Link is the only place Nevadans can qualify for subsidies to help offset the costs of monthly premiums, and four out of five Nevadans who purchase a plan on Nevada Health Link qualify for financial assistance (tax credits). All plans offered through the Exchange cover the 10 “essential health benefits,” including pre-existing conditions and all COVID-19-related diagnosis and treatment. Consumers must enroll in a plan by Dec. 31, 2020, to have health coverage effective on Jan. 1, 2021. Anyone who enrolls between Jan. 1 and Jan. 15 will have coverage effective on Feb. 1, 2021. For more information go to NevadaHealthLink.com or call 800-547-2927.
Medicaid recipients: Nevada Medicaid covers all vaccines that are recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) as a preventative services benefit; this includes the COVID-19 vaccine. All Nevada Medicaid recipients will have COVID-19 vaccine coverage. The vaccine will be provided at no cost to recipients who are eligible or enrolled in Fee-for-Service or Managed Care. Nevada Medicaid also covers COVID-19 testing and medically necessary treatment. To apply for Nevada Medicaid, go to https://accessnevada.dwss.nv.gov/.
Uninsured patients: Nevadans who do not have health insurance can go to https://www.nevadahealthlink.com/ to see if they qualify and find free local assistance from a certified broker or navigator. Nevada Health Link applications include review for coverage by Medicaid and many other providers. The uninsured may also seek the assistance of a Federally Qualified Health Center: http://dhcfp.nv.gov/Pgms/CPT/FederallyQualifiedHealthCenters/FQHC/.
According to Nevada Regulation 054-20, all health insurers are prohibited from imposing cost-sharing or medical management techniques to restrict access to COVID-19 screening, testing, or vaccines. People who are insured and are charged for COVID-related services should report the case to the Nevada Insurance Commissioner and the case may be referred for investigation. Patients can file a complaint at https://doi.nv.gov/Consumers/File-A-Complaint/.
More information on Nevada’s COVID-19 response can be found at NVHealthResponse.nv.gov.
