The federal Medicare program is designed to provide affordable health care coverage for senior citizens 65 years of age and older. If you are approaching the age of 65, you should be preparing to enroll in the Medicare program as soon as possible. Once you are enrolled, you will start by receiving benefits from Medicare Part A and Medicare Part B – also known as Traditional Medicare. The chart below will explain which parts cover what benefits.
Coverage and Benefits
The program is designed to be as affordable as possible for retired persons living on a fixed income. For this reason, Part B has monthly premiums and an annual deductible (which you can learn more about by clicking here). Every Medicare beneficiary must pay these costs. However, if you have a long enough employment history, you may get a break on Part A. If you have been employed for more than ten years, or forty quarters, you won’t have to pay the annual deductible associated with Part A. Anything less than that, however, and you will be required to pay the additional expense before receiving hospital benefits from Part A.
Nevada residents can begin making use of Medicare health insurance at the age of 65. Medicare is available to all residents and is free to those that have worked at least 10 years or 40 quarters during their lifetime. If you enroll in Medicare in Nevada you are automatically enrolled into Medicare Part A, the most basic form of Medicare coverage. In this part you get inpatient coverage, some outpatient coverage and coverage for hospice care and nursing home care. If you want additional coverage, you can spend a bit more money to upgrade and also enroll in Medicare Part B. From Part B you get additional outpatient services, more preventative care and greater inpatient coverage as well.
Patients with Medicare Parts A and B that would like further coverage are eligible for Medicare Part C also known as Medicare Advantage and Medicare Part D or prescription coverage. Medicare Advantage is a form of private insurance that offers standard Medicare coverage and additional coverages as well. Medicare Part D is specifically to pay for prescription medications and can be added on to a current policy if you pay the premium to do so. There are several different types of Medicare coverage and you can make use of them by signing up and paying the premiums of what you are interested in getting coverage for.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
The Different Medicare Plans in Nevada Today
Nevada has a significant population of 379,860 seniors who are currently receiving Medicare benefits. Of those, one third (125,353 people) have replaced their Traditional Medicare plan with a Medicare Advantage policy. An additional 46,390 seniors (or 12%) are supplementing their Medicare with a Medigap policy. As for the other 55%, well, it’s hard to say. They could either be enjoying additional coverage and benefits through an employer, or they may be relying on Traditional Medicare alone to help cover their medical expenses.
Are you unsure of your Medicare status? If you have any questions about your status or your enrollment period, you can click here for more information about Medicare benefits.
Why is Supplemental Coverage so Important?
Even if you are newly retired and aren’t in poor health right now, supplemental coverage can be invaluable in the future when your health care needs increase. You see, Traditional Medicare can only provide you with a certain amount of coverage. The coverage which it does not provide you with, often referred to as “coverage gaps”, will likely be your responsibility to pay out of pocket. And when that happens, you could get slammed with thousands of dollars in medical bills.
|Medicare Part A Costs||Medicare Part B Costs|
Fortunately, it is possible to protect yourself from these potentially expensive coverage gaps. The top two methods most seniors choose are Medigap supplement insurance, and Medicare Advantage policies. We’ll go into detail about each option now.
About 35% of all residents eligible for Medicare in Nevada are using some form of an added insurance policy such as Medigap or Medicare Advantage to help cover the costs of quality health care. People today are paying more for medical care than they ever have in the past, and for that reason they often have to resort to making use of added insurance policies to protect themselves against excessive medical costs.
Many seniors are turning to supplemental health insurance policies available today, and there are many of them to choose from. These policies don’t do away with Medicare, but they do help add to the coverage and reduce the out-of-pocket costs that you are expected to pay when you have Medicare.
If you’re looking for a tool to help with filling your Medicare coverage gaps, an added insurance policy could be just the thing for you. Consider adding one onto your current Medicare plan to curb your costs. There are several to choose from and whether you get an Advantage plan or a Medigap policy, it could be just what you need to reduce the costs that are left behind after Medicare pays towards your healthcare.
If you need additional insurance coverage other than what you’re getting from Medicare Part A and Medicare Part B, you can choose from either Medigap or Medicare Advantage for the coverage that you need. Both plans offer added protection against healthcare costs, but they accomplish that protection in different ways.
Medigap Policies in Nevada
Nevada Medigap insurance is the same as it is in any other state – the only thing that changes from one location to the other is the price, and the insurance provider. This is because the government works in tandem with private insurance companies to make sure that all ten of the available Medigap plans give you a cost-effective and comprehensive form of coverage. You have the option to choose between plans A, B, C, D, F, G, K, L, M, and N. Each plan was crafted with known Medicare coverage gaps in mind to precisely reduce potential out-of-pocket medical expenses.
Top Medicare Supplement Plans in the Area
|Type||Starting From||Part A Deductible||Part B Deductible||Excess||Nursing||Travel|
|F||$93||$0||$0||100% Covered||100% Covered||100% Covered||Request Info|
|C||$128||$0||$0||Not Covered||100% Covered||100% Covered||Request Info|
|G||$103||$0||$147||100% Covered||100% Covered||100% Covered||Request Info|
|B||$104||$0||$147||Not Covered||Not Covered||Not Covered||Request Info|
|N||$80||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|D||$116||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|A||$76||$1||$147||Not Covered||Not Covered||Not Covered||Request Info|
|L||$77||$304||$147||Not Covered||75% Covered||Not Covered||Request Info|
|K||$54||$608||$147||Not Covered||50% Covered||Not Covered||Request Info|
|M||$105||$608||$147||Not Covered||100% Covered||100% Covered||Request Info|
Nevada Medicare Advantage Options
Medicare Advantage is another way of saying “Medicare Replacement Insurance”, because that is exactly what such policies do. They are underwritten by private insurance companies, and are legally required to provide you with the exact same (or better) benefits that you are currently getting from Traditional Medicare. With any luck, you may be able to add additional coverages and benefits to your policy – such as dental or vision – for a relatively affordable additional expense.
