Health insurance exchange will base rates on age, location

By Cy Ryan

Wednesday, Sept. 4, 2013 | 3:22 p.m.

The final rate formulas have been approved for those who will buy a health insurance plan from the state’s new Silver State Health Insurance Exchange starting Oct. 1.

According to Nevada Insurance Commissioner Scott Kipper, four companies are offering health coverage through the exchange, which was created under President Barack Obama’s new health care law.

Rates are based on age and location, with higher rates being charged in rural counties than in Clark County.

Nevadans with limited incomes will be eligible for subsidies under the new law, which requires all Americans to carry health insurance beginning Jan. 1.

Jon Hager, director of the insurance exchange, said he expects 118,000 residents to use the exchange to get the required insurance. One advantage of going through the exchange is that individuals will get the subsidy only through the exchange, officials said.

The insurance policies must include coverage for such things as ambulatory and emergency room care, hospitalization, maternity, mental health, substance abuse, prescription drugs, rehabilitation, lab services, preventive care and pediatric coverage.

There are four levels of plans. For instance, the so-called “bronze plan,” the least expensive plan, would pay 60 percent of the visit to a doctor. The most expensive plan, called the “platinum plan,” would cover 90 percent of the physician’s bill. The premiums paid would depend on the type of plan chosen.

Hager and Kipper could not give an average premium cost because there are too many variables, but consumers can get the network information through nevadahealthlink.com or doi.nv.gov/rates.

The four companies that have joined the exchange are Anthem, Health Plan of Nevada, Nevada Health Co-op and Saint Mary’s.

A list of doctors who will accept coverage from the firms will be published, but there is no estimate of the how many will be included.

For more information, consumers can call the exchange at 775-684-7020 or the insurance division in Las Vegas at 702-486-4009 or in Carson City at 775-687-0700.