Before you start

Nevada residence
Income information for subsidy or Medicaid eligibility
An SSN or ITIN for marketplace applications
A qualifying life event, if enrolling outside the annual open-enrolment window

Step-by-step

1
Enrol in your employer's plan within the new-hire window
Typically 30 days from your start date, and missing it can mean waiting for the next open enrolment. Compare the deductible and out-of-pocket maximum, not just the premium.
Via employerWho: YouFirst 30 days of employment
2
Check whether a union plan applies
A large share of Strip hospitality work is covered by the Culinary Union's health fund rather than a conventional employer plan, and its benefits and rules differ from a standard marketplace product. If your job is unionised, this is the plan you will actually be using — read it rather than assuming.
Via employerWho: You
3
Without an employer plan, use Nevada Health Link
Nevada runs its own exchange and its own enrolment platform. Going to HealthCare.gov will not get you a Nevada plan. Open enrolment runs on an annual calendar; outside it you need a qualifying life event such as moving state, losing coverage, marriage or a birth.
OnlineWho: You
4
Check Nevada Medicaid eligibility first
Nevada expanded Medicaid, covering adults up to 138% of the federal poverty level with no premium. Newcomers on modest early incomes frequently qualify, and Medicaid enrolment is open year-round rather than in a window.
OnlineWho: You
5
Register with a primary care physician immediately
Do this while you are well. New-patient waits in the valley are long because the physician supply is thin, and an established relationship is what gets you referrals and urgent slots later. Confirm the practice is in your plan's network before the first visit.
In personWho: YouMonth 1
6
Learn the urgent care versus emergency room distinction
An emergency room visit for something a clinic could treat can cost thousands even when insured. Urgent care handles fractures, stitches, infections and heat illness far more cheaply, and the valley has them densely.
In personWho: You
7
Take heat illness seriously between June and September
Heat is the leading weather-related cause of death in Clark County, and it kills people who are indoors without working air conditioning as well as people outdoors. Know the signs of heat exhaustion versus heat stroke, keep your unit's air conditioning maintained, and treat a failed AC in July as an emergency repair, not a scheduling problem.
In personWho: You

Documents you’ll need

Proof of Nevada residence
Income documentation for subsidies or Medicaid
SSN or ITIN
Immigration documents for marketplace eligibility categories
Evidence of losing prior coverage, if using a special enrolment period

Things most newcomers don’t know

HealthCare.gov is the wrong address in Nevada.

Nevada left the federal platform and runs Nevada Health Link on its own technology. Search results and older guides still point people at HealthCare.gov, which cannot enrol you in a Nevada plan. Going to the wrong site is a common way people miss the open-enrolment deadline entirely.

Source: Nevada Health Link

The shortage is of doctors, not of insurance.

Nevada ranks near the bottom nationally for active physicians per head, and worse for several specialisms — which is why UNLV and Roseman opened medical schools. The practical effect is long new-patient waits and referrals that travel. Establish with a primary care physician in month one, while you are healthy.

Source: community-reported

Strip hospitality often means a union health fund, not a company plan.

The Culinary Union's health fund covers a large slice of the resort workforce. Its network, its rules and its eligibility hours are its own, and they are not what a general 'US employer insurance' explainer describes. If you are joining a unionised property, read the fund's material specifically.

Source: community-reported

Heat is a medical emergency category here, not a weather complaint.

Clark County records heat-associated deaths in the hundreds in bad summers, and a substantial share involve people indoors with failed or absent air conditioning. Treat AC maintenance as a health measure, know the difference between heat exhaustion and heat stroke, and never leave anyone — or any animal — in a parked car.

Source: Southern Nevada Health District

Common mistakes to avoid

Going to HealthCare.gov instead of Nevada Health Link and missing open enrolment.
Missing the 30-day new-hire enrolment window at a new employer.
Waiting until you are ill to find a primary care physician, then discovering the new-patient wait.
Choosing a plan on premium alone and meeting a five-figure deductible.
Treating a broken air conditioner in July as an ordinary maintenance ticket.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.