Medicare Plan Options
There are several types of Medicare plans available in Nevada offering different out-of-pocket costs and coverage, including Original Medicare, the basic fee-for-service Medicare plan. You can add a Medicare Prescription Drug Plan if you have a higher-than-average need for prescription drugs or a Medigap plan, which provides supplementary insurance to pay for things not covered by Original Medicare. Nevada’s Medicare Advantage program is another option to explore if you need more comprehensive coverage for expenses like dental and vision care.
Original Medicare includes Part A hospital insurance, which covers hospital stays, some home health care, and care provided in a skilled nursing facility and hospice. It pays Part B medical insurance claims resulting from outpatient care, doctor visits, medical supplies, and preventative services like cancer screenings. Original Medicare doesn’t cover everything, including long-term care, dentures or most dental care, eye exams for prescription eyeglasses, hearing aids, and prescription drugs. If you or your spouse paid Medicare taxes while working, you might qualify for premium-free Part A coverage, but everyone pays a monthly premium for Part B.
Medicare Advantage Plans
Medicare Advantage, referred to as Medicare Part C, provides an all-in-one alternative to Original Medicare. MA plans are provided by private insurance companies approved by Medicare. Medicare Advantage Plans bundle Medicare Parts A and B, and many include a prescription drug plan. MA plans must cover everything Original Medicare covers, but most cover additional health care needs, such as vision, dental, and hearing services. Some plans cover over-the-counter drugs, rides to doctor appointments, and more. Each MA plan has specific out-of-pocket costs and rules on which health care providers you can see.
Medicare Prescription Drug Coverage Plans
Medicare prescription drug plans, or Medicare Part D, are optional coverage you can add to Original Medicare to cover prescription costs. You must have Medicare Part A and/or Part B to get Part D, which can be added to Original Medicare and some Medicare Advantage Plans that don’t already include prescription coverage, specifically PFFS plans. You can’t add separate Part D coverage to HMO and PPO MA plans, even if they don’t have prescription drug coverage. Each Part D plan varies in its monthly premiums, the drugs covered, and the costs for individual generic and brand-name drugs.
Medicare Supplement Insurance Plans
Medicare Supplement Insurance plans, called Medigap, help fill the coverage gaps in Original Medicare but can’t be added to Medicare Advantage Plans. Private insurance companies sell Medigap policies, which have separate monthly premiums and require you to have parts A and B coverage. Medigap supplements your Original Medicare benefits and can help pay your deductibles, copay, and coinsurance costs. Medicare pays its share of approved health care costs, and Medigap pays its share. Medigap premiums vary, and policies usually don’t cover long-term care, private-duty nurses, eyeglasses, hearing aids, or dental or vision care.
Medicare in Nevada by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|327,036||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Nevada
Medicare is a complex program that many seniors find confusing, which can be especially true if you’re new to Medicare or trying to change plans. Local resources that provide support to Medicare beneficiaries can help you make important health care coverage decisions. You’ll find numerous locations throughout the state that host programs offered through the Nevada Care Connection or Department of Health & Human Services, where you can receive help learning about Medicare and choosing the best option for your needs.
Nevada Care Connection – Resource Centers
Established in 2005, Nevada Care Connection acts as the state’s Aging and Disability Resource Center (ADRC) program. ADRC is a collaboration of partners working to provide services to older adults, Nevadans with disabilities, caregivers, and their families. Community organizations serve as resource centers and are part of the Nevada Medicare Assistance Program (MAP). There are six resource centers, providing free, unbiased Medicare information and counseling. MAP volunteers offer one-on-one assistance in person or by phone with Medicare questions, enrollment, appeals, grievances, Part D coverage, and additional support programs.
Contact Information: Website | 702-486-3831
State Health Insurance Assistance Program
Nevada’s State Health Insurance Assistance Program (SHIP) provides you with Medicare information, counseling, and assistance through a statewide network of volunteers. SHIP counseling sites are available throughout the state. SHIP volunteers provide free one-on-one help with eligibility and benefits for Medicare programs, general coverage and limitations, enrollment in Part D prescription drug plans, claims, and Medigap. Volunteer counselors provide unbiased information to help you determine your health insurance needs and make informed decisions about your long-term care options. SHIP offers outreach information through classes, seminars, meetings, senior fairs, and health fairs.
Contact Information: Website | 775-687-4210 or 800-307-4444
Nevada Senior Medicare Patrol
The Department of Health & Human Services Aging and Disability Services Division operates Nevada’s Senior Medicare Patrol (SMP), which helps you resolve issues and complaints with Medicare, Medicaid, and other health-related matters. SMP uses staff, volunteers, and partners to provide in-person counseling sessions and a toll-free counseling helpline that operates 40 hours per week. The agency helps you detect, report, and prevent health care errors, fraud, and abuse through counseling, education, and outreach. Referrals to other community resources are provided if needed. Fraud and abuse complaints are reported for investigation.
Contact Information: Website | 775-687-4210 or 888-838-7305
CARE Law Program
The Carson and Rural Elder (CARE) Law Program provides low-cost and pro-bono legal services if you’re a senior aged 60 or older and live within Nevada’s 15 rural counties. The CARE Law Program’s primary focus areas are Medicare and Social Security issues, Medicaid and nursing home planning, advance directives, powers of attorney, estate planning, debt and consumer issues, guardianships, homestead and real property issues, and elder abuse issues. All seniors in the covered counties are eligible for services. CARE Law doesn’t have any specific standards to determine eligibility.
Contact Information: Website | 775-687-4680, extension 9