A Snapshot of Medicare in Las Vegas and Nevada
There are 652,000 Medicare beneficiaries in Nevada, making up 18% of the total population. 14% of Las Vegas and Nevada Medicare beneficiaries are also on Medicaid. For those with limited incomes and resources, Las Vegas and Nevada Medicare beneficaries have 4 Medicare Savings Plan Options available to them.
Enrollment for Medicare Advantage vs. Original Medicare in Las Vegas and Nevada
Las Vegas Nevada Medicare beneficiaries have choices when it comes to getting their Medicare benefits. They can choose to either get these benefits thru "Original Medicare" or they can choose a Medicare Advantage Plan, Known as Medicare Part C. Medicare Advantage is a bundled approach to Medicare, and plans are provided and managed by private insurance companies. Those on Original Medicare can also enroll in a Medicare Supplement (Medigap) plan and/or a prescription drug plan. 56% of Nevada Medicare beneficiaries are on Original Medicare and the other 44% have chosen Medicare Advantage plans (source). Below is a summary of the Pros and Cons of both Medicare Advantage and Orogonal Medicare with Supplemental Insurance.
Las Vegas and Nevada Medicare Advantage Plans
(find out more-click on the words above)
Medicare Advantage plans, also known as Medicare Part C plans, are offered by private insurance companies approved by Medicare. These plans provide an alternative to Original Medicare by combining the benefits of Parts A and B into a single plan. Medicare Advantage plans often include additional benefits like prescription drug coverage and may offer extras such as dental, vision, and fitness programs. They also have downsides though. These plans must offer at least the same level of coverage as Original Medicare, but each has its own cost-sharing structures and rules, and this can result in more surprises. Additionally, Medicare Advantage plans limit you to provider networks and also may require prior authorization for some healthcare services, which can slow down treatment.
44% of Nevada Medicare beneficiaries choose to enroll in one of the 68 Medicare Advantage plans available statewide. Plan availability varies by zip code, and the details of every plan, including premiums, deductibles, networks, and ratings vary. For example, Clark County has 46 Medicare Advantage plans available from twelve insurance carriers. The monthly premiums range from $0 to $34. Washoe County has 31 plans available from eleven carriers. The monthly premiums of these 31 plans range from $0 to $180.
Las Vegas and Nevada Medicare Supplement Plans
(find out more-click on the words above)
Medicare Supplement plans, also known as Medigap plans, are private insurance policies that help fill the gaps in coverage left by Original Medicare (Parts A and B). These plans are designed to cover the 20% of costs not covered by Original Medicare, allowing for better financial predictability among Medicare beneficiaries. Nationwide, Medicare beneficiaries have ten Medigap plan options. These plans are standardized and regulated by the federal government, meaning that the coverage remains consistent across insurance companies, although prices may vary. These plans work alongside Original Medicare and can be used at any healthcare provider that accepts Medicare (which is about 90% of doctors nationwide).
When you enroll in a Medicare Supplemental plan matters! The best time to enroll is during the Medigap Open Enrollment period, which occurs during the first six months that you’re enrolled in Medicare Part B. During your Medigap Open Enrollment Period, you cannot be denied coverage, regardless of your age or medical history. Outside of this period of time and some other guaranteed issue periods, you may have to go through medical underwriting (answering questions about your age and health history), and insurance companies can reject your application.
The Nevada Medigap Birthday Rule
In 2021 the Nevada legislation enacted (AB250) that provides Medigap enrollees with an annual opportunity to switch to a different plan. This provision took effect in 2022. It ensures that Medigap enrollees in Nevada have a 60-day window, starting the first day of their birthday month, during which they can switch to any other available Medigap plan that has equal or lesser benefits. Medigap plan change applications submitted during this window are guaranteed-issue, Actually it's called an OPEN ENROLLMENT which means the application cannot be rejected and the insurer cannot increase the premium due to medical history (equal or lesser value means the plan can be at the same letter level as the one they have, or any of the lower levels, but not a higher level).
Several other states already had similar “birthday rule” annual plan change windows for Medigap enrollees, but the majority of the states do not. To be clear, anyone with Original Medicare can apply for any available Medigap plan at any time. But after the initial enrollment window has passed, insurers can use medical underwriting to determine whether the applicant is eligible for coverage. Nevada’s new law ensures that people with medical conditions aren’t stuck with their current Medigap plan forever. But it does not allow a person to upgrade to a more robust Medigap plan. And it also does not allow a Medicare beneficiary who doesn’t already have Medigap to enroll in a Medigap plan (after their initial enrollment window) on a guaranteed-issue basis.
If you already have a Medigap plan, you’re eligible for a special Medigap enrollment period that starts on the first day of your birth month and lasts for 60 days after. During this period, you can switch to any Medigap plan with equal or lesser coverage without going through medical underwriting.
