Medicare Advantage in Nevada

Unlike traditional Medicare, which is split into Part A for hospital coverage and Part B for medical coverage, Medicare Advantage combines these elements under a single plan and often includes additional benefits. Most Medicare Advantage Plans cover prescription drugs, while others provide extras such as vision, dental and hearing coverage. Some plans will even pay for fitness programs and transportation to doctor’s appointments. Although Medicare Advantage does include costs such as premiums and deductibles, it streamlines coverage and benefits into a single plan, minimizing the separate premiums seniors would otherwise pay under Original Medicare enrollment. 

Medicare Advantage Plans can vary since they are offered through private insurance companies rather than the federal government. Private insurers are required to provide services equal to Original Medicare, but they can choose what additional options to include. Also, unlike the universal nature of traditional Medicare, which provides coverage for any facility or provider that accepts Medicare, Medicare Advantage usually involves a network of providers and doctors to maximize discounts. Because of this, seeing a physician outside of the network can increase out-of-pocket costs.

Medicare Advantage Plans attract a large number of the over 583,000 eligible Nevada seniors, and the plans have grown in popularity since 2022. Enrollment in 2023 sits at 49% of those eligible, which is slightly higher than the national average of 48% and reflects a 9.09% increase over the total number of enrollees in 2022. With the number of eligible enrollees only growing 2.96% over the last year, this increase is significant and indicates growing interest in these Medicare alternatives.

When deciding between Original Medicare and Medicare Advantage, older adults can use this guide to understand the key differences between the two and see what plans are available in Nevada. Seniors can also explore eligibility requirements and find plans that fit their needs and budgets.

The Top 10 Medicare Advantage Plans in Nevada

Any private health insurance provider can offer Medicare Advantage, and Nevada features numerous options from various providers. Nevada seniors can choose their care networks and additional benefits as they shop for health plans that best fit their needs. The table below shows the top 9 Medicare Advantage providers in the state based on the number of enrollees and offers price ranges for different plan options. The information provided is accurate as of July 2023. The latest information on plans available in Nevada can be viewed at Medicare.gov.

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. 

*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.

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.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources