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Medicare in Nevada

October 6, 2016

To many Americans age 65 and older, health insurance is essential. Medicare, the government-sponsored health insurance program, offers Nevada Medicare beneficiaries valuable benefits. Individuals living in Nevada may choose to have Original Medicare, which encompasses Part A and Part B, or they may choose to receive their Medicare benefits through alternative means. The Medicare Part C program allows Medicare beneficiaries to enroll in Medicare Advantage plans offered by Medicare-approved private insurance companies in Nevada and elsewhere in the United States. The Medicare Part D program provides prescription drug coverage from stand-alone Medicare Part D Prescription Drug Plans offered by private insurance companies contracted with Medicare.

Original Medicare for Nevada beneficiaries

Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and it’s available to United States citizens and legal permanent residents of 5 or more continuous years and who are 65 or older, as well as to those under 65 with certain disabilities or health conditions such as end stage renal disease (permanent kidney failure) or Lou Gehrig’s disease.

Most Nevada Medicare beneficiaries enroll in Original Medicare during the seven-month Initial Enrollment Period. The Initial Enrollment Period begins three months before you turn 65, includes your birthday month, and ends three months after your birthday month. You can also enroll in Medicare during the General Enrollment Period, which takes place every year from January 1 to March 31. But be aware that if you miss your Initial Enrollment Period and sign up for Medicare at a later date, you may have to pay higher monthly premiums. This is referred to as a Medicare late-enrollment penalty.

If you are age 65 or older and covered by an employer or union sponsored group health plan, you may defer enrolling in Medicare until your group health coverage ends. In this case you will be eligible for a Special Election Period of eight months’ duration in which you can enroll in Part A and Part B without incurring a late-enrollment penalty.

Many Nevada Medicare beneficiaries are eligible to enroll in Medicare Part A premium-free because they worked 10 years or more and paid Medicare taxes during that time. Individuals who have not fulfilled the requisite contributions to Medicare may have to pay a premium for Medicare Part A coverage. Medicare Part A health benefits include:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health services

Medicare Part B, also part of Original Medicare, provides  medical insurance. You are responsible for paying a monthly Part B premium. Medicare Part B coverage includes:

  • Outpatient services
  • Physician services, including preventive screenings and diagnostic tests
  • Medicare-approved clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs (for example, medications administered at a doctor’s office)

Medicare plan options in Nevada

As a Nevada Medicare beneficiary, here are some of the Medicare plan  options that may be available to you.

You may consider enrolling in a Medicare Advantage plan or in a Medicare Advantage Prescription Drug plan.  Medicare Advantage plans are required by the government to offer at least the same coverage as Original Medicare, Part A and Part B (except for hospice care, which is paid by Medicare Part A).  Many Medicare Advantage plans offer additional benefits such as routine vision, hearing, and dental coverage.  Furthermore, you may be able to enroll in a Medicare Advantage Prescription Drug plan, which provides health and prescription drug coverage through a single plan.   Remember, however, if you enroll in a Medicare Advantage plan, you have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium to maintain your health insurance coverage.

You might want to learn about Medigap (Medicare Supplement) plans if you decide to stay with Original Medicare.

If you decide to stay with Original Medicare, you may also want to consider adding prescription drug coverage.  While Original Medicare does not provide prescription drug coverage (except in limited circumstances such as during hospital stays), Medicare Part D allows beneficiaries to enroll in a stand-alone Medicare Part D Prescription Drug Plan offered by private insurance companies contracted with Medicare.  To be eligible to enroll in a stand-alone Medicare Part D Prescription Drug Plan, you must have Medicare Part A and/or Part B and live in the plan’s service area.  Stand-alone Medicare Part D Prescription Drug Plans in Nevada have different costs, depending on the extent of the coverage you select, but most plans require payment of a monthly premium, annual deductible, and copayment or coinsurance for covered prescription drugs.

Living in Nevada, you may have access to a variety of options for your Medicare medical and prescription drug coverage.  As you explore these options and the various Medicare plans offered by private insurance companies, it’s a good idea to customize your search to identify the plans that are available where you live; then compare the plans to determine the one that best matches your health-care and prescription drug coverage needs and budget considerations.  You may want to enter your zip code in the plan finder on this page to start your search.  You will also have the opportunity to enter your prescription drugs if you choose.

For more information about private Medicare-approved insurance for Nevada beneficiaries, please see:

Nevada resources for Medicare beneficiaries

There are a number of resources designed to help Nevada Medicare beneficiaries with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you:

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