Medicare Coverage in Nevada
The Medicare program provides health insurance coverage to eligible U.S. citizens and legal permanent residents (of five years or longer) who are age 65 or older, or who qualify under the age of 65.
As of 2015*, there were 445,997 total beneficiaries enrolled in the Medicare program in Nevada, according to the Centers for Medicare & Medicaid Services (CMS). Of this total, there were 149,826 residents enrolled in the Medicare Advantage (Medicare Part C) program, through which they are guaranteed the same coverage provided through Original Medicare (except for hospice care, which Medicare Part A covers). In 2015, 150,293 Nevada beneficiaries received their prescription drug coverage through stand-alone Medicare Part D Prescription Drug Plans, while 144,634 received coverage for both their medications and Original Medicare benefits through Medicare Advantage Prescription Drug plans.
Types of Medicare coverage
A bit of background: the federal fee-for-service Medicare health insurance program is called Original Medicare, and includes Part A (hospital insurance) and Part B (medical insurance). Some beneficiaries stay with this program and choose no other coverage. You can add to this coverage by enrolling in a stand-alone Medicare Part D Prescription Drug Plan and/or a Medigap plan (both described in the table below).
Medicare Advantage (Medicare Part C) offers an alternative way to get your Original Medicare coverage; you’re still in the Medicare program if you have a Medicare Advantage plan. See more information in the table below.
Each plan type may have different out-of-pocket costs or coverage details. In the case of Medicare Advantage, different plans might have different additional benefits beyond Medicare Part A and Part B. However, no matter what kind of Medicare plan you sign up for, you still need to continue paying your Medicare Part B premium.
As a Medicare beneficiary in Nevada, you may want to compare all available plans in your service area with your health and prescription drug needs in mind.
| Medicare Insurance Plan Type | Description |
|---|---|
| Medicare Advantage Plan | A health plan offered by private insurance companies that contract with Medicare. This type of Medicare Advantage plan provides Medicare Part A* (hospital insurance) and Part B (medical insurance) benefits. Many of these plans include additional benefits, such as wellness plans. |
| Medicare Advantage Prescription Drug plan | A type of Medicare Advantage plan that includes prescription drug coverage, so you can get all your Medicare benefits in one plan. The formulary (list of covered prescription drugs) may change at any time. You will receive notice from your plan when necessary. |
| Stand-alone Medicare Prescription Drug Plan (Part D) | Prescription drug coverage offered by private insurance companies that contract with Medicare. Each Medicare Prescription Drug Plan may vary in terms of costs, availability, and prescription drugs covered. As with Medicare Advantage Prescription Drug plans, be aware that a plan’s formulary may change at any time. You will receive notice from your plan when necessary. |
| Medicare Supplement (Medigap) plan | Medigap plans are offered by private insurance companies, and can help you pay your out-of-pocket costs for services covered under Original Medicare. |
*Under Medicare Part C, hospice benefits are provided directly through Medicare Part A instead of through the Medicare Advantage plan.
Nevada Aging and Disability Services Division
The Aging and Disability Services Division in the State of Nevada, Department of Health and Human Services, coordinates and delivers supportive services for Nevada’s seniors. Its mission is to help individuals over the age of 60 to lead independent and meaningful lives. Examples of the services provided through this department include the State Health Insurance Assistance Program (SHIP), Advocate for Elders, and the Senior Medicare Patrol (SMP), and more. The Nevada State Health Insurance Assistance Program (SHIP) offers seniors free one-on-one assistance with trained volunteers on topics such as Medicare claims, billing programs, comparing Medicare plans, and long-term care options. The Senior Medicare Patrol (SMP) aims to inform seniors on how to locate and report instances of Medicare fraud, waste, and abuse.
*Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015.