Medicare Supplement Plans in Nevada

Summary: Medicare Supplement plans in Nevada offer supplemental coverage to fill in the out-of-pocket expense gaps of Original Medicare. Learn all about Medigap plans in Nevada and how they can benefit you. Estimated Read Time: 12 mins

Table of Contents:

1. Best Medicare Supplement Plans in Nevada
2. Eligibility for Medigap Plans in Nevada
3. What is the Cost of Nevada Medicare Supplement Plans?
4. Companies Offering Medigap Plans in Nevada
5. Medigap Plans in Nevada for the Disabled Under 65
6. Medicare Supplement Plan Rating Methods in Nevada
7. Medigap Guaranteed Issue Protections in Nevada
8. When to Enroll in Medigap Plans in Nevada
9. Does Nevada Allow Medicare Excess Charges?
10. What is the Nevada Birthday Rule?
11. Additional Medicare Coverage Options in Nevada

Medicare Supplement plans in Nevada (or Medigap plans) can help fill the gaps in out-of-pocket costs that Original Medicare (Medicare Part A and Part B) leaves behind.

Medicare Part B only covers 80% of the services and equipment that Medicare approves. As the name suggests, Medigap plans are there to provide gap coverage by paying 20% of expenses for Medicare benefits you would otherwise be responsible for.

It’s important to note that Medicare Supplement policies are not issued by the federal government like Original Medicare is. Instead, private insurance companies that follow strict federal guidelines offer this supplemental coverage.

If you are a Nevada senior on Medicare, it may be in your best interest to review the Medicare Supplement options in your area and understand their benefits.

Below, we review Medicare Supplement plans in Nevada, what they cover, average costs, and how they can meet your healthcare needs.

Best Medicare Supplement Plans in Nevada

Various private insurance carriers offer up to 10 different Medicare Supplement insurance plans in Nevada. Regardless of which company you choose, the Medigap plan benefits stay the same. You can also use your policy with any physician who accepts Original Medicare because Medigap plans don’t have networks.

This is because all Medicare Supplement plans in Nevada are standardized. For example, if you enroll in Medigap Plan G with Aetna or if you enroll with Cigna, the benefits for Plan G will be the same with either of those carriers or any other insurance company offering Medigap plans in Nevada.

When it comes to budget and healthcare needs, there is no one-size-fits-all best plan for everyone. However, many Medicare beneficiaries find that Nevada Medicare Supplement Plans F, G, or N suit what they’re looking for in affordable and comprehensive coverage.

Medicare Supplement Plan F in Nevada

Medicare Supplement Plan F in Nevada offers the most comprehensive coverage of the three plans but is only available to select Medicare enrollees. To be eligible for this plan, you must enroll in Original Medicare before January 1, 2020.

Medigap Plan F in Nevada covers 100% of your out-of-pocket costs after Original Medicare pays its portion. The only out-of-pocket cost on this plan is the monthly premium.

Medigap Plan F in Nevada includes:

• Part A deductible, coinsurance costs, hospital costs, and hospice care coinsurance
• Part B deductible, copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Nevada is one of three states that also offers Innovative Plan F. Innovative Plan F is not offered by all carriers but includes all the same benefits as standard Plan F, with additional benefits such as vision coverage. 

Medicare Supplement Plan G in Nevada

Medicare Supplement Plan G in Nevada is the next best plan and the top option for those who do not qualify for Medicare Supplement Plan F. If you enroll in Medicare Supplement Plan G in Nevada, you receive 100% coverage for your out-of-pocket costs after you meet the Medicare Part B deductible.

Medigap Plan G in Nevada includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan N in Nevada

Lastly, Medicare Supplement Plan N in Nevada is your best option if you want comprehensive coverage for a low monthly premium. If you enroll in Plan N, you are responsible for covering the Medicare Part B deductible, a $20 copay at the doctor or specialist, a $50 copayment at the emergency room (if not admitted), and excess charges, if applicable.

Medigap Plan N in Nevada includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays/coinsurance
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Although this plan comes with more out-of-pocket responsibility, if you do not go to the doctor often, this may be a good choice for you.

Who is Eligible for a Medicare Supplement Plan in Nevada?

