State of Nevada
Nevada Check Up State of Nevada

DHCFP INDEX

FREQUENTLY ASKED QUESTIONS
  1. What is Nevada Check Up?
  2. How do I qualify?
  3. How do I apply?
  4. What is the difference between Nevada Check Up and Medicaid?
  5. After I send in my application, how long until I get a response from Nevada Check Up?
  6. How much does it cost?
  7. How does Nevada Check Up work?
  8. What health care services are provided?
  9. Does Nevada Check Up cover children if they travel outside the state?
  10. Can parents be covered or is the program just for children?

What is Nevada Check Up?

Nevada Check Up is the State of Nevada’s Children’s Health Insurance Program. It provides low-cost, comprehensive health care coverage to low income, uninsured children 0 through 18 years of age who are not covered by private insurance or Medicaid.

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How do I qualify?

A child may qualify for Nevada Check Up if:

The child may not be covered by or appear eligible for Medicaid; The child is a U.S. citizen or "qualified alien." Legal residents need to have 5 years residency(applying for Nevada Check Up will not affect a family's immigration status);  The child is under age 19 at the date the coverage will begin; and

The family’s gross annual income is between 100% and 200% of the Federal Poverty Level guidelines.

2013 Poverty Guidelines for web site

Family Size

100%

200%

1

$11,490

$22,980

2

$15,510 $31,020

3

$19,530

$39,060

4

$23,550 $47,100

5

$27,570 $55,140

6

$31,590 $63,180

7

$35,610 $71,220

8

$39,630 $79,260

9

$43,650 $87,300

10

$47,670 $95,340

 

At 100%, add $4,020 for each additional family member.

At 200%, add $8,040 for each additional family member.

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How do I apply?

The process is easy. The head-of-household completes the on-line application.

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What is the difference between Nevada Check Up and Medicaid?

Nevada Check Up provides coverage for families who have a higher income than those who are eligible for Medicaid. Nevada Check Up also charges premiums, and Medicaid does not. With a few exceptions, both programs offer the same health services coverage. Federal law prohibits Nevada Check Up from providing coverage to children who are eligible for Medicaid. However, the goal of Nevada Check Up and Medicaid is to make sure all eligible children are insured.

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After I send in my application, how long until I get a response from Nevada Check Up?

Your Nevada Check Up application is processed within 45 days of the day we receive it, if it is complete.

  1. Fill in all required fields on the application.
  2. Be sure to sign the application.

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How much does it cost?

The only cost to the Nevada Check Up participant is a quarterly premium. We do not require our participants to pay co-payments, deductibles, or other charges for covered services. Premiums are determined by family size and income. They are charged per family, not per child. For instance, if your family is at the $25 premium level, you will only pay $25 for all your children to be covered per quarter.

For Native American Families who are members of federally recognized tribes, or an Eskimo, Aleut or other Alaska Native enrolled by the Secretary of the Interior, quarterly premiums are waived. To have the premium waived these families need to mark “Native American” and write down their child’s tribal affiliation in the optional ethnicity section on the application and provide verification of affiliation.

Family
of 2

Quarterly Premiums

Total Annual Premiums

Family
of 3

Quarterly Premiums

Total Annual Premiums

Up to $23,265

$25

$100

Up to $29,295

$25

$100

$23,266 -$27,142

$50

$200

$29,296 - $34,177

$50

$200

$27,143 - $31,020

$80

$320

$34,178 - $39,060

$80

$320

 

Family
of 4

Quarterly Premiums

Total Annual Premiums

Family
of 5

Quarterly Premiums

Total Annual Premiums

Up to $35,325

$25

$100

Up to $41,355

$25

$100

$35,326 - $41,212

$50

$200

$41,356 - $48,247

$50

$200

$41,213 – $47,100

$80

$320

$48,248 - $55,140

$80

$320

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How does Nevada Check up work?

If you live in Clark County or Washoe City, you will receive health services through a Managed Care Organization(MCO). You may choose from Health Plan of Nevada or Amerigroup. If you do not choose an MCO, we will assign you to one. The MCOs have a network of providers who accept Nevada Check Up patients. You may take your child to any provider in your MCO's network who is accepting Nevada Check Up patients. Children in the rural areas receive care through any Nevada Medicaid provider that accepts Nevada Check Up.

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What health care services are provided?

Nevada Check Up covers medical, dental, and medical vision services. Some of these include:

Physician
Chiropractor
Dental
Vision
Medical Equipment
Hospital Inpatient and Outpatient hospital
Laboratory and X-Ray
Prescription Drugs
Ambulance
Non-Emergency Transportation
Mental Health
Home Health
Well-Child, Well-Baby Visits
Immunizations

For information on how often your child should see his/her doctor and what medical care/immunizations your child should have, click here to go to this web site: http://health.nv.gov/

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Does Nevada Check Up cover children if they travel outside the state?

Nevada Check Up can pay for medical care received outside the state only if it is an emergency and the provider agrees to accept payment at Nevada Check Up rates.

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Can parents be covered or is the program just for children?

Nevada Check Up only provides services to children from birth to 18 years, 11 months.

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