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Nevada Medicaid programs, such as Nevada Health Link help low-income or disabled individuals access the care they need to thrive. These programs assist children, adults, and senior adults with prescriptions, care services, and physical and mental health needs.
Permanent low-income Nevada residents may qualify to receive assistance from these programs, enabling them to take control of their well-being.
Are you ready to broaden your healthcare options? Nevada’s Medicaid programs might offer an affordable, comprehensive solution! Nevada Medicaid has various programs designed to assist children, adults, and seniors who qualify for its coverage.
Did you know nearly 900,000 Nevada residents use the state’s Medicaid programs? Although this seems like a high number, Nevada’s unenrolled low-income population exceeds the number of current enrollees. You may qualify for extensive Nevada Medicaid coverage to protect your health.
You may also qualify for supplemental insurance from third-party or private providers. These insurance providers develop flexible, inexpensive plans that work with your Medicaid program. To prevent shouldering the debt of unexpected medical expenses, many Nevadans extend their Medicaid coverage to include a more comprehensive range of benefits and services by way of private health insurance. Learn more about your eligibility, how to apply, and the coverage you’ll receive below.
You likely have some questions about how Medicaid works. What is Nevada Medicaid, and how can you access it? Nevada Medicaid is a federally funded program that helps low-income or disabled individuals access much-needed healthcare.
Each state uses these funds to develop state-wide healthcare programs to address its qualifying population’s medical concerns. Nevada Medicaid programs include:
Is Nevada Medicaid free? The answer depends on your income and whether you have diagnosed disabilities. For many residents, some services cost nothing, while others incur minimal fees. Your income, owned assets, and health condition will influence the amount you pay to access these programs’ benefits.
A Nevada Medicaid card signifies that its holder qualifies for and receives program assistance. Each Medicaid card has a unique number sequence identifying the holder and their coverage or benefits. Once the Nevada Department of Health and Human Services accepts your application, you’ll receive a Nevada Medicaid card of your own. Take it to every health or medical service appointment to receive your benefits.
Ready to learn how to apply for Nevada Medicaid? You can complete and submit your Nevada Medicaid application using one of three methods:
DWSS
PO Box 15400
Las Vegas, NV 89114
Applications for senior adult programs, Nevada Medicaid, and Nevada Check Up may take between 45 and 90 days to go through the system. If you applied online or registered for portal access, you can use your account to stay updated about your application’s progress. Once your application receives approval, you should receive a notification and an acceptance letter with your Medicaid card.
What factors determine your Nevada Medicaid eligibility? Your eligibility mostly depends on your income. Eligible federal poverty levels depend on an applicant’s condition. For example, the average adult must have an FPL of 138%, while the threshold for pregnant women and children is much higher.
Other Nevada Medicaid eligibility factors include:
The Nevada State government encourages all enrollees to check their eligibility and calculate their Nevada Medicaid income limits before applying for assistance.
After applying for Medicaid coverage, you must wait 45 to 90 days. Most application processes last no longer than 45 days. If the program accepts your application, you’ll receive your Medicaid card by mail. Keep this card secure and readily available for all medical appointments.
You must renew your Medicaid coverage annually. Your Access Nevada account will easily facilitate the process. Under some circumstances, the DWSS will automatically renew your coverage according to the accessible information on your account.
However, you will most likely receive a renewal packet by mail two months before the coverage expiration date. You can fill out this renewal packet before mailing it back to the DWSS. Otherwise, you can renew your Medicaid assistance online or over the phone. Find detailed information about the renewal process here.
What happens if you misplace or lose your Nevada Medicaid card? Call the DWSS at one of the following phone numbers: (702) 486-1646 or (775) 684-7200.
Alternatively, you can download the NVMedicaid application. Then, follow the prompts to download a digital version of your card. This method ensures your access as long as you have your mobile device.
Many residents aren’t exactly sure what Nevada Medicaid covers. Confusion often arises because coverage may vary depending on the state. Below, you’ll find detailed information about who and what Nevada Medicaid covers.
Adult residents can only receive emergency dental care through Nevada Medicaid. Emergency dental services may include the following:
Nevada’s dental service limitations cause many adults who use Medicaid to seek supplemental dental plans from third-party providers. For those who have more serious dental issues and anticipate requiring more visits to the dentists, investing in private dental plans in Nevada is advisable.
Nevada Medicaid provides reimbursements to medical practitioners and pharmacies for prescription coverage. You might even access some over-the-counter drugs under certain circumstances. Other pharmaceutical coverage benefits include:
Medicaid in Nevada may offer limited coverage for extended healthcare services, including the following:
However, a qualified healthcare professional must first recommend them. You cannot access them of your own volition.
Additionally, treatment facilities must receive state funding or accept Medicaid. This often limits an enrollee’s options in many ways. If you have a known mental health condition, explore supplemental coverage from an eligible marketplace insurance carrier.
Routine checkups and basic medical treatments will only get you so far. Many patients require additional care, but they go without because of financial concerns, lack of coverage, and restricted access. Investing in quality disability insurance is an excellent way to assist with some of the costs incurred with not being able to work either temporarily or permanently, and to help with the cost of medical needs.
