nevada-silver-life-and-health---gina-espinal

Why It’s Important to Update Your Income and Household Information on an ACA Plan

Wed, 27 May 2026 06:00:17 GMT

How life changes can impact your ACA coverage, costs, and eligibility

When you enroll in an ACA (Affordable Care Act) health plan, the information you provide plays a key role in determining your eligibility and costs. This is especially true for your income and household size. But, your situation doesn’t always stay the same throughout the year.

If your income or household changes, it’s important to update your Marketplace application as soon as possible. Here’s why it matters, whether you receive financial assistance or not.

If You Receive Subsidies (Premium Tax Credits)

If you’re getting a subsidy to lower your monthly premium, keeping your information up to date is critical.

Avoid owing money at tax time
Subsidies are based on your estimated annual income. If your income increases and you don’t report it, you may receive more financial help than you qualify for, and you will have to pay some of it back when you file your taxes.

Make sure you’re getting the right amount of help
If your income decreases, you could qualify for a larger subsidy, which lowers your monthly premium. Updating your income ensures you’re not overpaying.

Maintain correct eligibility
Changes in household size, like marriage, divorce, or having a child, can affect how much assistance you qualify for and what plans are available to you. It is important to take a moment to ensure that the information about your household is correct.

If You Do NOT Receive Subsidies

Even if you’re paying full price for your coverage, updating your information is still important.

You could become eligible for savings
If your income drops during the year, you may qualify for premium tax credits or even cost-sharing reductions. Updating your information allows you to access those savings right away. You don’t have to wait for next year’s enrollment.

You may qualify for Medicaid
A significant income decrease could make you eligible for Medicaid, which may offer lower costs and additional benefits.

Stay aligned with your current situation
Household changes, like adding or removing dependents or moving to a new area, can impact your plan options and eligibility. Keeping your application current helps avoid complications later.

Stay Ahead of Potential Issues

Your ACA coverage is based on your current life situation, not just what it looked like when you enrolled. Updating your income and household information helps ensure you’re paying the right amount, receiving the correct level of financial assistance, and staying properly covered throughout the year.

You can typically do this by logging into your Marketplace account, based on where you originally enrolled (HealthCare.gov or your state’s exchange). Keeping your ACA application current helps ensure your coverage stays aligned with your needs, helps you avoid financial surprises at tax time, and may open the door to savings you didn’t realize were available.

Not sure how to make an income update? We can help! Reach out for guidance.

ACA Mental Health Coverage: Not Optional, Essential

Wed, 20 May 2026 06:00:06 GMT

How ACA plans ensure access to mental health care

When it comes to health insurance, mental health is no longer treated as an afterthought. Under the Affordable Car e Act (ACA), mental health and substance use disorder services are included as one of the 10 Essential Health Benefits , meaning every ACA-compliant plan must provide coverage. This requirement ensures that individuals and families have access to the care they need, reinforcing the idea that mental health is just as important as physical health.

What Mental Health Services Are Included?

While specific plan details can vary, most ACA plans include the following mental health and substance use services:

Outpatient Mental Health Care
This includes therapy, counseling, and visits with licensed professionals such as psychologists, psychiatrists, or clinical social workers. These services are often the first step for individuals seeking support.

Prescription Medications
Most plans include coverage for medications such as antidepressants, anti-anxiety medications, mood stabilizers, and other behavioral health prescriptions, depending on the plan’s drug list.

Preventive Services
Many ACA plans cover certain screenings (like depression and alcohol misuse) at no additional cost when received from in-network providers.

Telehealth and Virtual Care
Increasingly, plans offer access to virtual therapy and psychiatric services, making it easier for individuals to receive care from the comfort and privacy of home.

Inpatient Mental Health Services
For more serious conditions, plans typically cover psychiatric hospital stays and residential treatment programs, similar to how medical hospitalizations are covered.

