Medicare Advantage

Plans In Nevada

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Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare.

 

Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs.

 

These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.

 

Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. 

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Questions? Call us today at (702) 573-7766 and one of our friendly, patient and knowledgeable staff will be glad to answer all your questions.

 

Or if you prefer, please schedule a convenient time using our simple calendar Medicare in Nevada Information Here.

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Start by selecting your preferred option and you will be taken to a calendar page showing available dates and times.

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What Are The Different Types Of Medicare Advantage Plans In Nevada?

 

Below are the most common types of Medicare Advantage Plans in Nevada:

 

-Health Maintenance Organization (HMO) Plans

-Preferred Provider Organization (PPO) Plans

-Special Needs Plans (SNPs)

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Typical questions clients ask about Health Maintenance Organization Plans in Nevada:

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Q. Can I get my health care from any doctor, other health care provider, or hospital?

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A. No. You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except for emergency care, out-of-area urgent care, or temporary out-of-area dialysis, which is covered whether it’s provided in the plan’s network or outside the plan’s network).

Q. Do these plans cover prescription drugs?

 

A. In most cases, yes. If you’re planning to enroll in an HMO and you want Medicare drug coverage (Part D), you must join an HMO plan that offers drug coverage. If you join an HMO plan without drug coverage, you can’t join a separate Medicare drug plan.

 

Q. Do I need to choose a primary care doctor?

 

A. In most cases, yes.

Q. Do I have to get a referral to see a specialist?

A. In most cases, yes. Certain services, like yearly screening mammograms, don’t require a referral.

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Q. What else do I need to know about this type of plan?

 

A. If your doctor or other health care provider leaves the HMO plan’s network, your plan will notify you. You may choose another doctor in the plan’s network. 

 

If you get non-emergency health care outside the plan’s network without authorization, you may have to pay the full cost.

 

It’s important that you follow the plan’s rules, like getting prior approval for a certain service when needed.

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Typical questions clients ask about Preferred Provider Organization (PPO) Plans in Nevada:

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Q. Can I get my health care from any doctor, other health care provider, or hospital?

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A. Yes. PPO plans have network doctors, specialists, hospitals, and other health care providers you can use. You can also use out-of-network providers for covered services, usually for a higher cost, if the provider agrees to treat you and hasn’t opted out of Medicare (for Medicare Part A and Part B items and services).

 

You’re always covered for emergency and urgent care.

 

Q. Do these plans cover prescription drugs?

 

A. In most cases, yes. If you’re planning to enroll in a PPO and you want Medicare drug coverage (Part D), you must join a PPO plan that offers drug coverage. If you join a PPO Medicare Advantage Plan without drug coverage, you can’t join a separate Medicare drug plan.

 

Q. Do I need to choose a primary care doctor?

 

A. No.

 

Q. Do I have to get a referral to see a specialist?

 

A. In most cases, no. But if you use plan specialists (in-network), your costs for covered services will usually be lower than if you use non-plan specialists (out of network).

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Typical questions clients ask about Special Needs Plans (SNPs)in Nevada:

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An SNP provides benefits and services to people with specific diseases, certain health care needs, or limited incomes. SNPs tailor their benefits, provider choices, and list of drugs (formularies) to best meet the specific needs of the groups they serve.

Q. Can I get my health care from any doctor, other health care provider, or hospital?

A. Some SNPs cover services out of network and some don’t. Check with the plan to see if they cover services out of network, and if so, how it affects your costs.

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Q. Do these plans cover prescription drugs?

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A. Yes. All SNPs must provide Medicare drug coverage (Part D).

 

Q. Do I need to choose a primary care doctor?

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A. Generally, yes.

 

Q. Do I have to get a referral to see a specialist?

A. In most cases, yes. Certain services, like yearly screening mammograms, don’t require a referral.

 

Q. What else do I need to know about this type of plan?

• These groups are eligible to enroll in an SNP.

 

People who live in certain institutions (like nursing homes) or who live in the community but require nursing care at home (also called an “Institutional SNP” or I-SNP).

 

• People who are eligible for both Medicare and Medicaid (also called a “Dual Eligible SNP” or D-SNP). D-SNPs contract with your state Medicaid program to help coordinate your Medicare and Medicaid benefits.

 

• People who have specific severe or disabling chronic conditions (like diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, or dementia) (also called a “Chronic condition SNP” or C-SNP). Plans may further limit membership to a single chronic condition or a group of related chronic conditions.

 

• An SNP provides benefits targeted to its members’ special needs, including care coordination services.

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Questions? Call us today at (702) 573-7766 and one of our friendly, patient and knowledgeable staff will be glad to answer all your questions.

 

Or if you prefer, please schedule a convenient time using our simple calendar Medicare in Nevada Information Here.

​

Start by selecting your preferred option and you will be taken to a calendar page showing available dates and times.

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