Nevada residents can obtain health insurance if they are over the age of 65, or if they have disabilities (even when employed). Nevada Medicare insurance is is a federally-funded program, but the Nevada state government also offers certain assistance programs for its Medicare beneficiaries.
The core Medicare coverage is from Original Medicare, with Part A and Part B. Medicare Part A covers hospital services including inpatient care. Medicare Part B covers outpatient care, preventive services, and durable medical supplies.
Typically, beneficiaries do not have to pay a premium for Medicare Part A as most beneficiaries qualify for premium-free Part A after working for 10 years and dutifully paying taxes. Medicare Part B requires a premium, but for individuals who earn less than $85,000 a year, this premium is only $134 a month. That is much more affordable than the average cost of premiums in the state, which is $445 a month.
Both Medicare Part A and Part B come with deductibles, copays, and coinsurance. These are the out-of-pocket expenses that Medicare beneficiaries may have to cover themselves.
While Original Medicare may be obtained from Medicare directly, some beneficiaries may wish to purchase supplemental plans that add greater coverage than what Medicare Part A and Part B offer. These supplemental plans can be purchased from some Nevada private carriers that have been approved by Medicare.
These plans may cover additional health services that are not covered in Original Medicare. Other plans may cover the cost of deductibles and other out-of-pocket expenses involved with Medicare Part A and Part B.
A common supplemental plan covers the cost of Medicare prescription drugs. This type of plan is called Medicare Part D.
These plans are referred to as Medicare Part C. They combine the benefits of Original Medicare and supplemental plans into one comprehensive Medicare plan. They may be obtained from private carriers in Nevada which have Medicare approval.
Some residents of Nevada may have difficulties in paying for Medicare expenses. This isn’t surprising, as Nevada has a poverty rate of 15.2%. The state offers various Medicare Savings Programs (MSP) that provide financial assistance to certain groups of Medicare beneficiaries. To make certain that this assistance is reserved only for low-income beneficiaries, the eligibility requirements come with limits for income and resources.
Nevada residents may receive assistance from any of the 4 Medicare Savings Programs. The first is for Qualified Medicare Beneficiaries (QMB), which pays for the premiums for both Part A and also covers deductibles, copayments, and coinsurance. An individual can be eligible for the QMB program with a monthly income of less than $1,032. Married couples have a combined income limit of $1,392.
The 2nd MSP is for Specified Low-Income Medicare Beneficiaries (SLMB), and this SLMB pays for Medicare Part B premiums. The income limit for individuals is $1,234 a month while married couples cannot have a combined monthly income of more than $1,666.
The 3rd MSP is for Qualified Individuals (QI). This also pays only for Medicare Part B premiums, but the funding for the program may be more limited. To be eligible for the QI program, an individual’s monthly income should be less than $1,386. A married couple’s combined monthly income should be less than $1,872.
These 3 MSPs have a resource limit of $7,560 for individuals and $11,340 for married couples. The house the beneficiary lives in and the car they use are not counted as resources for the MSP program limit.
The 4th MSP is for Qualified Disabled and Working Individuals (QDWI). This pays for the premiums of Medicare Part A. To qualify for the QDWI program, an individual has to earn less than $4,132 a month and have resources no greater than $4,000 in value. For married couples, the combined monthly income limit is $5,572 while the resource limit is $6,000.
Nevada runs the State Health Insurance Assistance Program (SHIP) that offers free and unbiased counselling regarding Medicare and Medicaid for Nevada residents. The Southern Nevada Toll-Free Hotline is 800-307-4444, while the Northern Nevada Toll-Free Hotline is 844-826-2085.
Nevada residents can also contact Medicare at any time as they are open 24/7. The contact number for Nevada Medicaid is 1-800-633-4227.
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