To be eligible for Medicare Supplement plans, Nevada residents must meet the eligibility requirements for Original Medicare. These requirements typically include:

• Being at least 65 years old.
• Being a United States citizen for at least five years.

There are exceptions to these requirements that may allow individuals to qualify for a Medicare Supplement insurance plan at a younger age. These exceptions include:

• Being diagnosed with end-stage renal disease (ESRD). However, any Medicare coverage won’t start until after a waiting period, which is typically four months of undergoing dialysis. 
• Being diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
• Receiving Social Security Disability Insurance (SSDI) for at least 24 months.

It’s important to note that if you are currently enrolled in a Medicare Advantage plan (Medicare Part C) and wish to enroll in a Medigap plan, you will need to choose one or the other. It is not possible to have both types of coverage simultaneously.

Before applying for a Medigap policy, you must first disenroll from your Medicare Advantage plan, which can only be done during valid election periods. These periods include the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period.

What is the Cost of Nevada Medicare Supplement Plans?

The cost of a Medicare Supplement plan in Nevada depends on age, gender, level of coverage, location, and other factors.  For example, someone in Las Vegas with Medicare Supplement Plan G Nevada has the same coverage as someone else in Reno with Medigap Plan G with another carrier. However, the premium will differ.

The chart below compares the average premium rates of a 65 and 75-year-old male and female in the same Nevada ZIP Code.

* If on Medicare before 1/1/20

*Sample costs sourced from Medicare.gov

Remember, the chart above is just an example of an average premium range. Your actual costs may be higher or lower than those listed above due to the aforementioned factors or other personal factors.

Companies Offering Medigap Plans in Nevada

When it comes to Medigap plans in Nevada, seniors have the option to choose from various reputable insurance carriers. Assessing your healthcare needs and budget will help you determine which insurer is the right fit for you. Here are some of the top companies offering Medicare Supplement plans in Nevada:

• Aetna
• Anthem/Blue Cross Blue Shield of Nevada
• Cigna
• Humana
• AARP/UnitedHealthcare

While the cost of monthly premiums is an important consideration when selecting a Medicare Supplement insurance company, there are other factors to consider as well. Independent credit agencies like A.M. Best and S&P assess the financial stability of insurance providers, providing insights into their ability to cover your healthcare expenses effectively. Additionally, consumer agencies like the Better Business Bureau (BBB) evaluate customer service based on complaints, giving you valuable information about the overall consumer experience. Taking all these factors into account will allow you to make an informed decision when choosing a Medigap insurer for your supplemental coverage in Nevada.

Medicare Supplement Eligibility for Disabled Individuals Under 65

If you receive SSDI benefits for 24 months or are diagnosed with amyotrophic lateral sclerosis or end-stage renal disease, you are eligible for Original Medicare. Some states require insurance carriers to offer Medicare Supplement plans to those under 65. However, Nevada does not have this requirement. The Silver State does not require Medigap companies to provide Medicare Supplement plans in Nevada to those under 65.

While not required, some carriers may offer a short list of Medicare Supplement plans in Nevada to those under 65 at inflated premium rates. Due to these high costs, many Medicare enrollees under 65 turn to Medicare Advantage plans for coverage. This way, you will at least have a cap on out-of-pocket spending and may receive additional benefits specific to your disability.

However, once you turn 65, you will receive another Medigap Open Enrollment opportunity. At this time, many Medicare enrollees under 65 will switch to Medigap at a much lower premium.

Medicare Supplement Rating Methods in Nevada

There are three rating methods for Medigap policies in Nevada. They are:

• Attained-Age Rated
• Issue-Age Rated
• Community Rated

Most Medigap insurers in Nevada use the attained-age rating method. This means that the premiums for Medicare supplements are based on your current age. Initially, when you enroll in a Medigap policy, the premiums are typically lower and gradually increase as you age. This increase in premiums is usually due to the higher healthcare costs associated with aging and the greater use of medical services.

Under the issue-age rating method, the premium is based on your age at the time of enrollment. Generally, if you enroll as soon as you are eligible at 65, you will have lower premiums that do not increase solely due to age. However, the premium may still increase over time due to factors such as inflation.

