Paul Sanchez
Nevada has a variety of health insurance options for its residents, including Medicaid, private insurance, and Medicare. The state's Medicaid program offers coverage for low-income residents, with eligibility based on income and asset limits, while private insurance plans are available through the state-run Marketplace, Nevada Health Link. Additionally, Medicare is a federal program for those aged 65 and older, and Nevada has a children's health insurance program called Nevada Check Up for those who do not qualify for Medicaid. Nevada no longer has a penalty for residents without health insurance, and the state offers various plans to cater to different needs, such as bronze, expanded bronze, silver, and gold plans, as well as catastrophic coverage.
| Characteristics | Values |
|---|---|
| Penalty for not having health insurance | There is no longer a penalty for being without health insurance in Nevada. The fee for not having health insurance ended in 2019. |
| Health insurance plans | Bronze, expanded bronze, silver, and gold plans are offered by Nevada insurance carriers. Companies also offer catastrophic health insurance plans. |
| Enrollment period | The 2022 enrollment period began on November 1, 2021, and ended on January 15, 2023. |
| Medicaid eligibility | Medicaid provides free or low-cost medical benefits to low-income residents. |
| Children's Health Insurance Program (CHIP) | CHIP covers medical and dental care for uninsured children and teens up to age 19. |
| Nevada Check Up | A program for children who don't qualify for Medicaid but whose household incomes are at or below 200% of the Federal Poverty Level (FPL). |
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What You'll Learn
No penalty for being uninsured
In Nevada, there is no longer a penalty for being without health insurance. The fee for not having health insurance ended in 2019, meaning that residents no longer pay a tax penalty for not having health coverage. This change means that if you don't have health coverage, you don't need an exemption to avoid paying a tax penalty.
Prior to this change, Nevada had the second-highest uninsured rate (21%) in the country when Obamacare was implemented in 2013. More than half a million residents out of a population of nearly 2.8 million were uninsured at this time. The uninsured rate dropped to 15% in 2014, the same year that Nevada adopted Medicaid expansion. This expansion allowed the state to use federal funding to expand Medicaid to low-income adults without children. Since the expansion, over 747,000 childless adults in Nevada gained coverage.
As of 2019, Nevada still had nearly 350,000 (11.5% of the population) residents without health insurance. However, this number represents an improvement from 2013. Nevada's Medicaid program helps pay for some to all medical expenses for certain low-income residents. As of October 2019, more than half a million low-income adults and children were enrolled. About two in seven Nevadans earn less than 200% of the FPL (up to $25,760 for a single person in 2021).
Nevada's Medicaid office also runs a children's health insurance program called Nevada Check Up. It covers kids from birth to 18 in households that earn up to 200% of the FPL ($26,500 to $53,000 for a family of four in 2021). Participants in the Nevada Check Up program are charged a quarterly premium based on income. Enrollment is available year-round.
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Medicaid's asset limit exemptions
In Nevada, there are several exemptions to Medicaid's asset limit. Generally, one's home is exempt from the asset limit, although it is not exempt from Medicaid's Estate Recovery Program (MERP). This means that after a long-term care Medicaid beneficiary's death, Nevada's Medicaid agency may attempt to reimburse the cost of care through the estate of the deceased, which is often their home.
Other exemptions include personal belongings, such as clothing, household furnishings, an automobile, and irrevocable burial trusts. For couples, there is a Community Spouse Resource Allowance (CSRA) that protects a larger amount of a couple's countable assets for the non-applicant spouse of a Nursing Home Medicaid or Medicaid Waiver applicant. In 2025, the CSRA allows the non-applicant spouse to keep up to $157,920 of the couple's assets. Additionally, there is a Monthly Maintenance Needs Allowance (MMNA) for non-applicant spouses, which is the minimum amount of monthly income required to avoid spousal impoverishment. In 2025, the MMNA in Nevada is $3,948. If a non-applicant spouse's monthly income is below this amount, income can be transferred from their applicant spouse to reach the $3,948 monthly threshold.
It is important to note that Nevada has a 60-month Medicaid Look-Back Period for Nursing Home Medicaid or Medicaid Waiver applications. During this period, Medicaid ensures that no assets were gifted or sold under fair market value, including asset transfers made by a spouse. This rule discourages applicants from gifting assets to meet the asset limit, and those who violate it are penalized with a period of Medicaid ineligibility.
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Medicaid's Look-Back Rule
In the United States, the Medicaid Look-Back Rule is a period during which a person's financial records are reviewed to determine their eligibility for Medicaid. The review includes all asset transfers within the specified period, including those made by the applicant's spouse. The Look-Back Rule aims to prevent individuals from gifting or transferring assets to meet Medicaid's asset limit. The rule applies to individuals applying for long-term care services, such as nursing home care, assisted living, and in-home care.
