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Medicare and Nevada Medicaid


For Nevadans aged 65 or older, their income and resources may deem them dually eligible for both Medicare and Medicaid. Nevada Medicaid will assist certain low income or disabled individuals receiving Medicare Part A (hospital insurance), Part B (supplemental insurance), and/or Part D (prescription coverage), pay for their health care costs depending on their income. The state Medicaid program may pay all of your premiums or a significant portion, and if your income is low enough they will also pay for Medicare Part A deductibles and coinsurance.

There are multiple categories of assistance for Medicare through Medicaid, including Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). To be considered in one of these groups, you must have Medicare Part A, and your resources including bank accounts, stocks, and bonds are less than or equal to $6,680 for an individual, or $10,020 for a couple in Nevada.

 

Eligibility Groups

 

Additional Benefits

For those both enrolled in Medicare and receiving assistance from Medicaid, the Nevada Medicaid program offers several different benefits tailored to individuals over age 65. Though technically considered optional, these services apply to Qualified Medicare Beneficiaries and elderly individuals, and will certainly be approved if you fit one of those categories and it will ultimately save money. Services that benefit Medicare members include:

  • Podiatry for QMB eligibles
  • Chiropractic for QMB eligibles
  • Intermediate care facility services for those 65 years and older
  • Adult day health care
  • Intermediate care facility for the mentally disabled
  • Private duty nursing
  • Personal care services
  • Pharmacy
  • Dental
  • Optometry
  • Physical, occupational, and speech therapies
  • Hospice

 

2012 Nevada Medicare Amounts

 

Part A

Inpatient Hospital

Deductible

Per Benefit Period                       $1,036

Coinsurance

Days 61-90                                   $267

Lifetime Reserve Days (60)          $534

 

Skilled Nursing Facility

Coinsurance

Days 21-100                                   $133.50

 

Monthly Premium

40 quarters of Social Security work credit:                     Free

30 – 39 quarters of Social Security work credit:             $244

Less than 30 quarters of Social Security work credit:     $443

 

Part B

Deductible

Per Calendar Year                          $140

Premium                                        $99.90*

 

*Part B premiums may be elevated based on a person’s adjusted gross income from the previous year’s tax return. Medicare members required to pay a higher Part B premium include:

  • Individuals with an income over $85,000
  • Those who are married but file taxes separately with incomes over $85,000
  • Married couples filing a joint tax return with income over $170,000

Part B premiums for 2012 follow the guidelines below for those who file an individual tax return. This includes Medicare members who are head of household, qualifying widow[er] with dependent child, or married filing separately who lived apart from their spouse for the whole taxable year.

 

Monthly premiums in Nevada for married members who file a separate tax return and have lived with their spouse during the taxable year vary according to these income regulations:

 

Resources

Medicare.gov

Nevada Department of Health and Humans Services

 

 

Sources:

 

1. Nevada Department of Health & Human Services. “Medicaid Services Manual”. https://dhcfp.nv.gov/MSM Table of Contents.htm.

2. Nevada Aging and Disability Services. “Medicare”. http://www.nvaging.net/medicare.htm.

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