With the community-rated method, all individuals enrolled in the same Medigap plan in a specific geographic location pay the same premium, regardless of their age. Similar to the issue-age rating method, the premium may increase due to external factors like inflation, but not based on age.

Medigap Guaranteed Issue Protections in Nevada

Under federal law, Medicare Supplement plans are required to provide guaranteed issue protections, commonly referred to as guaranteed issue rights or GI rights. These protections ensure that individuals in Nevada can enroll in a Medigap plan without facing coverage denial or higher premiums based on pre-existing conditions. The purpose of these protections is to ensure access to Medigap coverage when it is needed.

One significant guaranteed issue right is the Medicare Advantage trial period. If you initially joined a Medicare Advantage (Part C) plan when you first became eligible for Medicare and decide to disenroll within the first year, you have a one-time guaranteed issue right to enroll in a Medigap plan. This allows you to obtain Medigap coverage without undergoing medical underwriting.

Another important protection is available for those who experience a loss of coverage. If you lose employer-based retirement coverage or if your current Medigap plan is terminated or discontinued, you have a guaranteed issue right to enroll in another Medigap plan.

This guaranteed issue right also applies if you move out of state and your Medigap carrier is no longer available. To qualify for this protection, you must apply for a new Medigap plan within 63 days of the termination of your existing plan.

Additionally, there are guaranteed issue rights associated with Medicare Advantage plans. If your Medicare Advantage plan is terminated, you move out of its service area, or you lose coverage due to circumstances beyond your control, you have a guaranteed issue right to enroll in a Medigap plan. To be eligible for this protection, you must apply for a Medigap plan within 63 days of the termination of your Medicare Advantage plan.

When to Enroll in a Medigap Plan in Nevada

Once you enroll in Medicare Part B, whether due to age or disability, you have a 6-month Medigap Open Enrollment Period to select a Medicare supplement policy. During this period, you are guaranteed coverage with the plan and company of your choice. You have the option to choose from a list of standardized plans labeled A through L.

It is important to note that if you do not purchase a plan within this 6-month open enrollment period, you will be subject to medical underwriting, and insurance companies may charge higher monthly premiums or deny coverage altogether based on your health conditions when you apply.

Does Nevada Allow Medicare Excess Charges?

Medicare Part B excess charges are a rare additional cost on top of the Medicare-approved amount for a service. Excess charges apply only when your provider accepts Medicare but does not accept Medicare assignment.

If your provider does not accept Medicare assignment, they may bill you for an additional 15% excess charge. Although these charges are rare, Nevada allows physicians who do not accept Medicare assignment to bill for them. However, if your doctor accepts Medicare assignment, you will never be responsible for an excess charge.

What is the Nevada Birthday Rule?

Nevada has an annual birthday rule when Medicare Supplement policyholders can change their Medigap selection. The 60-day window opens on the first day of a beneficiary’s birthday month each year.

During this time, if you already have a Medicare Supplement policy, you will have an opportunity to switch plans and/or carriers without answering underwritten health questions. Yet, you may only switch to a Medicare Supplement policy of equal or lesser coverage.

You will need to answer underwriting health questions if you wish to switch Medicare Supplement plans in Nevada outside your birthday rule open enrollment window. Yet, in this case, pre-existing health conditions may prevent you from obtaining the coverage of your choice.

Additional Medicare Coverage Options in Nevada

Medicare Supplement plans in Nevada are not the only options for health insurance coverage in Nevada. When you enroll in Medicare Part A, Part B, or both, you may sign up for a Medicare Part D plan.

Medicare Part D is a vital part of your Medicare coverage. This plan allows you to receive prescription drug coverage. Enrolling in a Medicare Part D plan as soon as you’re eligible is essential to avoid the Medicare Part D late enrollment penalty.

If you decide a Medicare Supplement plan is not for you, you can always sign up for a Medicare Advantage (Medicare Part C) plan in Nevada. Medicare Advantage plans are an excellent option for enrollees who do not mind navigating a provider network and wish to have a lower monthly premium. However, Medicare Advantage plans often do come with more out-of-pocket costs.

Lastly, ancillary coverage through dental, vision, and hearing plans are available in Nevada. These options can provide helpful coverage alongside Original Medicare and a Medigap plan.