Substance Use Disorder Treatment
Coverage includes services like detox programs, inpatient and outpatient rehabilitation, and ongoing counseling for substance use disorders.

Mental Health Parity: Equal Treatment Matters

In addition to requiring coverage, the ACA enforces mental health parity , which is a critical consumer protection. This means that mental health and substance use benefits must be treated the same as physical health benefits.

For example, a plan cannot:

Charge significantly higher copays for therapy than for primary care visits
Impose stricter visit limits on mental health services
Require more burdensome approval processes than those used for medical care

This parity helps ensure that individuals seeking mental health support are not disadvantaged compared to those receiving physical health treatment.

What Can Vary by Plan?

Although coverage is required, not all plans are identical. Key differences can include:

Provider Networks
Not all therapists, psychiatrists, or treatment facilities are in-network, which can affect both access and cost.

Out-of-Pocket Costs
Deductibles, copays, and coinsurance can vary widely depending on the plan you choose.

Prior Authorization Requirements
Some services may require approval before coverage is provided.

Prescription Drug Coverage
Each plan has its own formulary, which determines which medications are covered and at what cost.

What To Do With This Information

Mental health care is a fundamental part of overall health, and under the ACA it’s treated that way. By including mental health and substance use services as essential benefits and enforcing parity protections, ACA plans provide more comprehensive and equitable access to care.

However, understanding the details of your specific plan is still important. Taking the time to review coverage, provider networks, and costs can help ensure you or your family members receive the support you need, when you need it.

How VA Benefits and Medicare Can Work Together

Wed, 13 May 2026 06:00:23 GMT

How VA health coverage and Medicare differ—and when having both may make sense

If you’re a Veteran, you may have access to both VA health benefits and Medicare. Understanding how these two programs can work together can help you make more informed decisions about your healthcare coverage—both now and in the future.

Do You Need Both VA Benefits and Medicare?

VA benefits and Medicare are separate programs, and each has its own rules, provider networks, and coverage guidelines.

VA benefits typically cover care received at VA facilities or through VA-approved providers. The VA may also authorize service provided at non-VA facilities in limited circumstances.
Medicare (Part A and Part B) helps cover care from providers who accept Medicare nationwide.

Because Medicare covers care provided by a wider range of providers than the VA, many Veterans choose to enroll in Medicare when they become eligible, even if they already use VA benefits.

How Coverage Works

In most cases, VA benefits and Medicare do not coordinate benefits for the same service. This means:

The VA generally pays for care at VA facilities or non-VA facilities in limited circumstances when authorized by the VA.
Medicare generally pays for care received outside the VA system (from Medicare-approved providers).

Why Some Veterans Enroll in Medicare

While every situation is unique, there are a few common reasons Veterans consider enrolling in Medicare:

1. Greater Flexibility
Medicare allows you to receive care outside of the VA system, which may be helpful if you travel frequently or want additional provider options.

2. Avoiding Late Enrollment Penalties
If you delay enrolling in Medicare Part B and later decide to sign up, you may incur a late enrollment penalty that can increase your premium. The Part B late enrollment penalty increases each year and is applied for as long as you are enrolled in Part B.

3. Having other Healthcare Options . If funding for VA health benefits is reduced in future years, it is helpful to have other healthcare options to rely on.

Prescription Drug Coverage Considerations

Veterans who receive prescription drug coverage through the VA may already have creditable coverage, per the Medicare standards. However, Medicare Part D may still be a logical thing for you to add to your prescription coverage, depending on individual needs, pharmacy preferences, and access to medications.

Important Considerations

You are not required to enroll in Medicare to keep VA benefits.
Costs, coverage, and provider access can vary depending on the program and services used.
Decisions about enrolling in Medicare should take into account your healthcare needs, budget, and preferred providers.

Final Thoughts

Having both VA benefits and Medicare can provide added flexibility and peace of mind, but it’s important to understand how each program works independently. Reviewing your options annually can help ensure your coverage continues to meet your needs.

