Northern Nevada’s health insurance market is different than in many of its surrounding areas. Every individual, especially HR managers and small business owners, could benefit from learning more about the market before spending thousands on an insurance plan. While the system isn’t complex, it’s important to have a basic understanding of how it works. This article offers information about purchasing health insurance in northern Nevada, our local provider groups, and more.

Paperwork for health insurance in northern Nevada

Our Hospital Groups

Here in Reno, we have two major hospital groups: Renown and St. Mary’s / Northern Nevada Medical Center. For the past three years, Renown has expanded to become one of the largest groups in Nevada. The Renown group now has over 12 urgent care centers and two main hospital facilities. St. Mary’s is owned by Prime Healthcare, and Northern Nevada Medical Center is owned by Universal Health Services. St. Mary’s Health Network includes 10 major healthcare facilities throughout the Reno area.

Some insurance companies in Nevada work with both of these groups, while some work exclusively with one or the other.

Our Insurance Companies

This year, small businesses in Nevada can choose between seven insurance companies. Three of these options are national companies: Aetna, Anthem and United Healthcare. The remaining four are local companies: Health Plan of Nevada, Hometown Health, Prominence and Sierra Health and Life. When looking to purchase health insurance in northern Nevada, look at how providers connect with hospital groups to find the coverage that’s right for your business.

Consequences of Choosing a National Carrier

Looking at the way these groups connect can help you make an informed health insurance decision. For example, many of our national insurance carriers like Aetna, Anthem, and United work with both hospital groups. This convenience is perhaps one of the greatest advantages of choosing a national carrier.

However, there are major downsides to choosing national carriers. Since they serve so many people, they couldn’t care less whether you’re happy with their product. In fact, these companies have so many clients that they’ve lost thousands of clients a day without being affected. They also gain thousands of clients each day, so they have no commitment to any one single client. Additionally, because these companies need to cover doctors across the U.S., their rates tend to be higher.

Benefits of Local Health Insurance Companies

The biggest advantages of choosing a local health insurance company are low costs and better coverage. Our local insurance companies (Prominence, HPN, Hometown Health…) have the advantage of offering lower rates than other national carriers. Since they primarily cover individuals in Northern Nevada, they primarily cover the doctors here too.

Prominence is owned by the same company that owns Northern Nevada Medical Center (Universal Health Services) and Hometown Health is owned by Renown.

The biggest downside to choosing a local company is dealing with out-of-network costs. You can incur these costs by visiting a doctor outside the plan’s covered network of doctors. With local insurance companies, this is much more likely to happen. For example, if you were covered by Prominence and saw a Renown doctor or a doctor outside of Nevada in a non-emergency situation, you would incur out-of-network costs. Emergencies are an exception to the covered network terms.

Hard & Fast Rules for Health Insurance in Northern Nevada

For Businesses, Don’t Be Afraid to Go Local

If your business is located in Nevada and you don’t have employees traveling across the country, local insurance companies may be your best choice. Local carriers have lower prices, allowing you to “buy-up” or improve your employee benefits for the same cost as a more expensive plan from a national carrier. These carriers also have strong doctor lists in their local area.

If your employees live outside of Nevada or frequently travel, look for national carrier options. These national insurance companies could cost more, but they make a better impression when recruiting national talent. Since the doctors lists for these companies is larger, your employees will have the ability to live and work outside of the state with the same coverage.

For Individuals, Look Up Your Doctor First

Unfortunately, this year two out of three available companies use the same doctors list. As an individual purchasing health insurance in northern Nevada, check to see which company covers your current doctors. After that, you can choose the company that best fits you, your location, and your budget.

Ambetter is currently renting their doctors list from Hometown Health, meaning many of the same doctors are contracted with each company. Unless you qualify for a subsidy through Healthcare.gov, Hometown Health will be offering the least expensive plans this year.

Some plans are better than others depending on where you live. For residents of Las Vegas and southern Nevada, it will be Health Plan of Nevada. Here in the Reno/Carson City area, Hometown Health may be the best. In the rural counties of Nevada, residents should opt for Ambetter.

For more information about purchasing individual or small business health insurance in northern Nevada, contact us at 775-828-1216 or visit the Health Benefits Associates website.