The Look-Back Rule is typically a 60-month (5-year) period that immediately precedes an individual's Medicaid application date. During this time, state officials review financial documents provided by the applicant, including bank accounts, IRAs, Social Security benefits, pensions, homes, vehicles, and other assets or income. Any transfers made within the Look-Back Period are scrutinized, and if violations are found, a Penalty Period of Medicaid ineligibility is established. This means that the applicant will have to wait for a certain period before becoming eligible for Medicaid coverage. The length of the Penalty Period is calculated by dividing the monetary value of the transfer by the average monthly cost of nursing home care in the applicant's state.
It is important to note that the Look-Back Rule does not apply to all Medicaid programs. For example, it does not apply to the Regular Medicaid program, also known as Aged, Blind, and Disabled Medicaid. Additionally, each state may have different rules and exceptions for their Look-Back Period. For instance, California has a more lenient Look-Back Period of 30 months for Nursing Home Medicaid, while New York has a 60-month Look-Back Period for the same program but no Look-Back Period for Community Medicaid.
To avoid violating the Look-Back Rule, individuals can consult with a Certified Medicaid Planner or an elder law attorney specializing in Medicaid planning. These professionals can guide applicants through the complex rules and regulations, helping them structure their assets and income to qualify for Medicaid without violating the Look-Back Period. Additionally, certain asset transfers are exempt from penalties, such as transfers made for the benefit of a spouse or a child with a permanent disability. Proper planning and knowledge of the rules can help individuals avoid penalties and ensure their eligibility for Medicaid benefits.
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Premium tax credits
In Nevada, there is no longer a penalty for being without health insurance. The tax penalty for not having health coverage was removed in 2019.
The premium tax credit (PTC) is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace. To receive this credit, certain requirements must be met and a tax return with Form 8962, Premium Tax Credit (PTC), must be filed.
For the tax years 2021 and 2022, the American Rescue Plan Act of 2021 (ARPA) temporarily expanded eligibility for the premium tax credit by eliminating the rule that a taxpayer with a household income above 400% of the federal poverty line cannot qualify for a premium tax credit.
The premium tax credit can be claimed by individuals who meet the following requirements:
- Have health insurance coverage through a Health Insurance Marketplace and have paid the share of the premium not covered by advance credit payments by the due date of the tax return.
- Are unable to obtain affordable coverage through an eligible employer-sponsored plan that provides minimum value.
- Are not eligible for coverage through a government program, such as Medicaid, Medicare, CHIP, or TRICARE.
It is important to note that certain victims of domestic abuse and spousal abandonment can claim the credit using "Married Filing Separately". Additionally, advance credit payments can be made to lower the out-of-pocket cost for health insurance premiums. These advance payments may affect the amount of the premium tax credit and, consequently, the tax refund. Therefore, it is crucial to promptly report any changes in household income or family size to the Marketplace.
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Medicaid eligibility
In Nevada, there is no longer a penalty for being without health insurance. The tax fee for not having health coverage ended in 2019, so you don't need an exemption to avoid paying this penalty.
Medicaid is a health care program for low-income individuals of all ages. There are varying coverage groups, but the focus here is on long-term care Medicaid eligibility for elderly Nevada residents (aged 65 and older).
To qualify for long-term care Medicaid in Nevada, applicants must meet the following requirements:
- Residency and Citizenship: Applicants must be Nevada residents and either U.S. citizens or lawful permanent residents with the proper immigration status.
- Age/Disability: Applicants must be 65 years or older, blind, or disabled. They must meet medical requirements consistent with the level of care requested and require care for 30 consecutive days.
- Income Limit: For single applicants, the income limit is $3,021/month. Applicants with excess income may establish a Qualified Income Trust (QIT) to qualify. Nevada is an income-cap state, meaning there is a hard income limit for Medicaid long-term care eligibility.
- Assets: Applicants must also meet Medicaid's asset limits. Nearly all income that a Medicaid applicant receives is counted towards eligibility. This includes employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Exemptions include personal belongings (e.g. clothing), household furnishings, an automobile, irrevocable burial trusts, and generally one's primary home.
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Frequently asked questions
No, there is no longer a penalty for being without health insurance in Nevada. The tax penalty for not having health coverage ended in 2019.
Yes, Nevada operates a state-run marketplace called Nevada Health Link, which offers individual health plans for purchase.
Medicaid provides free or low-cost medical benefits to low-income residents. In 2021, about two in seven Nevadans earned less than 200% of the FPL (up to $25,760 for a single person).
Yes, Nevada's Medicaid office runs a program called Nevada Check Up, which covers children from birth to 18 in households that earn up to 200% of the FPL. The Children's Health Insurance Program (CHIP) is another option for children up to age 19.
Nevada insurance carriers offer catastrophic health insurance plans for adults under 30 with fewer healthcare needs. Additionally, Medicaid and Nevada Check Up provide coverage for low-income residents who meet the income requirements.
