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Medicare in Nevada: Eligibility, How to Apply, & More

May 8, 2022

Medicare in Nevada: Eligibility, How to Apply, & More

Despite its nickname as “The Silver State,” Nevada actually produces a tremendous amount of gold. In fact, it’s the United States’ largest gold-producing state and the fourth-largest on the planet.

Gold isn’t just a commodity that Nevada produces, there are a lot of residents in their golden years, as well. A full 16% of the state’s population is 65 and older, which means a lot of Nevadans use Medicare as health coverage. 

If you’re one of those who is 65 or older, you might have questions about your Medicare coverage, from how to apply for Medicare in Nevada to who qualifies for Medicare in Nevada. This guide will answer these common questions and help you understand how to take full advantage of your health coverage. 

Let’s get started!

Medicare in Nevada

Medicare is a federal health insurance program designed to help provide coverage for Americans who have less access to employer-provided health insurance. As a result, those who qualify are of retirement age or have specific health conditions.

Original Medicare has a variety of parts, each of which covers different medical needs:

  • Medicare Part A is coverage for inpatient hospital care
  • Medicare Part B is medical coverage for doctor’s appointments, outpatient procedures, medical equipment, and more
  • Medicare Part D is coverage for prescription drugs and is sold separately from Medicare Parts A and B

You can also choose to have Medicare Advantage instead of Original Medicare. Medicare Advantage is a full replacement for Original Medicare and often includes additional benefits.

Who is Eligible for Medicare in Nevada?

As mentioned, Medicare is focused on Americans who have less access to employer-provided health insurance. 

To qualify for Medicare in Nevada, you must be a U.S. citizen or permanent resident who’s lived in the United States for at least five years, for whom at least one of the following apply:

  • Age 65 or older
  • Under 65, but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • Having Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease
  • Having end-stage renal disease (ESRD)

How Much Does Medicare Cost in Nevada?

Each part of Medicare has its own costs, including a monthly premium, deductible, and copayment or coinsurance.

If you choose Original Medicare, you’ll generally get Medicare Part A without a monthly premium. If you need inpatient hospital care, you’ll have a deductible of $1,556 (in 2022) and then your coverage will kick in. You’ll have a $0 coinsurance for days 1-60 in a year, and a $389 per day coinsurance for days 61-90.

Medicare Part B has a monthly premium of $170.10 in 2022. The annual deductible is $233. After that, you’ll pay 20% of the Medicare-approved amount of your medical care.

Medicare Part D is sold separately by private insurance companies. The monthly premium, deductible, and copayments will vary depending on the plan. You’ll also want to ensure that your preferred pharmacies and any needed medications are included in the plan before you enroll.

Another option is enrolling in Medicare Advantage. These plans are sold by private insurance companies and often cost the same as your Part B premium. Some plans will cost a bit more. They will also have their own deductibles and copayments for care.

How to Get Medicare in Nevada

Most Americans become eligible for Medicare around their 65th birthday. When you become eligible, you may be enrolled in Original Medicare Parts A and B automatically. However, that doesn’t give you prescription drug coverage or give you the chance to consider Medicare Advantage plans.

If you’re in your initial enrollment period, it’s important to take the time to compare the various plans available to you. For example, you might decide Original Medicare with a Medigap plan makes the most sense, or you might opt for an Advantage plan.

You can review your options and sign up online or by talking to a licensed agent who helps you compare plans and choose the best one for your needs.

If you’d like to enroll in Original Medicare and you’re not automatically enrolled, you can do one of the following:

  • Contact your local Social Security office
  • Call 1-800-772-1213 to enroll over the phone
  • If you retired from a railroad, call the Railroad Retirement Board at 1-877-772-5772
  • Sign up for Part A online at www.socialsecurity.gov and Part B using Form CMS-40B

Medicare Advantage in Nevada

Medicare Advantage plans are popular with Medicare beneficiaries because they offer additional benefits, often at no additional cost.

For example, many Medicare Advantage plans include a prescription drug plan without charging an additional premium. You might also be able to get perks Original Medicare doesn’t cover, such as vision or dental benefits.

The thing that’s important to keep in mind about Medicare Advantage plans is that they generally have a limited provider network focused on your local area. Often, you cannot get non-emergency care outside of that network. As a result, if you travel often you might benefit from sticking with the national network of Original Medicare. 

What are the Medicare Plans in Nevada?

In general, Nevadans have the choice to go with Original Medicare or a Medicare Advantage plan. 

If you choose Original Medicare, you’ll want to review Medigap plans during your initial enrollment period (when acceptance is guaranteed) and you’ll likely want to add a Medicare Part D prescription drug plan.

If you go with an Advantage plan, you’ll want to compare various plans to ensure that your preferred doctors and specialists are included, as well as the prescription drugs you need. You’ll also want to look at the deductibles and other out-of-pocket costs before committing to a plan. Of course, a plan that gives you additional benefits is always nice as well!

When you’ve looked at all the Medicare plans in Nevada, you can choose the one that makes the most sense for your situation. If you need to make a change, you have that opportunity during the annual enrollment period each year.

Learn More About Medicare in Nevada

Understanding the details of each available Medicare plan can feel overwhelming, but talking to a licensed agent can help you compare plans and choose the option that makes sense for you. If you’d like help or have additional questions about Medicare in Nevada, we’re here for you. Contact us today!



 

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