Las Vegas and Nevada Part D (Prescription Drug Coverage) Plans
Las Vegas and Nevada Medicare beneficiaries can secure prescription drug coverage through a Medicare Advantage plan that includes Part D coverage or through one of Nevada’s 23 stand-alone Part D plans. Plan availability varies by county. For example, Clark County has 23 available plans with monthly premiums ranging from $0.00 to $118.40. When looking at these plans, it’s important to not only look at the premiums, but also the price of the prescriptions you take.
Even if you aren’t currently taking any prescription medications, you should consider getting one of the lower-cost drug plans to avoid the Part D Late enrollment penalty in case you do need prescription coverage later on.
Medicare Part D enrollment is available during the annual election period from October 15 to December 7. You may change your mind more than once during this window; the last plan you pick will take effect January 1 of the coming year.
Getting help paying for prescription drug coverage
Medicare Extra Help Program
(find out more-click on the words above)
Medicare beneficiaries with low income and resources may be eligible for the Extra Help program.
Extra Help (also known as the Part D Low-Income Subsidy) helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance.
You automatically qualify for Extra Help if you:
If you don’t automatically qualify for Extra Help, you can learn more about the program by access the information on our Medicare Help page or by giving us a call or dropping us an email or text. As licensed Advisors here in Las Vegas and Nevada we know the Guidelines and what you need to do to apply for and receive "Extra Help" We can walk you through the application.
Additional Ways to save on Medicare prescription coverage in Las Vegas and Nevada
Get help paying for Medicare in Las Vegas and Nevada
Medicare Extra Help only helps with prescription-related Medicare expenses. The following two government programs help low-income Medicare beneficiaries with additional Medicare expenses.
Las Vegas and Nevada Medicaid
(find out more-click on the words above)
Medicaid is a joint federal and state government program that helps low-income individuals get access to healthcare. States are responsible for running Medicaid programs, so each is a little different. The Las Vegas and Nevada Medicaid program is run by the Department of Health and Human Services (DHHS).
Medicare Savings Programs
(find out more-click on the words above)
Medicare Savings Programs (MSPs) are included in Las Vegas and Nevada Medicaid programs. MSPs help Medicare beneficiaries with low income and resources pay for Medicare-related expenses. There are four Medicare Savings Programs available to Nevada residents:
Get a summary of Medicaid programs for Medicare beneficiaries in Las Vegas and Nevada by accessing the information on our Medicare Help page or by reaching out to us.
Supplemental Security Income (SSI) BenefitsEligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:
You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.
Las vegas and Nevada Medicare Eligibility and Enrollment Steps
If you are a US citizen and meet one of the following criteria, you are eligible for Medicare:
Three simple steps for Nevada Medicare enrollment:
You first become eligible for Medicare during your Initial Enrollment Period, which is a 7-month period surrounding your 65th birthday.
Your Initial Enrollment Period starts three months before and ends three months after the month you turn 65.
There are 652,000 Medicare beneficiaries in Nevada, making up 18% of the total population. 14% of Las Vegas and Nevada Medicare beneficiaries are also on Medicaid. For those with limited incomes and resources, Las Vegas and Nevada Medicare beneficaries have 4 Medicare Savings Plan Options available to them.
Enrollment for Medicare Advantage vs. Original Medicare in Las Vegas and Nevada
Las Vegas Nevada Medicare beneficiaries have choices when it comes to getting their Medicare benefits. They can choose to either get these benefits thru "Original Medicare" or they can choose a Medicare Advantage Plan, Known as Medicare Part C. Medicare Advantage is a bundled approach to Medicare, and plans are provided and managed by private insurance companies. Those on Original Medicare can also enroll in a Medicare Supplement (Medigap) plan and/or a prescription drug plan. 56% of Nevada Medicare beneficiaries are on Original Medicare and the other 44% have chosen Medicare Advantage plans (source). Below is a summary of the Pros and Cons of both Medicare Advantage and Orogonal Medicare with Supplemental Insurance.
Las Vegas and Nevada Medicare Advantage Plans
(find out more-click on the words above)
Medicare Advantage plans, also known as Medicare Part C plans, are offered by private insurance companies approved by Medicare. These plans provide an alternative to Original Medicare by combining the benefits of Parts A and B into a single plan. Medicare Advantage plans often include additional benefits like prescription drug coverage and may offer extras such as dental, vision, and fitness programs. They also have downsides though. These plans must offer at least the same level of coverage as Original Medicare, but each has its own cost-sharing structures and rules, and this can result in more surprises. Additionally, Medicare Advantage plans limit you to provider networks and also may require prior authorization for some healthcare services, which can slow down treatment.
