Individual Coverage on Nevada Health Link

Is It Right for You?

With individual coverage, an individual or family pays a monthly premium and a private health insurance company agrees to pay some of the costs of approved medical services when needed, including preventive care, lab tests, surgery, or prescription drugs. If you have low to moderate income, the government may help you pay for your monthly premium and get a plan with lower copayments.

Answer the questions on this page to see if it might make sense for you to get individual health coverage. If it does, sign up using Nevada Health Link, the easiest place to comparison shop for an individual plan. Nevada Health Link is the only way to get help from the government to pay for your private insurance.

Do You Have Any Better Options?

If you can get Medicaid, Medicare, or employer-sponsored coverage, you don’t qualify for government help to pay for an individual plan. That means they are usually a better choice than getting an individual plan, because they cost less.

Can You Get Medicaid?

Medicaid is a government health program for people with low income. It’s a great program that usually has no monthly premium and copayments for services that are usually much lower than copayments required by individual plans. Also, Medicaid may cover some services that an individual plan doesn't cover.

If you can’t get Medicaid, individual coverage through Nevada Health Link might be a good option for you.

You may qualify for Medicaid if you are in one of these situations:

• Your family’s income is at or below 138% of the Federal Poverty Guidelines (FPG) ($1,835 per month or less for a person, $3,795 or less for a family of four). The income limits are higher if you are 18 or younger or are pregnant. There are no limits to how much money or other resources you have. Learn more about income-based Medicaid.
• You have a disability or are elderly:
  • Medicaid for people with disabilities and seniors may offer additional services, but has more eligibility requirements, such as having a disability (or being 65 or older), having low resources, and different income rules. In general, you must qualify for Supplemental Security Income (SSI) or SSI's 1619(b) status to get disability-based Medicaid, but some people get it without getting SSI or 1619(b). Learn more about disability-based Medicaid.
  • Health Insurance for Work Advancement (HIWA) lets people with disabilities who have more income or resources than the regular Medicaid limits keep their Medicaid coverage by paying a monthly premium. Learn more about HIWA.

Can You Get Medicare?

Medicare is a government health program for seniors (65 years old or older) and people with disabilities. To get Medicare coverage, you or a family member must have worked for a certain number of years and met other eligibility rules.

If you get Medicare, you cannot get government help to pay for an individual health plan. You can still buy an individual plan through Nevada Health Link, but you have to pay the entire premium yourself. Note: If you get Medicare and want more coverage than it offers, look into Medicare Advantage or Medicare supplement policies. Nevada Health Link does not offer these.

If you can’t get Medicare, individual coverage might be a good option for you.

Can You Get Employer-Sponsored Coverage?

Many employers offer private health coverage as a job benefit for employees, their children until they turn 26, and their spouses. If your employer offers you health coverage that would cost you less than 9.96% of your household’s income and that coverage meets a certain benefits level, you won't qualify for government help paying for an individual plan. If you can get employer-sponsored coverage, but sign up for an individual plan anyway, you will have to pay the full premium.

Note: Before 2023, the spouse or children of an employee would not qualify for subsidies on Nevada Health Link if the employer offered coverage that was affordable for the employee's policy alone, even if the cost to add the rest of the family wasn't affordable. This was called the "family glitch." Learn more about affordability rules for family members and how it affects eligibility for tax credits on Nevada Health Link.

If you can’t get employer-sponsored coverage, individual coverage might be a good option for you.

When an Individual Plan Is Your Best Option

You should get an individual plan through Nevada Health Link if you cannot get health coverage from:

• Your job
• Your spouse’s job
• Your parent’s job
• Medicaid, or
• Medicare.

If you cannot get health coverage from any of the above options and your family’s income is at or below 400% of the Federal Poverty Guidelines (FPG), which is $62,600 for an individual ($128,600 for a family of four), the government may help you pay your monthly premium via a tax credit. You may also qualify for a plan with lower expenses, such as smaller copayments, if your family’s income is at or below 250% of the Federal Poverty Guidelines (FPG) ($39,125 for an individual; $80,375 for a family of four).

Note: From 2021 through 2025, there was no income limit for getting subsidies that help pay individual coverage premiums. However, a 400% of FPG income limit is set to return for 2026. DB101 will be updated if there are any changes.

When Nevada Health Link looks at your income, they count most of your earned and unearned income. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect whether you get help paying for individual coverage.

Try Nevada Health Link's tools for estimating premiums.

Health Coverage Income Limits for Your Family

Your family size:	123456789101112
Income limits for your family:
	$15,960
	$5,680
	$15,650
	$5,500
	400
	205
Income-based Medicaid (138% FPG)
Nevada Check Up (NCU) (205% FPG)
Subsidized private plans, reduced fees (250% FPG)
Subsidized private plans (400% FPG)
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Notes: Some types of income do not count against these limits, including SSI benefits. Different programs sometimes use slightly different numbers for the Federal Poverty Guidelines (FPG). Disability-based Medicaid eligibility is not included here. For private plans with subsidies, your monthly premium amount depends on your income.

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How to Sign Up

Nevada Health Link is a one-stop shop where you can compare plans, figure out which is right for you, and enroll. Nevada Health Link is the only way to get government help to pay for your individual plan.

Start out by comparing your options using Nevada Health Link's tools for estimating premiums. This can help you make an informed decision when you are ready. If you find Nevada Health Link confusing or think there is a mistake, get help by calling Nevada Health Link at 1-800-547-2927 or 711 (TTY) or get free local help from enrollment professionals.

Open Enrollment

Open enrollment for individual plans has ended for this year. People in certain situations can still sign up for a health plan under special enrollment rules.

Usually, you can only sign up for an insurance plan through Nevada Health Link during a specific time called open enrollment:

• To get an individual plan that covers you during 2027, you must sign up between November 1, 2026 and January 15, 2027.
• If you do not sign up during that time, you are not usually allowed to sign up for an individual plan through Nevada Health Link until another year has passed.

Special Enrollment

You can sign up for an individual plan through Nevada Health Link even though it is not the usual open enrollment period if:

• You lose other health coverage you had
• Your income changes and you gain or lose eligibility for government help paying for your coverage
• You become a legal resident of the U.S.
• You move
• There was a mistake in your enrollment, or
• In other life-changing circumstances, such as having a child or getting married.

Note: American Indians do not have these restrictions on enrollment and can enroll any time of year.