Last Updated on
October 6, 2016
As a Medicare beneficiary in Nevada, you may want to think about enrolling in a Medicare plan that includes prescription drug coverage. Medicare Part D in Nevada, as in the rest of the United States, is designed to help you cover your prescription drug expenses. Each Medicare plan that includes prescription drug coverage has a different cost, depending on your location and zip code, but most require payment of a monthly premium, annual deductible, and copayments or coinsurance.
If you live in Nevada and are enrolled in Medicare, you may be receiving health coverage through Original Medicare, Part A and Part B. To receive prescription drug coverage, you may want to think about enrolling in Medicare Part D. Here’s a look at what Medicare Part D in Nevada can offer.
Medicare plans that include prescription drug coverage in Nevada each have their own list of covered prescription drugs, called a formulary. (A formulary may change at any time. You will be notified when necessary.) The formulary divides drugs into various categories called tiers, each with a different cost: the bottom tier includes the least expensive medications, while the highest tier features the higher-priced drugs. If your doctor or health-care provider determines that a prescription drug in a higher tier is medically necessary for your treatment instead of a similar prescription drug in a lower tier, you or your doctor can to ask your plan for a tiering exception and benefit from a lower copayment for a higher tier medication.
Most Medicare plans that include prescription drug coverage in Nevada and the rest of the U.S. allow you to choose between brand-name prescription drugs and generic prescription drugs. The Food and Drug Administration (FDA) describes generic prescription drugs as using the same active ingredients as brand-name prescription drugs, at the same strength and dosage, and with the same method of administration. Also, the FDA requires generics to be tested and have the same ingredients as brand-name prescription drugs. Generic prescription drugs generally cost less than the brand-name versions, resulting in significant savings. If for some reason a generic prescription drug is not available, your prescription drug plan may let you substitute it with a similar generic prescription drug instead of paying the higher price for the brand-name prescription drug, so be sure to discuss all prescription drug options with your doctor or health provider.
You can enroll in Medicare Part D in Nevada, and throughout the U.S., during your Medicare Initial Enrollment Period, which lasts seven months. This period begins three months before you turn 65, includes your birthday month, and ends three months after that month. You must either have or be eligible to enroll in Medicare Part A to enroll in Medicare Part D in Nevada. If you’re enrolled in Medicare due to a disability, you can enroll in Medicare Part D from three months before until three months after your 25th month of disability.
Another time you can enroll in Medicare Part D in Nevada is during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year. If you disenroll from Medicare Advantage during this period and return to Original Medicare, Part A and Part B, you can enroll in a stand-alone Medicare Part D Prescription Drug Plan through February 14 as well.
You may also enroll in Medicare Part D in Nevada or throughout the U.S. during the Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage, which runs from October 15 to December 7 each year. And you can switch Medicare plans that include prescription drug coverage during the same period.
Always keep in mind that if you go without creditable prescription drug coverage for 63 days or more after your Initial Enrollment Period ends, you may have to pay a late-enrollment penalty for as long as you remain enrolled in Medicare Part D. The penalty for Medicare Part D is calculated using 1% of the national base beneficiary premium and the number of full months you were eligible for Medicare Part D but didn’t enroll. This amount is then added to your Medicare Part D monthly premium. The national base beneficiary premium may increase each year, which means your late-enrollment penalty may also increase annually.
Another important thing to remember is that even if you enroll in a Medicare plan that includes prescription drug coverage, you have to remain enrolled in Medicare Part A, and pay any Part A premiums (if you’re not entitled to premium-free Medicare Part A coverage), to retain your health insurance coverage. Also note that in Nevada and the rest of the United States, Medicare beneficiaries are required to live in the service area of their chosen Medicare plan that includes prescription drug coverage.
There are various Medicare plans that include prescription drug coverage available in Nevada and throughout the U.S. A Medicare Part D Prescription Drug Plan is a stand-alone plan that Medicare beneficiaries can have alongside Original Medicare, Part A and Part B, to help cover costs for prescription drugs, while a Medicare Advantage Prescription Drug plan combines health and prescription drug coverage into a single plan, offering at least the same coverage as Original Medicare. Medicare Advantage Prescription Drug plans will sometimes offer extra benefits, like vision, hearing, and dental, all for a single premium.
When comparing Medicare Part D Prescription Drug Plans in Nevada, it’s important to take into consideration your personal prescription drug requirements, since it’s your prescription drug cost–more so than your premiums or deductibles–that generally determine your out-of-pocket expenses.
It may also be a good idea to re-examine your Medicare plan that includes prescription drug coverage at the end of each year, to be aware of any changes to your coverage. Medicare Part D Prescription Drug Plans in Nevada, as in the rest of the United States, are able to change their premiums, copayments, deductibles, and prescription drug formularies on an annual basis, which means that your current plan may not suit your prescription drug needs in the coming year. You may even want to shop for a new plan every year during the Annual Election Period.
Visit the following pages for more information about Medicare in Nevada: