Medical Plans

Medical plans are not all the same. Which one is right for you?

Medical Plan Highlights

We offer three medical plans, one from Health Plan of Nevada (HPN) and two from Sierra Health & Life (SHL).

All plans offer excellent coverage but operate differently, so take some time to learn about the plans before enrolling.

A HMO plan gives you more predictable costs but less flexibility since all care must be received within the HPN network.

Here is a summary of the key plan features:

  • You must choose a primary care physician (PCP) from Health Plan of Nevada’s HMO provider directory to manage routine care, referrals, and hospital stays.
  • The plan offers in-network preventive care and virtual care through NowClinic® at no cost to you.
  • There is no deductible to meet before your plan shares in the cost of care.
  • You will pay predictable copays for most services and prescriptions.
  • Out-of-network care isn’t covered except in the case of an emergency.

This PPO plan has contracts with the SHL network of physicians and other medical professionals from which you can select your provider.

Here is a summary of the key plan features:

  • You do not need to select a primary care physician.

  • You do not need referrals from a physician to see other providers in the network.

  • The plan offers in-network preventive care and virtual care through NowClinic® at no cost to you.

  • If you receive in-network care, you will only pay for copays, deductible, and/or coinsurance.

  • if you receive out-of-network care, you will pay a higher amount. In some cases, you will need to pay directly and file a claim to receive reimbursement.

This is a High Deductible Health Plan (HDHP) with in- and out-of-network coverage. There is one notable difference between the HDHP and a traditional PPO plan: the deductible is higher and you must pay the deductible before the plan pays benefits for most services.

Here is a summary of the key plan features:

  • Your payroll contributions are lower compared to the PPO medical plan.

  • The plan offers in-network preventive care and virtual care through NowClinic® at no cost to you.

  • You will have access to a Health Savings Account (HSA) and the option to contribute pre-tax funds to lower your taxable income and save for future
    health expenses.

  • We contribute money to your HSA – up to$750 for individual coverage and up to $1,500 for teammate + dependent(s).The amount we contribute is pro-rated throughout the year based on your date of hire.

HPN Solutions HMO

Policy/group #: 50501002
Call: 
(702) 242-7300
Website: 
myhpnonline.com

SHL Solutions PPO
SHL Solutions HSA PPO

Policy/group #: 50501002
Call: 
(702) 242-7700
Website: 
myshlonline.com

Medical Plan Comparison

HPN Solutions HMO

SHL Solutions PPO

SHL Solutions HSA PPO

Coverage

In-network

In-network

In-network

HSA/HRA Funding

None

None

Yes; $750 for individual and
$1,500 for dependent coverage tiers to HSA

Annual Deductible

None

$1,500 individual*
$3,000 family*

$3,000 individual*
$6,000 family*

Annual Out-of-Pocket Maximum

$6,250 individual*
$12,500 family*

$5,000 individual*
$10,000 family*

$3,000 individual*
$6,000 family*

Outpatient Services

Preventive Care

No charge

No charge

No charge

Primary Care/Specialist Office Visits

Office Visit: $25 copay/visit
Specialist: $50 copay/visit

Office Visit: $25 copay/visit
Specialist: $40 copay/visit

$0 copay after deductible*

Virtual Visit

$0 copay/visit via NowClinic®

$0 copay/visit via NowClinic®

$0 copay/visit via NowClinic® after deductible

Urgent Care

$30 copay/visit

$25 copay/visit

$0 copay after deductible*

Emergency Room

$250 copay/visit + 20%*

$200 copay/visit + 20%*

$0 copay after deductible*

Diagnostic Lab and X-Ray

X-Ray $25 copay/service
Lab $15 copay/service

X-Ray $35 copay/service
Lab $15 copay/service
(deductible does not apply)

$0 copay after deductible is met

Outpatient Surgery

Hospital: $300 copay/surgery + $150 copay physician fee
Ambulatory Center: $150 copay/surgery + $75 copay physician fee

Physician/Facility: 20% after deductible*,**

$0 copay after deductible*,**

Inpatient Hospitalization

Physician: $150 copay/surgery; Facility: 20%*

Physician/Facility: 20% after deductible*,**

$0 copay after deductible*,**

Mental Health/Substance Abuse

Outpatient

$25 copay

$25 copay**

$0 copay after deductible*,**

Inpatient

20%*

$20 copay after deductible*,**

$0 copay after deductible*,**

* of EME (Eligible Medical Expense)
** 50% reduction if no prior authorization
Note: For out-of-network coverage details, email radiologypartners@alliant.com to request the plan SBC. See Prescription Drug coverage information.

Virtual care

NowClinic® offers access to virtual health care visits, which means you can sit back and talk to board-certified doctors anywhere you’re most comfortable. It’s perfect for those times when you’re too busy to get an appointment with your primary care doctor or they are simply too far away.

What Does it Cost?

Nothing! We offer virtual care through NowClinic at no cost to you so you can reach physicians and get personalized care 24/7.

How to Access?

To learn more and get started, go to NowClinic.com or download the NowClinic® app on the App Store or Google Play.

What Can Be Treated?

  • Fever

  • Migraine

  • Cold and flu

  • Headaches

  • Sinus problem

  • Sore throat

  • Stomach ache

  • Bladder infection

Behavioral health therapy is available by appointment only. Call Behavioral Healthcare Options at (702) 364-1484 or toll-free (800) 873-2246, TTY 711, to arrange a convenient time.

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