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Medicare in Nevada


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Overview of Medicare in Nevada

In 2018, approximately 498,000 residents of Nevada received Medicare coverage, according to the Centers for Medicare & Medicaid Services (CMS). As a Medicare beneficiary living in Nevada, you may have several options when it comes to your Medicare coverage. Some of those choices may include:

Original Medicare is the federally administered health-care program for eligible United States citizens and legal permanent residents of at least five continuous years who are 65 and older. You may also be eligible for Medicare coverage if you’re under 65 through disability or certain health conditions, including end-stage renal disease and amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease).

In Nevada, as in the rest of the country, Original Medicare comes in two parts: Part A and Part B.

  • Medicare Part A covers inpatient hospital, skilled nursing facility, some home health visits, and hospice care.
  • Medicare Part B covers doctor services, outpatient care, and some home health and preventive medical services.

Original Medicare doesn’t cover everything. For example, Original Medicare offers limited prescription drug coverage; you’ll normally have to join a separate Medicare Prescription Drug Plan for help with most medications. Original Medicare also doesn’t pay for most types of long-term care, also known as custodial care. This includes care you receive at home or in a nursing home when personal care (such as help with getting dressed or bathing) is the only help you need.

Original Medicare, Part A and Part B, also does not pay for routine vision, routine dental services, or hearing. Some of these benefits may be available through a Medicare Advantage plan.

A Medicare Part D Prescription Drug Plan (PDP) is stand-alone coverage that you can purchase to help pay for your prescription drug costs in Original Medicare. These plans work alongside your Original Medicare coverage and are available from private insurance companies approved by Medicare and doing business in Nevada.

Medigap (Medicare Supplement) insurance plans are also offered by private insurance companies and can help you pay your out-of-pocket costs for services covered under Original Medicare.

As an alternative way to get your Original Medicare benefits, you may be eligible to enroll in a Medicare Advantage plan in Nevada. Offered by private insurance companies that contract with CMS, these plans provide at least the same level of Medicare benefits as the federal program (with the exception of hospice care, which is paid by Medicare Part A).

In addition, many Medicare Advantage plans also include additional coverage beyond Original Medicare, such as routine dental and vision care. Unlike Original Medicare, some plans may include prescription drug coverage alongside medical coverage. Also known as Medicare Advantage Prescription Drug (MA-PD) plans, these plans provide your Medicare Part A, Part B, and Part D benefits under a single plan.

To be eligible for a Medicare Advantage plan, you must have Medicare Part A and Part B, live in the service area of a Medicare Advantage plan, and not have end-stage renal disease (with some exceptions).

Keep in mind that you’ll need to keep paying your Medicare Part B premium, in addition to any additional premium required by your Medicare Advantage plan.

To find and compare Medicare plan options in your location, enter your zip code into the eHealth plan finder tool on this page. You can also enter in your prescription drugs to narrow your search to Medicare plan options that cover your medications.

Medicare resources in Nevada

Nevada Aging and Disability Services Division: This division of the Nevada Department of Health and Human Services offers a wealth of services and resources for seniors living in the state. Included are programs that specifically help beneficiaries navigate their health-care coverage options. The division offers a wide range of public presentations on topics pertaining to seniors and disabled residents in the state. In addition, this department oversees a number of senior programs, which include:

  • Senior Medicare Patrol – This fraud prevention organization is funded by a federal grant and designed to teach Nevada Medicare beneficiaries how to protect themselves from fraud. The office also instructs beneficiaries on how to handle errors on their claims.
  • Senior Rx – This program falls under the umbrella of the Nevada Department of Health and Human Services. The programs helps eligible beneficiaries with limited income with their prescription drug costs.
  • State Health Insurance Assistance Program (SHIP) – SHIP is a federal program administered on the state level that offers educational resources and personal counseling to Nevada Medicare beneficiaries. Through a statewide network of trained volunteers, beneficiaries can get answers to their Medicare and health coverage questions.

Nevada Aging and Disability Resource Center (ADRC): The Aging and Disability Resource Center offers a support system to Nevada Medicare beneficiaries. The office provides a wide range of services, including counseling on their options, planning assistance, and application support. Seniors and disabled residents in Nevada can get support online, over the phone, or in-person. The information and support provided at any of the offices is applicable throughout the entire state. The website offers downloads for both federal and state Medicare guides, as well as information and links for the Senior Medicare Patrol and State Health Insurance Assistance Program (SHIP).

Access to Healthcare Network: This agency was selected by the state of Nevada in 2007 to administer the Nevada Health Access Program (NHAP). NHAP provides health-care resources to uninsured Nevada residents. In addition, the office is home to the State Health Insurance Assistance Program (SHIP), which offers counseling, education, and resources to Nevada Medicare beneficiaries. The office provides assistance with claims, personal options counseling, and outreach information involving Medicare benefits and services.

Medicare statistical trends in Nevada

In 2018 –

  • 184,242 of Medicare beneficiaries (37%) in Nevada were enrolled in Medicare Advantage plans and other health plans. 314,030 individuals (63% of Medicare beneficiaries) were enrolled in Original Medicare Part A and/or Part B.
  • In 2018, 347,646 Medicare beneficiaries in Nevada received Part D prescription drug coverage either from a Medicare Prescription Drug Plan or from a Medicare Advantage Prescription Drug plan. Over half of these individuals received their Part D prescription coverage through a Medicare Advantage plan that included this benefit.
  • 97% of Nevada residents with Medicare have access to a Medicare Advantage plan.
  • 36 Medicare Advantage plans are available in Nevada.
  • 24 Medicare Prescription Drug Plans are available in Nevada.
  • 78% of people with Medicare Part D have access to a plan with a lower premium than what they paid in 2017.
  • 25% of people with Medicare Part D are eligible for Extra Help (also called the Low-Income Subsidy, or LIS).
  • $20.20 is the lowest monthly premium for a Prescription Drug Plan (premiums may be lower for individuals who qualify for Extra Help or higher for individuals who select the lowest premium Prescription Drug Plan and who also pay a late-enrollment penalty).

Statistical data from the Centers for Medicare & Medicaid Services, “Medicare Enrollment Dashboard”; and “2018 MA Part D Landscape State-by-State Fact Sheet”.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.

Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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