However, make sure you do some research into your Medicare Advantage provider network before you finalize a policy. While Advantage plans offer reasonably priced options, they do so at the expense of restricting their networks. For some seniors, this might mean having to choose between affordable health care, and a doctor they trust.
Medicare Advantage networks offer care to their members through either HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) networks. Your location, as well as the company which underwrites your policy, will determine which doctors and facilities you can visit.
Medigap vs. Medicare Advantage: Comparing the Two Most Popular Plans
Before you purchase Medicare Advantage or Medicare Supplement, you need to know what each of the policies has to offer. One major difference between the two is how healthcare policy payouts are handled. With Medicare Supplement (Medigap) your payouts from the policy are handed out after Medicare does its thing. You go in for healthcare, Medicare pays for some of the costs that you build up, Medigap pays for some of the costs that are left over, and the remaining costs become yours. With a comprehensive enough Medigap policy you won’t have any costs to worry about in the end.
Each of the two insurance policies are issued through a private insurance company, but they are very different programs. Medigap is a very standardized program with the same benefits no matter what insurance company you go through or what state you live in. It makes no difference who you work with, if you get a specific plan tier from one company, you’ll enjoy the same benefits that you would have had from a different company. That’s not the case with Medicare Advantage.
Medigap is a simple plan but Medicare Advantage is more complex. The plan offers the standard coverage included with Medicare Part A and Medicare Part B, but it also features extras. These extras make things more complicated when attempting to choose the right plan for yourself. You can add on dental, vision, prescription drug coverage and additional services that aren’t included with Original Medicare, but you have to compare policies carefully to get the best one.
Finally, you have to consider how pricing works with each of the policies. With Medigap the pricing is simple to understand. There’s a monthly premium to pay and there’s the uncovered portion of every healthcare service that you make use of. With Medicare Advantage prices vary and they depend on what part of Nevada you live in, what policy that you go with, what level of coverage you choose and the different healthcare services that you need. Prices can change, and they are much more difficult to track.
Here are several differences between the two different insurance add-ons. We covered most of those key differences above, but we dig into common questions and answers about the policies down below. Keep reading to learn more or talk with our team of specialists for the help that you need choosing a new Medicare policy.
|Questions||Medicare Advantage||Medicare Supplement|
|How are expenses covered under each plan?||First an estimate of expenses is put together based on medical costs in your area. Then the insurance company decides on a premium that you have to cover. Medicare pays for part of the premium and you pay the remaining balance on that premium for your medical coverage.||Medicare pays its portion of your healthcare expenses, then your Medigap policy covers a portion of the remaining balance, or all the balance if you get a very comprehensive plan. Finally, you are expected to pay the rest.|
|Will I still have to pay for Part B?||Yes||Yes|
|What will it cost me?||Medicare Advantage plans can be large and can be complicated. This makes it tough calculating the exact costs that you’ll be paying. They fluctuate based on how much care you need as well.||A Medigap policy will cost you the monthly premium and any remaining balance left over after paying. With a comprehensive policy the premium is all you will pay for covered care.|
|What will the plan cover?||Advantage plans cover Medicare parts A and B as well as any add-ons that you want to put on the policy. Different plans include extras like dental or prescription coverage.||Medigap policies cover just Medicare parts A and B and nothing else. They just add to the coverage for you, so you pay less out-of-pocket.|
|Is it easy to budget my health care expenses?||Not really. Budgeting with an Advantage plan is difficult because costs fluctuate with the care you need and with the market over time. Your costs could go up or down. If you don’t need much care, budgeting for the plan will be easier though.||If you’re using a comprehensive Medigap policy, budgeting is very simple. You just pay your premium and that’s it. If it isn’t a comprehensive policy, you will need to pay your premium and added care costs left over after you receive your care.|
|Is my plan guaranteed? Or can it be cancelled?||It is possible for Advantage plans to be cancelled. Usually plans can be cancelled during the renewal period each year.||Medigap plans are guaranteed as long as you pay your premium each month and your company does not go out of business.|
|Do I need to go through a pre-approval process before getting this plan?||Yes. It’s likely that you will need to go through a pre-approval process to get a Medicare Advantage policy.||No, the only sort of approval you need is to qualify for Medicare.|
|Must I work with a specific network of doctors and hospitals with this plan?||Yes, you will be limited to a specific network of doctors and hospitals on an Advantage plan.||You’ll enjoy more options to choose from with a Medigap policy and can go anywhere that Medicare is accepted.|
|Which of these plans is my best option?||Medicare Advantage is best if you have few medical needs and you live in an area with lots of hospitals and doctors to choose from.||Medigap is best if you have many healthcare needs, or you live in a location that doesn’t have too many doctors and hospitals to choose from.|
Nevada Medicare Offices & Contact Information
If you still have questions, that is perfectly understandable. Below is a directory filled with contact information you can use to ask Medicare insurance experts near you for all the answers you need. After all, your health is important – you should be as well informed as possible before making any serious decisions.
Choose at least one topic area you are interested in: Select All
Help with my Medicare options & issues
Other insurance programs
Complaints about my care or services
General health & health conditions
Claims & billing
Health care facilities & services in your area
Important Medicare Terms
- HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
- PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
- Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
- Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
- Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.