44% of Nevada Medicare beneficiaries choose to enroll in one of the 68 Medicare Advantage plans available statewide. Plan availability varies by zip code, and the details of every plan, including premiums, deductibles, networks, and ratings vary. For example, Clark County has 46 Medicare Advantage plans available from twelve insurance carriers. The monthly premiums range from $0 to $34. Washoe County has 31 plans available from eleven carriers. The monthly premiums of these 31 plans range from $0 to $180.
Las Vegas and Nevada Medicare Supplement Plans
(find out more-click on the words above)
Medicare Supplement plans, also known as Medigap plans, are private insurance policies that help fill the gaps in coverage left by Original Medicare (Parts A and B). These plans are designed to cover the 20% of costs not covered by Original Medicare, allowing for better financial predictability among Medicare beneficiaries. Nationwide, Medicare beneficiaries have ten Medigap plan options. These plans are standardized and regulated by the federal government, meaning that the coverage remains consistent across insurance companies, although prices may vary. These plans work alongside Original Medicare and can be used at any healthcare provider that accepts Medicare (which is about 90% of doctors nationwide).
When you enroll in a Medicare Supplemental plan matters! The best time to enroll is during the Medigap Open Enrollment period, which occurs during the first six months that you’re enrolled in Medicare Part B. During your Medigap Open Enrollment Period, you cannot be denied coverage, regardless of your age or medical history. Outside of this period of time and some other guaranteed issue periods, you may have to go through medical underwriting (answering questions about your age and health history), and insurance companies can reject your application.
The Nevada Medigap Birthday Rule
In 2021 the Nevada legislation enacted (AB250) that provides Medigap enrollees with an annual opportunity to switch to a different plan. This provision took effect in 2022. It ensures that Medigap enrollees in Nevada have a 60-day window, starting the first day of their birthday month, during which they can switch to any other available Medigap plan that has equal or lesser benefits. Medigap plan change applications submitted during this window are guaranteed-issue, Actually it's called an OPEN ENROLLMENT which means the application cannot be rejected and the insurer cannot increase the premium due to medical history (equal or lesser value means the plan can be at the same letter level as the one they have, or any of the lower levels, but not a higher level).
Several other states already had similar “birthday rule” annual plan change windows for Medigap enrollees, but the majority of the states do not. To be clear, anyone with Original Medicare can apply for any available Medigap plan at any time. But after the initial enrollment window has passed, insurers can use medical underwriting to determine whether the applicant is eligible for coverage. Nevada’s new law ensures that people with medical conditions aren’t stuck with their current Medigap plan forever. But it does not allow a person to upgrade to a more robust Medigap plan. And it also does not allow a Medicare beneficiary who doesn’t already have Medigap to enroll in a Medigap plan (after their initial enrollment window) on a guaranteed-issue basis.
If you already have a Medigap plan, you’re eligible for a special Medigap enrollment period that starts on the first day of your birth month and lasts for 60 days after. During this period, you can switch to any Medigap plan with equal or lesser coverage without going through medical underwriting.
Las Vegas and Nevada Part D (Prescription Drug Coverage) Plans
Las Vegas and Nevada Medicare beneficiaries can secure prescription drug coverage through a Medicare Advantage plan that includes Part D coverage or through one of Nevada’s 23 stand-alone Part D plans. Plan availability varies by county. For example, Clark County has 23 available plans with monthly premiums ranging from $0.00 to $118.40. When looking at these plans, it’s important to not only look at the premiums, but also the price of the prescriptions you take.
Even if you aren’t currently taking any prescription medications, you should consider getting one of the lower-cost drug plans to avoid the Part D Late enrollment penalty in case you do need prescription coverage later on.
Medicare Part D enrollment is available during the annual election period from October 15 to December 7. You may change your mind more than once during this window; the last plan you pick will take effect January 1 of the coming year.
Getting help paying for prescription drug coverage
Medicare Extra Help Program
(find out more-click on the words above)
Medicare beneficiaries with low income and resources may be eligible for the Extra Help program.
Extra Help (also known as the Part D Low-Income Subsidy) helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance.
You automatically qualify for Extra Help if you:
- Get full Medicaid coverage from Nevada
- Nevada pays your Part B premium
- You’re eligible for Supplemental Security Income (SSI)
If you don’t automatically qualify for Extra Help, you can learn more about the program by access the information on our Medicare Help page or by giving us a call or dropping us an email or text. As licensed Advisors here in Las Vegas and Nevada we know the Guidelines and what you need to do to apply for and receive "Extra Help" We can walk you through the application.
