Finding Medicare Plans in Nevada
Nevada offers a variety of Medicare plans, but sorting through your options to find the right coverage can be overwhelming. We don’t think it should be. We’ll help you navigate the many Medicare plans in Nevada to find the right coverage for you.
What Is Medicare and What Does It Cover?
Medicare is a federal health insurance program that covers a variety of health care expenses. It is available for people 65 and older and certain people under the age of 65 with a qualifying disability or illness. Medicare doesn’t cover everything, and it isn’t intended to pay 100% of your medical expenses. Medicare beneficiaries typically pay a portion of their medical bills through coinsurance, copayments, and deductibles.
To see what’s covered, we’ll look at the four parts of Medicare:
Original Medicare (Parts A and B)
Original Medicare is the federal component of Medicare and has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, skilled nursing facility care, hospice care, and nursing home care (as long as custodial care isn’t the only care needed).
Part B (Medical Insurance) covers outpatient services and supplies, like mental health care, ambulance services, and durable medical equipment (e.g., canes, blood sugar monitors, and walkers). Part B also covers some services that prevent or detect illnesses at an early stage, like flu shots, cardiovascular screenings, and diabetes screenings.
Original Medicare doesn’t cover everything. Services generally not covered by Original Medicare include:
- Long term care (custodial care)
- Most outpatient prescription drugs
- Hearing aids
- Eye exams and eyeglasses
- Most dental care and dentures
- Routine foot care
- Cosmetic surgery
That’s why there is such a wide variety of additional Medicare plans available to help expand your coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans, offered by Medicare-approved private insurance companies, work as an alternative to Original Medicare (Parts A and B). These plans must provide the same coverage as Original Medicare and often include additional benefits, like dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
You must first be enrolled in both parts of Original Medicare to enroll in a Medicare Advantage plan. Premiums for these plans can start at $0 and increase based on the level of coverage selected. In addition to your Part C premium, you’ll need to continue paying your Part B premium.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans are designed to work alongside your Original Medicare to provide coverage for prescription medications. Prescription drug coverage is not provided by Original Medicare nor Medigap plans. These plans, offered by Medicare-approved private insurance companies, separate medications into tiers, each with an associated copay/coinsurance. Each plan provides a drug formulary, allowing you to check which tier(s) your medications fall into. This enables you to compare plans and find the one that provides the best value for your prescription needs.
Medicare Supplement Plans (Medigap)
As we mentioned earlier, Medicare beneficiaries are still responsible for paying a portion of their medical bills. This is where Medicare Supplement plans come in. Medigap plans are available through private insurance companies and work in tandem with your Original Medicare. They help to reduce out-of-pocket expenses by covering things like copayments. coinsurance, and deductibles.
Am I Eligible for Medicare Plans in Nevada?
To qualify for Medicare, you must be eligible for Social Security benefits. Most people first become eligible for Medicare when they turn 65 years old.
If you’re 65 or older, you may qualify for Medicare if:
- You are a citizen or permanent resident (having lived in the US for at least 5 years), and
- You or your spouse worked at a job that paid towards your Medicare through Social Security deductions for at least 10 years.
If you’re under 65, you may qualify for Medicare if you have:
- been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD)
- received Social Security Disability Insurance (SSDI) for at least 24 months
If you’re unsure about your eligibility or will be turning 65 within the next six months, we can help. You can view local plans online or talk to a licensed insurance agent by calling the number above.
When Can I Enroll in A Medicare Plan?
Medicare Advantage and Medicare Prescription Drug Plans
Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. This IEP is a seven-month period, starting three months before your 65th birthday month.
You can then make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period runs from October 15th to December 7th every year.
Key Fact: You’ll have another chance to enroll in Original Medicare during the General Enrollment Period. This period runs from January 1st to March 31st each year. Then, if you’d like to enroll in a Medicare Advantage plan, you can do so from April 1st to June 30th each year.
Medicare Supplement Plans
You are guaranteed the Medicare Supplement plan of your choice if you enroll during your Medigap Open Enrollment Period. This six-month period begins at the start of your 65th birthday month, assuming you’ve enrolled in Medicare Part B. Otherwise, your Medigap Open Enrollment Period would start the same month as your Medicare Part B coverage.
Important Note: You could be charged higher premiums or be denied coverage entirely if you don’t enroll in a Medigap plan during your Medigap Open Enrollment Period.
Special Enrollment Periods
If you’ve recently experienced a qualifying life event, you may be eligible for a Special Enrollment Period. Special Enrollment Periods enable you to make changes to your coverage outside of the periods discussed above. Qualifying life events include moving outside of your plan’s coverage area, moving into or out of a care facility, and more. Our licensed insurance agents are here to help you determine whether you qualify for a Special Enrollment Period.
How Do I Select a Medicare Plan?
We’re here to help you consider your options and find the coverage that’s right for your needs. You can speak to a licensed insurance agent by giving us a call, or you can compare plans side-by-side online by using the form below.
Additional Medicare Resources in Nevada
The State Health Insurance Assistance Program (SHIP) is available to Nevada residents who are on Medicare, their caregivers, and those aging into Medicare. SHIP is comprised of volunteers who provides free assistance and counseling so that seniors and their caregivers can make informed decisions about their health insurance.
Nevada’s Medicare Savings Program is available to Medicare beneficiaries that meet certain income requirements. The program helps consumers pay for Medicare premiums and copays.
Sources: Medicare.gov; http://adsd.nv.gov; www.nevadaadrc.com