Learn about key insurance terms and find tools to help you compare costs.
Key Insurance Terms for Consumers to Know and Tools to Compare Costs of Health Insurance Policies
The insurance industry uses certain terms often misunderstood by consumers such as co-pays, deductibles or acronyms like QHP, PPO, HMO, and the list goes on. These terms are important for consumers to understand when shopping for a health insurance policy.
The Nevada Division of Insurance has developed and makes available on its website a Glossary of Health Insurance Terms. Below are a few of the most common insurance terms available on this glossary.
- Coinsurance: A percentage of a health care provider's contracted charge for which the patient is financially responsible under the terms of the policy.
- Co-payment: A dollar amount which a patient must pay when visiting a health care provider.
- Exchange: Exchanges were set up as part of the ACA to connect individuals and small businesses to a variety of insurance plans from different health insurance companies, as well as offering tools and resources to help you choose the plan that's right for you or your small business. The Nevada Exchange is the Nevada Health Link which is the only health insurance resource that can provide you with federal tax credits and subsidies to help cover the cost of your insurance. You can visit the Nevada Health Link at www.nevadahealthlink.com
- Advance Premium Tax Credit (APTC): The federal subsidy available to qualified purchasers of QHPs on the Exchange.
- Qualified Health Plan (QHP): A health insurance plan sold on the Health Insurance Exchange
- Essential Health Benefits (EHB): The list of benefits that must be covered in all individual and small group plans.
In addition to understanding key health insurance terms, consumers can compare the cost of insurance policies for individual and small group plans that can be purchased on and off the Exchange.
The approved health insurance rates for individual and small group markets can be viewed by consumers online at healthrates.doi.nv.gov or by downloading the Division’s smartphone app NDOI Connect in the Apple App Store and Google Play.
By utilizing the Rate Wizard, consumers can compare the health insurance plans available. These rates are displayed by age, county, and are for non-smokers. The search results are displayed and then sortable by plan name, carrier name, metal tier, and whether it is offered on or off the Exchange. This allows the search to be limited for quicker focused results.
Additional documents for each policy such as the Schedule of Benefits and the full coverage contract are also available for review.