Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare Advantage, also known as Medicare Part C, is a program that combines the benefits of Medicare Parts A and B into a single plan. Unlike Original Medicare, private insurers provide Medicare Advantage. Those insurers must at least offer Original Medicare benefits, but many insurers go further than this, providing additional benefits to their customers. Companies may provide vision and dental cover, transportation to medical appointments or other value-added services.
Medicare allows Medicare Advantage providers to set their own out-of-pocket costs but may also provide prescription drug coverage. The insurance companies have some leeway when it comes to setting rules for using in-network care providers. Beyond this, these companies must abide by the rules set by the Centers for Medicare and Medicaid Services. The Medicare Advantage program is popular in Nevada. There are just over 566,000 individuals in the state who are eligible to join Medicare Advantage, and the enrollment rate in 2020 was about 40% compared to 42% nationwide.
This guide looks at the Medicare Advantage plans available in Nevada and what those plans cover. It also discusses the eligibility requirements for Medicare Advantage in Nevada and how seniors can find the plans that best suit their individual needs.
The Top 10 Medicare Advantage Plans in Nevada
There are numerous insurance companies offering Medicare Advantage plans in Nevada. This means eligible individuals have a lot of choices in terms of networks, coverage and additional benefits. The following table lists the 10 most popular Medicare Advantage providers in the state, ranked by the number of users enrolled. Most providers offer more than one Medicare Advantage plan, so the cost information shown is a range. The enrollment figures displayed are the combined total of all the Medicare Advantage plans state providers offer. The plan information is up to date as of April 2022. Seniors can get the latest information about the plans available in their area by visiting Medicare.gov.
Name
Total Enrollment
Star Rating
Min Cost
Max Cost
Plan Types
UnitedHealthcare
100,142
4
$0
$32
HMO, PPO
Humana
69,548
4
$0
$152
HMO, PPO
Aetna Medicare
32,356
3
$0
$49
HMO, PPO
Senior Care Plus
19,013
4
$180
$180
HMO
Prominence Health Plan
16,640
3.5
$0
$0
HMO
Anthem Blue Cross and Blue Shield
13,624
3.5
$0
$0
HMO, PPO
Wellcare by Allwell
5,003
0
$0
$30
HMO, PPO
Alignment Health Plan
2,238
0
$0
$0
HMO
SelectHealth
1,441
5
$0
$0
HMO
SCAN Health Plan
1,016
0
$0
$0
HMO
How Medicare Advantage Plans Work in Nevada
Before selecting a Medicare Advantage plan in Nevada, seniors should understand the different types of available plans. Providers typically offer several plan options, including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Each plan has different requirements relating to the need for referrals, in-network care providers and how the plan handles care through out-of-network providers. Plans may also differ in terms of the prescription drug cover offered. Seniors can find descriptions of the four most common plan types below:
What Medicare Advantage Plans Cover in Nevada
Medicare Advantage plans cover everything Medicare Parts A and B cover, except hospice care. In addition to basic coverage for preventative screenings, hospital care and durable medical equipment, Medicare Advantage plans may provide additional benefits such as prescription drug coverage, hearing aids and vision or dental care. Individual insurance companies can set their own policies for what they do and do not cover outside of the federally required elements of Medicare Parts A and B.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Nevada
To qualify for Medicare Advantage, seniors must already have Medicare Parts A and B, live in the plan’s service area and meet all basic Medicare eligibility requirements. These requirements include holding U.S. citizenship or being a permanent legal resident who has lived and worked in the United States for at least five years. Nevada seniors must be aged 65 or over to qualify for Medicare or be living with a qualifying disability or illness. As with other forms of health insurance, Medicare has set enrollment periods. Seniors can only enroll in a new plan during these enrollment periods. There are also predefined periods during which seniors can change plans. The following table provides more information about enrollment periods.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Nevada
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Nevada’s Department of Health and Human Services offers an information and counseling program known as the State Health Insurance Assistance Program (SHIP). This program gives Medicare members access to a network of volunteers around the state who provide one-on-one assistance and counseling on many issues related to aging, insurance and the variety of Medicare options available. Counselors can help seniors assess which plan is the most appropriate for their needs, including eligibility and the appeal process, as well as assistance enrolling in a Prescription Drug Plan (Part D), if needed.
The toll-free counseling number for all Nevada residents is 1-800-307-4444. Help is also available from SHIP volunteers at various counseling sites and local senior centers.
Nevada Office for Consumer Health Assistance (OCHA)
The Office for Consumer Health Assistance is another resource that helps Nevada residents access health care and prescription drugs and understand their rights under various plans and policies. This includes managed care, insurance provided by an employer, the Employee Retirement Income Security Act, Medicare and Medicaid. State residents who aren’t insured, or are underinsured, can also receive assistance and access to resources from the OCHA.
Seniors can call the OCHA during regular business hours at 1-702-486-3587 or toll-free at 1-888-333-1597. Alternatively, in the case of specific issues and complaints regarding a health insurance company or hospital, seniors can print and fill out a request for assistance form.
Nevadans with low-incomes may benefit from the Medicare Savings Programs available in the state, which help people gain and maintain access to health care by paying their Medicare premiums and co-pays. As of 2020, these programs can help eligible residents save at least $104.90 per month. Eligibility is split into four categories that are largely based on income, and this eligibility category determines which benefits are provided. The specific income and resource limits for each category are listed on the website.
The Aging and Disability Services Division operates various resource centers around the state under the Nevada Care Connection program. The purpose is to help Nevadans find out which options are available for them in matters related to aging, disabilities and insurance. Caregiver support and veterans services are also available. Nevada Care Connection staff can help make health care more accessible and individualized by providing information tailored to the individual and helping them connect with appropriate governmental agencies and health care providers.
The Senior Medicare Patrol is made up of volunteers in local communities who help seniors and their families and caregivers detect and report Medicare fraud and keep their personal information secure. SMP staff give presentations at seniors fairs and community events.