Additional Ways to save on Medicare prescription coverage in Las Vegas and Nevada
- Change pharmacies - Pharmacies charge different prices and some Medicare plans have preferred pharmacies where costs are extra low. One of our Nevada Medicare agents can help you find the pharmacy that saves you most.
- Switch the brand or form - Changing to a different brand (or generic) medication and considering different forms (e.g., tablet to pill) could help you save money each month.
- Shop around during the Open Enrollment Period - Medicare plans change every year. Look into any changes your drug plan makes, and check pricing on other plans each year to be sure you’re always getting the best value.
Get help paying for Medicare in Las Vegas and Nevada
Medicare Extra Help only helps with prescription-related Medicare expenses. The following two government programs help low-income Medicare beneficiaries with additional Medicare expenses.
Las Vegas and Nevada Medicaid
(find out more-click on the words above)
Medicaid is a joint federal and state government program that helps low-income individuals get access to healthcare. States are responsible for running Medicaid programs, so each is a little different. The Las Vegas and Nevada Medicaid program is run by the Department of Health and Human Services (DHHS).
Medicare Savings Programs
(find out more-click on the words above)
Medicare Savings Programs (MSPs) are included in Las Vegas and Nevada Medicaid programs. MSPs help Medicare beneficiaries with low income and resources pay for Medicare-related expenses. There are four Medicare Savings Programs available to Nevada residents:
- The Qualified Medicare Beneficiary (QMB) Program pays for Medicare Part A and Part B premiums, deductibles, and coinsurance.
- The Specified Low-Income Beneficiary (SLMB) Program pays for your Medicare Part B premium.
- The Qualifying Individual (QI) Program pays for your Medicare Part B premium.
- The Qualified Disabled Working Individual (QDWI) Program pays for the Medicare Part A premium.
Get a summary of Medicaid programs for Medicare beneficiaries in Las Vegas and Nevada by accessing the information on our Medicare Help page or by reaching out to us.
Supplemental Security Income (SSI) BenefitsEligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:
- You are 65 and older, blind, or have a disability
- You have limited income and limited resources
You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.
Las vegas and Nevada Medicare Eligibility and Enrollment Steps
If you are a US citizen and meet one of the following criteria, you are eligible for Medicare:
- You’re 65 or older
- You have certain disabilities, like End-Stage Renal Disease or ALS
Three simple steps for Nevada Medicare enrollment:
- Enroll in Original Medicare (Part A & Part B)
- Choose your additional Medicare Insurance coverage
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (drug coverage)
- Set yourself up for success by finding doctors, sharing your plan information with your pharmacy, and accessing additional benefits that come with your coverage.
You first become eligible for Medicare during your Initial Enrollment Period, which is a 7-month period surrounding your 65th birthday.
Your Initial Enrollment Period starts three months before and ends three months after the month you turn 65.
Representing many of the Private Insurance companies that sell:
Medicare Advantage Plans, Medicare Part D and Medigap Supplemental Insurance
We are licensed in the following states as an Insurance Marketing Group:
*Nevada #210603 *Arizona License #2147056 *Utah License #234923 *Idaho 773252 *California #4053866 *Oregon 2147056,*Washington State 919217 *Texas #1873256 *New Mexico 2147056
Medicare Advantage Plans, Medicare Part D and Medigap Supplemental Insurance
We are licensed in the following states as an Insurance Marketing Group:
*Nevada #210603 *Arizona License #2147056 *Utah License #234923 *Idaho 773252 *California #4053866 *Oregon 2147056,*Washington State 919217 *Texas #1873256 *New Mexico 2147056
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Not Connected with or endorsed by the United States Government or the Federal Medicare Program
Medicare has neither reviewed nor endorsed this information
"We do not offer every plan in your area. Currently we represent 11 organizations which offer 68 products in your area.
Please contact www.Medicare.gov, or your local State Health Insurance Program (SHIP) to get information on all of your options"
A licensed insurance sales agent may mail, call or e-mail as a result of completing any informational forms on this website to discuss Medicare Advantage (Part C) plans, Medicare Part D Prescription Drug Plans or Medicare Supplement Insurance.
Please Note:
Clicking on any of the links provided will take you from our Medicare Information website to a non-Medicare information or to a different website.
Medicare has neither reviewed nor endorsed this information
"We do not offer every plan in your area. Currently we represent 11 organizations which offer 68 products in your area.
Please contact www.Medicare.gov, or your local State Health Insurance Program (SHIP) to get information on all of your options"
A licensed insurance sales agent may mail, call or e-mail as a result of completing any informational forms on this website to discuss Medicare Advantage (Part C) plans, Medicare Part D Prescription Drug Plans or Medicare Supplement Insurance.
Please Note:
Clicking on any of the links provided will take you from our Medicare Information website to a non-Medicare information or to a different website.