Obamacare (ACA) in Nevada — health insurance in Las Vegas

The Affordable Care Act (ACA) created marketplaces where you can compare individual and family health insurance plans. Nevada has its own state-based marketplace, Nevada Health Link, and does not use HealthCare.gov. It is the only way in Nevada to receive the federal tax credits that lower your premium.

If you live in Las Vegas, Henderson or the metro area, your ZIP code, your age and your income determine which health plans are available to you and how much financial help you can receive. You can enroll with the help of a licensed agent, at no cost to you.

• Open enrollment, according to Nevada Health Link: from November 1, 2026 to January 15, 2027.
• If you enroll between November 1 and December 31, your coverage starts January 1, 2027.
• If you enroll between January 1 and 15, your coverage starts February 1, 2027.
• Outside those dates you can only enroll with a Special Enrollment Period: in most cases you have 60 days after losing your coverage (including through divorce), moving to Nevada or within the state if you already had coverage, getting married, or having or adopting a baby.

Note: the October 15 to December 7 period is for Medicare, not for the Marketplace. Source: Nevada Health Link Policy Manual (Sept. 2026).

• Nevada residents without affordable coverage through their job or a public program. In 2027, employer coverage is considered affordable if your share of the premium for the employee-only plan is no more than 10.22% of your household income; for your spouse and children it is measured using the cost of the family plan.
• Families looking for an individual or family plan on the Marketplace.
• By immigration status, starting January 1, 2027, the subsidy goes to citizens, lawful permanent residents, Cuban and Haitian entrants, and citizens of the COFA countries. Other lawfully present people (for example, refugees, asylees and certain parolees) can buy a plan, but without a subsidy.
• If your income is below 138% of the federal poverty level, most people qualify for Nevada Medicaid. Children may qualify for Nevada Check Up (the state's CHIP program).

In Nevada, Marketplace plans are organized mainly into three levels. As a reference, the plan pays on average about 60% of your medical costs with Bronze, 70% with Silver and 80% with Gold; you pay the rest through deductibles, copays and coinsurance. The higher the percentage the plan pays, the higher the monthly premium tends to be.

There are also catastrophic plans, if offered in your area, for people under 30 or for those with a hardship exemption: they have a low premium and a very high deductible, and they do not allow a subsidy.

Sara helps you balance the monthly premium, deductible and provider network based on your health and budget — without recommending a plan before understanding your situation.

Premium tax credits (the “subsidy”) lower what you pay each month. For 2027 coverage they are calculated using your household income and only apply between 100% and 400% of the federal poverty level. Using the figures the Marketplace uses for 2027, 400% equals about $63,840 a year for one person and $132,000 for a family of 4.

• Cost-sharing reductions: if your income is between 100% and 250% of the poverty level and you choose a Silver plan, you pay less in deductibles and copays.
• The subsidy is an advance on a tax credit: when you file, you use Form 1095-A, which Nevada Health Link sends you, to complete Form 8962. Starting with tax year 2026, the full excess is repaid, with no cap.
• Report any change in income or household to Nevada Health Link during the year: that way they adjust your subsidy and you avoid owing money when you file.

Sources: Nevada Health Link Manual and IRS — premium tax credit.

All Marketplace plans cover the 10 essential health benefits:

• Outpatient care (visits without a hospital stay).
• Emergency services.
• Hospitalization.
• Pregnancy, maternity and newborn care.
• Mental health and substance use disorder services.
• Prescription drugs.
• Rehabilitative and habilitative services and devices.
• Laboratory services.
• Preventive and wellness services and chronic disease management.
• Pediatric services, including dental and vision care for children.

And they cannot deny you coverage or charge you more because of a pre-existing condition. Source: HealthCare.gov.

During the consultation we review with you whether you could qualify for a subsidy or for Medicaid, compare the health plans available in your ZIP code and tell you which documents you need to enroll, at no cost to you.