When it comes to health insurance, 2018 is going to be a banner year for Nevada. For those people under 65, huge rate increases are in the works. After anthem tried to file a 63% increase, they decided to pull out of the individual marketplace completely. Prominence has also decided to discontinue its presence in the individual marketplace as well. A new company named Centene, got a Medicaid contract in Clark County starting July of 2017 and with that contract had strings attached asking them to fill Anthem's shoes in the marketplace. Great thing about Centene is they have a lot of experience with the individual markets and are quite happy to fill those shoes. Their plans will be called Silver Summit. From what I know now is their plans don't require referrals and the hospital network they have contracted is the UHS system (Valley hospitals). The individual plans will have a similar provider network to the medicaid plan already available.
If you purchase insurance direct from an insurance company without government help (or interference), we have a new PPO coming to southern Nevada, called Hometown Health. They will be providing 22 individual and also small group plans. They are base out of Reno and have been serving that area for some time. There plans will not have any provider networks outside of the state, but locally they have a fairly healthy list as they have been contracting doctors and hospitals for quite some time gearing up for this offering.
If you are a Medicare beneficiary living in Pahrump, Humana is going to be offering a couple PPO plans that they have offered in Clark County. This gives Pahrumpians a chance at something other than the 2 HMO options they currently have. Those in Clark county also get an alternative to CareMore, as Humana is competing with them, offering a plan that gives a $50 discount on Part B premiums. The difference is Humana's plan will be a PPO.
All other plans from last year seem to be staying in place with a few new tweaks for the year. Prepare to see slightly higher out of pocket maximums on your under 65 plans and slightly higher copays on your Medicare plans for both prescriptions and ER/Urgent care visits. You will also see some provider network adjustments to most of your plans as well.
If you live in southern Nevada, particularly Clark County, we will be getting a new PPO provider available to us. Out of state networks won't be available, but at least you won't need to get referrals. Northern Nevada insurance carrier, Hometown Health (who is owned by the Renown hospital system) is rolling out their plans to span most of the state. If you own a small business, this is even better news as their PPO plans will cover most of the entire state.
If you havent heard the news then here you go. Anthem and Prominence are pulling out of the health insurance exchanges in Nevada for 2017. Good news is we have a newcomer! Centene health is releasing the Silver Summit healthplan. I am super excited because they are a strong company and want to serve the community.
i reached out to them and they gladly accepted my request to be able to sell their products for next year and i am ready to sell.
Southern Nevada might also be getting a new insurer from up north for people who purchase their insurance outisde of the exchanges. Hometown health has been contracting with doctors across the state and trying to break i to this market. It is exciting to see what they will have to offer.
We've heard a lot in the news about Republicans trying to either repeal or replace the Affordable Care Act. It seems all efforts have been thwarted either by their own party or the fact they can't agree on a good alternative. A lot of people are afraid they will lose their insurance and the CBO has claimed that millions of people will lose their insurance for all of the Republican plans submitted thus far.
The facts that no one seems to mention are that Republicans lack the 60 votes in order to pass anything except budgetary measures, the CBO has been wrong quite often (it fell way short of its ACA calculations and tries to predict human behavior, good luck with that one), and all of the bills have called for insurance carriers to keep covering those who have kept continual coverage. Some of the biggest concerns insurance carriers have with the ACA are the fact that they can't control costs of the people who get insurance on their own and purchase through the exchanges and individual markets. These members tend to use much more healthcare and only tend to purchase when they require more care. Insurance needs premiums from healthy as well as unhealthy people to be able to pay for healthcare costs. If they cannot control those costs then they lose money, cut services and have to come up with ways to make up the losses. Some of the problems have been insurance carriers raise rates, which price the healthy people out of buying insurance and keeping even more bad risk to hang around.