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Medicare in Nevada

Don’t gamble when it comes to your health

Reviewed by: Brett Braithwaite, Licensed Insurance Agent. Written by: Bryan Strickland.

Key Takeaways

  • Original MedicareOriginal Medicare (Parts A and B) is fee-for-service health insurance available to all Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). in Nevada is an option at age 65. It features hospital (Part A) and medical (Part B) coverage with the option of adding drug (Part D) and supplemental (Medigap) coverage.

  • Medicare AdvantageMedicare Advantage is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Nevada replaces Original Medicare and includes the benefits of Parts A and B while bundling drug and supplemental coverage and coverages like dental and vision.

  • Medicaid offers some similar coverages, but eligibility is based on need regardless of age. If you’re 65, you may qualify for both Medicare and Medicaid.

 

The state of Nevada has one slot machine for every two or so Medicare beneficiaries.

Testing your luck against a one-armed bandit is one thing, but pressing your luck when it comes to healthcare? That’s a losing proposition.

If you call Nevada home and have questions about Medicare, here’s the deal.

Who Qualifies for Medicare in Nevada?

Simply put, if you’re a U.S. citizen and are age 65 or older, you qualify for Medicare in Nevada.

You’re also eligible regardless of your age if you have End Stage Renal Disease or Lou Gehrig’s disease (also known as Amyotrophic Lateral Sclerosis or ALS). You also qualify if you have received 24 monthly payments of Social Security Disability Insurance or Railroad Board benefits.

What exactly is Medicare in Nevada?

Original Medicare (Parts A and B)

Part A covers a portion of your hospital-related expenses. Part B covers a portion of your other medical expenses.

Part D

Part D can be added to Original Medicare to cover a portion of your prescription drug expenses.

Medigap

A Medigap policy can be added to Original Medicare to help with deductibles, copays, coinsurance and, in some cases, to create an out-of-pocket maximum.

Medicare Advantage (Part C)

Medicare Advantage bundles the above coverages (including an out-of-pocket maximum) while offering additional ones like dental and vision coverage.

How do I Apply for Medicare in Nevada?

Your choices for applying for Medicare in NV include:

  • Enrolling online with the Social Security Administration. [1]
  • Visiting a local Social Security office. [2]
  • Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).

If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period, which is a seven-month window that includes the month of your 65th birthday as well as the three months before and the three months after your 65th birthday.

Who Qualifies for Medicaid in Nevada?

Each state has its own plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. The state of Nevada calls its Medicaid services Access Nevada, and the state has set up for a quick questionnaire to help residents determine what, if any, programs under the Medicaid umbrella for which they may qualify. [3]

Does Nevada have Free Healthcare?

Medicaid through Access Nevada can provide some free assistance to those who qualify. For Medicare beneficiaries not eligible for Medicaid but facing financial need, the state’s Medicare Beneficiaries program may help. [4]

Also, while not free:

  • The state of Nevada helps low-income residents who are on Medicare but not eligible for Medicaid with prescription costs through its Senior Rx Program. [5]
  • Medicare beneficiaries who have paid employment taxes for at least 10 years don’t have to pay a monthly premium for Part A of Original Medicare. However, the coverage is not free because of the deductibles, copays, and coinsurance responsibilities associated with Medicare plans in Nevada.

What are the Different Medicare Plans Available?

In the case of Original Medicare in Nevada, there’s only one plan — Parts A and B, which does open the option to add Part D and Medigap coverage from private insurance companies.

In the case of Medicare Advantage plans in Nevada, there are many plans.

  • Some Medicare Advantage plans mirror Original Medicare but are more affordable.
  • Some Medicare Advantage plans include options for dental, vision and hearing coverage.
  • Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs.
  • Some offer all of the above.

Original Medicare is simple. Medicare Advantage offers a variety that can be overwhelming. Still, it’s simple for a dedicated GoHealth licensed insurance agent to review your situation and figure out what Medicare Advantage plan is the right fit for your specific situation.

What are the Top 3 Medicare Advantage Plans?

The Centers for Medicare & Medicaid Services has a Medicare Star Rating system that assigns a rating of one to five stars (five being the highest-rated) to individual Medicare Advantage plans.

If you’re already on a Medicare Advantage plan and it’s not five-star, you are offered the opportunity to switch to a five-star plan each year. [6]

While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you all things considered.

Medicare in Nevada by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 469,892 people are enrolled in Medicare in Nevada. The total number of beneficiaries enrolled in Medicare Advantage in Nevada is 195,978. The previous year, 182,655 enrolled in Medicare Advantage. Medicare Advantage participation in Nevada went from 40.33% to 41.71% year over year. If you’d like to dive deeper into how Medicare in Nevada breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of New Hampshire
469,892
Beneficiaries with Part A & Part B
195,978
Medicare Advantage Beneficiaries
41.71%
Medicare Advantage Participation Rate
52.23%
% Female
47.77%
% Male
0.95
Average HCC Score
$11,050.67
Actual Per Capita Costs
17.70%
% Eligible for Medicaid
29.28%
% of Beneficiaries with an Emergency Department Visit
20.00%
Hospital Readmission Rate
74.46%
% Non-Hispanic White
6.93%
% African American
9.44%
% Hispanic
9.17%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Nevada Medicare Resources & Contacts

Beneficiaries spend an average of $11,050.67 each year on Medicare in Nevada. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Nevada-based resources, like these, may be able to help:

Nevada Medicare SHIP

1-800-307-4444

http://adsd.nv.gov/Programs/Seniors/SHIP/SHIP_Prog/

What should I know about Nevada SHIP?

The state’s Aging and Disability Services division administers the federally sponsored program that provides free, unbiased Medicare advice.

Senior Medicare Patrol

1-888-838-7305

http://adsd.nv.gov/Programs/Seniors/SMP/SMP_Prog/

What should I know about the Senior Medicare Patrol?

Helps Medicare beneficiaries protect themselves against fraud and deal with potential billing errors.

Access Nevada

1-800-992-0900

https://accessnevada.dwss.nv.gov/public/landing-page

What should I know about Access Nevada?

This state organization administers the federal Medicaid program and other cost-savings programs geared toward residents in need.

Veterans Benefits Administration

1-800-827-1000
Phone lines open M-F, 8 a.m. to 3:30 p.m.

https://www.lasvegas.va.gov/facilities/Veterans_Benefits_Administration.asp

What should I know about the Department of Veterans Affairs?

Helps Nevada’s veterans and their families secure the health-related benefits due for their service.

Nationwide Resources

Speak with an insurance agent that is licensed in Nevada about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in NV, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

Medicare Beneficiary Guide

For those currently enrolled in Medicare.

Medicare Plans Guide

Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.