Nevada Medicare Guide

Medicare doesn’t have to be complicated. Get free support from one of our licensed Nevada Medicare Advisors. Schedule a consultation or call us at (888) 604-0055 to ask questions and get help enrolling in the best Medicare coverage for your unique healthcare needs.

Below you can learn about your Medicare options and how and when to enroll.

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A Snapshot of Medicare in Nevada

There are 652,000 Medicare beneficiaries in Nevada, making up 18% of the total population. 14% of Nevada Medicare beneficiaries are also on Medicaid. For those with limited incomes and resources, Nevada also has four Medicare Savings Programs, which we’ll cover more later.

Enrollment for Medicare Advantage vs. Original Medicare in Nevada

One important decision Nevada Medicare beneficiaries must make is: Medicare Advantage or Original Medicare? Medicare Advantage is a bundled approach to Medicare, and plans are provided and managed by private insurance companies. Those on Original Medicare can also enroll in a Medicare Supplement (Medigap) plan and/or a prescription drug plan. 56% of Nevada Medicare beneficiaries are on Original Medicare and the other 44% have chosen Medicare Advantage plans (source). We cover the pros and cons of both Medicare Advantage and Medicare Supplement below.

Nevada Medicare Advantage Plans

Medicare Advantage plans, also known as Medicare Part C plans, are offered by private insurance companies approved by Medicare. These plans provide an alternative to Original Medicare by combining the benefits of Parts A and B into a single plan. Medicare Advantage plans often include additional benefits like prescription drug coverage and may offer extras such as dental, vision, and fitness programs. They also have downsides though. These plans must offer at least the same level of coverage as Original Medicare, but each has its own cost-sharing structures and rules, and this can result in more surprises. Additionally, Medicare Advantage plans limit you to provider networks and also may require prior authorization for some healthcare services, which can slow down treatment.

44% of Nevada Medicare beneficiaries choose to enroll in one of the 68 Medicare Advantage plans available statewide. Plan availability varies by zip code, and the details of every plan, including premiums, deductibles, networks, and ratings vary. For example, Clark County has 46 Medicare Advantage plans available from twelve insurance carriers. The monthly premiums range from $0 to $34. Washoe County has 31 plans available from eleven carriers. The monthly premiums of these 31 plans range from $0 to $180.

Our Nevada Medicare Advisors help older Americans pick the best Medicare plan to get all their healthcare needs covered while saving on costs. Schedule a free consultation or call us at (888) 604-0055 to learn about your Medicare options and receive personalized advice.

Nevada Medicare Supplement Plans

Medicare Supplement plans, also known as Medigap plans, are private insurance policies that help fill the gaps in coverage left by Original Medicare (Parts A and B). These plans are designed to cover the 20% of costs not covered by Original Medicare, allowing for better financial predictability among Medicare beneficiaries. Nationwide, Medicare beneficiaries have ten Medigap plan options. These plans are standardized and regulated by the federal government, meaning that the coverage remains consistent across insurance companies, although prices may vary. These plans work alongside Original Medicare and can be used at any healthcare provider that accepts Medicare (which is about 90% of doctors nationwide).

When you enroll in a Medicare Supplement plan matters! The best time to enroll is during the Medigap Open Enrollment period, which occurs during the first six months that you’re enrolled in Medicare Part B. During your Medigap Open Enrollment Period, you cannot be denied coverage, regardless of your age or medical history. Outside of this period of time and some other guaranteed issue periods, you may have to go through medical underwriting (answering questions about your age and health history), and insurance companies can reject your application.

The Nevada Medigap Birthday Rule

If you already have a Medigap plan, you’re eligible for a special Medigap enrollment period that starts on the first day of your birth month and lasts for 60 days after. During this period, you can switch to any Medigap plan with equal or lesser coverage without going through medical underwriting.

Nevada Part D (Prescription Drug Coverage) Plans

Nevada Medicare beneficiaries can secure prescription drug coverage through a Medicare Advantage plan that includes Part D coverage or through one of Nevada’s 23 stand-alone Part D plans. Plan availability varies by county. For example, Washoe County has 23 available plans with monthly premiums ranging from $7.90 to $118.40. When looking at these plans, it’s important to not only look at the premiums, but also the price of the prescriptions you take.

Even if you aren’t currently taking any prescription medications, you should consider getting one of the lower-cost drug plans to avoid the Part D late enrollment penalty in case you do need prescription coverage later on.

Getting help paying for prescription drug coverage

Medicare Extra Help Program

Medicare beneficiaries with low income and resources may be eligible for the Extra Help program. Extra Help (also known as the Part D Low-Income Subsidy) helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance.

You automatically qualify for Extra Help if you:

Get full Medicaid coverage from Nevada
Nevada pays your Part B premium
You’re eligible for Supplemental Security Income (SSI)

If you don’t automatically qualify for Extra Help, you can learn more about the program here or talk to one of our licensed Nevada Medicare Advisors who can help you understand eligibility and submit your application.

Other ways to save on Medicare prescription coverage in Nevada

Change pharmacies - Pharmacies charge different prices and some Medicare plans have preferred pharmacies where costs are extra low. One of our Nevada Medicare agents can help you find the pharmacy that saves you most.
Switch the brand or form - Changing to a different brand (or generic) medication and considering different forms (e.g., tablet to pill) could help you save money each month.
Shop around during the Open Enrollment Period - Medicare plans change every year. Look into any changes your drug plan makes, and check pricing on other plans each year to be sure you’re always getting the best value.

Get help paying for Medicare in Nevada

Medicare Extra Help only helps with prescription-related Medicare expenses. The following two government programs help low-income Medicare beneficiaries with additional Medicare expenses.

Medicaid

Medicaid is a joint federal and state government program that helps low-income individuals get access to healthcare. States are responsible for running Medicaid programs, so each is a little different. The Nevada Medicaid program is run by the Department of Health and Human Services (DHHS).

Medicare Savings Programs

Medicare Savings Programs (MSPs) are included in Nevada Medicaid programs. MSPs help Medicare beneficiaries with low income and resources pay for Medicare-related expenses. There are four Medicare Savings Programs available to Nevada residents:

The Qualified Medicare Beneficiary (QMB) Program pays for Medicare Part A and Part B premiums, deductibles, and coinsurance.
The Specified Low-Income Beneficiary (SLMB) Program pays for your Medicare Part B premium.
The Qualifying Individual (QI) Program pays for your Medicare Part B premium.
The Qualified Disabled Working Individual (QDWI) Program pays for the Medicare Part A premium.

Get a summary of Medicaid programs for Medicare beneficiaries in Nevada here, and reach out to us at (888) 604-0055 if you need any assistance.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

Nevada Medicare Eligibility and Enrollment Steps

If you are a US citizen and meet one of the following criteria, you are eligible for Medicare:

You’re 65 or older
You have certain disabilities, like End-Stage Renal Disease or ALS

Three simple steps for Nevada Medicare enrollment:

Enroll in Original Medicare (Part A & Part B)
Choose your additional Medicare insurance coverage
Medicare Supplement (Medigap)
Medicare Advantage (Part C)
Part D (drug coverage)
Set yourself up for success by finding doctors, sharing your plan information with your pharmacy, and accessing additional benefits that come with your coverage.

You first become eligible for Medicare during your Initial Enrollment Period, which is a 7-month period surrounding your 65th birthday. Your Initial Enrollment Period starts three months before and ends three months after the month you turn 65. You can learn more about when to enroll in Medicare here. If you have any questions, schedule a free consultation with one of our licensed Nevada Medicare Advisors or give us a call today at (888) 604-0055.

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