For personalized guidance, consider contacting Medicare directly at 1-800-MEDICARE or speaking with a licensed insurance professional. We are here to help.

Can’t Afford Your ACA Plan?

Tue, 05 May 2026 23:34:56 GMT

Here’s What to Do Before You Cancel

Health insurance costs can feel overwhelming, especially when premiums, deductibles, or everyday expenses start to stretch your budget. If you’re enrolled in an ACA (Affordable Care Act) Marketplace plan and thinking about canceling it because it feels unaffordable, you’re not alone.

But before you make that decision, it’s important to pause. Canceling your plan without exploring your options can leave you exposed to high medical costs and limit your ability to re-enroll later. In many cases, there are better solutions available, and a licensed insurance agent can help you find them.

Here’s what to do if your ACA plan no longer feels affordable.

1. Don’t Cancel Your Plan Right Away

It might seem like canceling your coverage is the quickest way to save money, but it can create bigger problems down the road.

If you cancel:

You may lose access to financial assistance (subsidies)
You could be uninsured for months until the next Open Enrollment Period
A medical emergency could result in significant out-of-pocket costs

Instead of canceling immediately, take time to explore your options.

2. Review Your Current Subsidy (You May Qualify for More Help)

Many people don’t realize that ACA subsidies (premium tax credits) are based on your current income , and if your income has changed since your enrollment, your savings might not be accurate anymore.

You may qualify for:

Lower monthly premiums
Reduced deductibles and copays (if eligible for cost-sharing reductions)
Expanded subsidies under recent federal updates

A small change in income, like reduced work hours or job changes, can increase your financial assistance. It is important to update your ACA application and see if increased financial assistance is available.

3. Talk to a Licensed Agent or Broker

This is one of the most important steps.

A licensed insurance agent can:

Review your current plan and costs
Check if you qualify for additional savings
Help you compare more affordable plan options
Guide you through plan changes or Special Enrollment Periods

Best of all, working with an agent typically costs you nothing . Their services are compensated by insurance carriers, not you.

Many people find that simply speaking with an agent uncovers options they didn’t know existed.

4. See If You Qualify for a Special Enrollment Period

Outside of Open Enrollment, you can only change plans if you qualify for a Special Enrollment Period (SEP) .

Common qualifying events include:

Loss of income
Change in household size (marriage, divorce, birth)
Moving to a new coverage area
Loss of other health coverage

If your household or financial situation has changed, you may be eligible to update your application and switch to a more affordable plan .

5. Consider Adjusting Your Plan (Instead of Dropping Coverage)

If your current plan is too expensive, you may be able to:

Switch to a lower-premium plan
Choose a plan with a higher deductible but lower monthly cost
Reevaluate your coverage level (Bronze, Silver, Gold)

Even a modest adjustment can make your plan more manageable while still protecting you from major medical expenses.

6. Explore Medicaid Eligibility

If your income has dropped significantly, you may qualify for Medicaid , which offers low-cost or no-cost coverage.

Eligibility varies by state, but many people are surprised to find they qualify after a change in income.

An agent can help you:

Determine eligibility
Assist with the application process
Transition coverage smoothly if needed

7. Understand the Risks of Going Without Coverage

It’s tempting to go without insurance to save money, but the risks are real.

Without coverage:

A single hospital visit can cost thousands of dollars
Preventive care and prescriptions become more expensive
You may delay needed health care, leading to worse health outcomes

Health insurance is designed to protect both your health and your finances .

You Have Options

If your ACA plan feels unaffordable, you’re not stuck, and you’re not alone. There are often solutions available that can lower your costs without sacrificing coverage.

The key takeaway is simple:

Don’t cancel your plan without speaking to a licensed agent first.

A quick conversation could help you:

Save money
Improve your coverage
Avoid gaps in insurance

When it comes to your health and financial security, it’s worth exploring every option before making a decision.