Medicaid and the End of the Federal Continuous Coverage Requirement
For the first time since the COVID-19 pandemic began, Nevada will resume its normal processes to redetermine eligibility for Mediciad enrollees. Many Nevadans will have to transition to other types of coverage or take action to keep their Medicaid benefits. Learn more…
Nevada Health Link uses an Account Transfer process. This means that once you fill out an application using NevadaHealthLink.com, you’ll find out if you’re eligible for Nevada Health Link or Medicaid. If you are eligible for Medicaid, we will send them your application.
Attention Medicaid Enrollees
Don’t risk a gap in your Medicaid or CHIP coverage, get ready to renew now.
Please update your contact information. It is important to keep your contact information with Division of Welfare and Supportive Services (DWSS) as current as possible to receive all communications regarding your eligibility. Your contact information should include your residence and mailing addresses, your phone number or message number, and your email address. Use this form to update you contact information: https://dhcfp.nv.gov/UpdateMyAddress/ or call 800-992-0900 to update your contact information.
Following these steps will help determine if you still qualify:
- Make sure your contact information is up to date.
- Check your mail for a letter.
- Complete your Redetermination Packet (if you get one) and send it back to Medicaid.
What is Medicaid?
Medicaid is an optional medical coverage program that states elect to provide to their residents. Depending on your income and family size, you or your family members may qualify for government-supplied healthcare, such as Medicaid. If you do qualify for Medicaid, there is no limited-enrollment period, meaning you can enroll at any time.
In Nevada, households with annual incomes of up to 138% of the federal poverty level may qualify for Medicaid. This is $16,753 per year for an individual, or $34,638 per year for a family of four.
Medicaid Assessment Federal Poverty Level (FPL) Chart
For more information on Medicaid in Nevada and to see if you’re eligible, visit Access Nevada. Access Nevada is the one stop portal for residents of the State of Nevada to apply for Medicaid, report changes in household circ*mstances, check the status of their case, receive online communications, and other account management tools.
What is Nevada Check Up?
Nevada Check Up is the State of Nevada’s Children’s Health Insurance Program (CHIP). Depending on your income, your children (birth through 18 years of age) may qualify for coverage through Nevada Check Up. If you qualify, you will be required to pay a quarterly premium based upon your family size and income, but won’t be responsible for things like co-payments and deductibles.
In Nevada, children living in households with an annual income of up to 200% of the federal poverty level may qualify for coverage through Nevada Check Up. This is $50,200 for a family of four.
Recently lost Medicaid in Nevada, now what?
You may qualify for a Special Enrollment Period to get enrolled in a Qualified Health Plan through Nevada Health Link!
If you had Medicaid coverage and lost it, or will lose it soon, you should contact Nevada Health Link or an Certified Enrollment Counselor or Broker/Agent in Nevada and see if you’re eligible to enroll in coverage through a special enrollment period. If you know you will lose coverage, you can enroll in a qualified health plan up to 60 days prior to your loss of coverage, with a coverage start date based on your loss of coverage. This will allow you to avoid a gap in coverage dates.
Following these steps will help determine if you still qualify:
- Make sure your contact information is up to date.
- Check your mail for a letter.
- Complete your Redetermination Packet (if you get one) and send it back to Medicaid.
How to Enroll
Are you in need of assistance with Long-Term Services and Supports?
Long-Term Services and Supports include services that:
- support individuals who need ongoing care due to age, physical or intellectual disability or chronic illness; and
- assist an individual or their caregiver, to live as independently as possible in their homes and communities.
Examples include: meals, transportation, chore services, personal care, counseling, respite for caretakers, adult day health care, benefits counseling, home modifications, assistive technology, etc.
If you would like more information, please visit https://dhcfp.nv.gov/Pgms/LTSS/LTSSHome/.
FAQs
Why were you denied Medicaid coverage or Minimum Essential Coverage (MEC)?
Medicaid eligibility depends on many various specifications. Below are some reason why you could be dropped from Medicaid coverage:
- Your income changed and you now make too much to remain on Medicaid
- You lost your minimum essential coverage (MEC)
- You are not pregnant or no longer pregnant
- You are not under a specific age – you aged out of Medicaid coverage
- You acquire, win, or are given assets that modify your financial status
- You fail to report a family change like getting married or adopting/having a child
What if you were denied Medicaid, but never had coverage?
If you were denied Medicaid/Nevada Check-Up outside of Open Enrollment after you applied during OEP, Nevada Health Link will permit a SEP due to Medicaid/NV Check-Up assessment application submitted during OEP and denial after OEP has ended. Consumers need to:
- Pick a plan within 60 days of denial
- Documents indicating the denial must be submitted within 30 days of choosing a plan
- Coverage starts when your premium is paid the first day of month after you pick a plan
- Need a different start date or need technical assistance? Contact us by calling 1-800-547-2927
- Learn more about SEPs and how to submit documents and what are the correct documents to submit.
However…
A Medicaid denial alone, without a loss of coverage, does not generally allow for a Special Enrollment Period for mid-year enrollment.
What if you enroll in a Qualified Health Plan and then gain Medicaid eligibility after Open Enrollment?
Federal law will not allow anyone to receive tax credits and subsidies through the Exchange while they are eligible for Medicaid coverage that counts as Minimum Essential Coverage. As soon as you or anyone in your household gains coverage, they should dis-enroll from their Nevada Health Link plan if it is subsidized.
Important: If you are enrolled in coverage through Nevada Health Link, it’s important that you notify us as soon as you learn you are newly eligible for Medicaid. You may end up having to pay full price coverage while receiving Medicaid benefits. In addition, you may be required to pay back the subsidies you received while duly enrolled.
If your Medicaid program counts as minimum essential coverage:You arenoteligible for a premium tax credit or other savings to enroll in a Nevada Health Link insurance plan. You shouldimmediatelyend Nevada Health Link insurance for anyone in your household who is enrolled in these Medicaid programs and is also using premium tax credits with a Nevada Health Link plan.
If your Medicaid program DOESN’T count as minimum essential coverage:Youareeligible for premium tax credits and other savings on a Nevada Health Link insurance plan, if you qualify based on your income and other criteria.
Contact information
Customer Assistance Service line: 1-800-547-2927 (TTY 711)
Hours: Monday through Friday 9:00 AM to 5:00 PM PST
Email: CustomerServiceNVHL@exchange.nv.gov
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