Medicaid in Nevada covers long-term care for qualifying disabled persons. Explore programs like LTSS and MAABD to learn about your long-term service options.
You cannot transfer your Medicaid to a different state or country. Although the federal government funds Medicaid programs, each state government decides which residents qualify and what their programs will cover. Therefore, you cannot typically travel beyond Nevada borders to schedule routine appointments or treatments unless you use managed care organizations.
However, Nevada Medicaid will cover out-of-state emergencies. For example, a Nevada resident travels to Texas to visit family over the holiday season. They survive a heart attack during their trip and must stay at a Texan hospital for services to ensure survival. Nevada’s Medicaid programs will pay for the ambulance ride, hospital stay, and treatment services.
However, If you are traveling outside of Nevada for leisure, invest in proper travelers insurance.
If you are a Nevada resident and a college student, you may apply for Medicaid programs designed for adults. Independent adults aged 18 or older who meet eligibility requirements can apply for and manage their government assistance and coverage. However, you may encounter some exceptions.
If you are a Nevada resident who attends an out-of-state college, you should explore your college’s affordable insurance plans developed to assist students. Nevada Medicaid generally doesn’t cover regular health services beyond Nevada’s borders.
If you attend a college in Nevada, ask about combining Medicaid with a supplement option provided by your university. You could access more extensive healthcare services while you are a student.
Nevada Medicare offers extensive options for qualifying senior adults. These programs include:
Find out whether you can combine your Medicaid coverage with Medicare assistance.
The Nevada government designed some additional Medicare programs to assist Native Americans and military or veteran subgroups. If you fall within one or both of these subgroups, you can access additional support and more extensive coverage to empower your health decisions. Learn more about these subgroups below.
If you are a Native American or of Native American descent and have tribal verification, you can access a diverse range of federally mandated and state-optional healthcare services. These services come with the following perks:
Remember to provide documentation of your tribal membership upon applying for Medicaid programs.
If you are an active military member, you likely have access to TRICARE plans and their benefits. TRICARE meets the national minimum requirements for qualified healthcare. However, you may supplement it with Medicaid if you meet the requirements.
When you seek services or treatments, remember that TRICARE expects Medicaid to cover the services first. TRICARE will pay for any additional expenses.
If you are a veteran who doesn’t have coverage from a veteran or military association, you might qualify for Medicaid. Veterans who have coverage may also find Medicaid helpful for spouses or dependents under certain circumstances.
Like most state Medicaid programs, Nevada Medicaid has treatment and service limitations for cardholders. You’ll find examples of coverage restrictions listed below.
What a state identifies as “medically unnecessary” may change from year to year. The term implies that a person doesn’t need the procedure to protect their health or save their life. However, some Medicaid programs won’t cover certain treatments despite their ability to improve a person’s mobility or quality of life.
Nevada Medicaid greatly restricts an adult’s access to dental care. If you don’t suffer from a qualified dental emergency, you cannot seek diagnostic or preventative care after you turn 21. You may only access tooth removal procedures, exams, and dentures under certain circumstances.
The Nevada government prevents as much financial and resource waste as it can. Unfortunately, this may prevent low-income people from accessing certain medical equipment, even if the equipment greatly improves a person’s life.
Although Nevada Medicaid will cover out-of-state medical emergencies, you cannot access resources and treatment options available in another state. A person covered by a managed care organization might access some out-of-state treatments under qualifying circumstances.
Surgeries, including facelifts, tummy tucks, and other cosmetic enhancements, are not covered by state-administered Medicaid programs. Such procedures fall under the medically unnecessary category.
Nevada Medicaid may cover certain over-the-counter medications if your primary doctor recommends them to treat your condition. However, you must pay for most such products out of pocket as they typically provide symptom relief rather than medical treatment.
Nevada Medicaid will only put forth $900 towards the cost of a funeral. Considering the rising cost of burial and related fees, ensure that your family is secured with comprehensive funeral insurance.
If you believe the above treatments or services could improve your quality of life, start exploring private or third-party coverage options. They can help you manage these services with affordable quarterly or monthly premiums while working alongside your Medicare coverage.
Now that you know what your coverage doesn’t include, learn more about what it can offer. What is Nevada Medicaid coverage designed to provide?
| Dental | |
|---|---|
| Remember: Medicaid provides extremely limited dental coverage for adults. However, your children could reap more extensive benefits from a qualified provider. | |
| Emergency exams | When an adult experiences intense pain, swelling, or other oral issues preventing them from managing their lives, they can undergo an emergency diagnostic exam. |
| Emergency extractions | If a dentist determines that a tooth poses a health risk to the patient, they can order an emergency extraction to prevent further health complications. |
| Some denture fittings | If a patient has multiple teeth removed, they can apply for full or partial dentures covered by their program. |
| Children’s dental services | Children or dependents under the age of 21 can access most routine dental services, including exams, cleanings, and fillings. |
| Vision | Medicaid cardholders can access the following ocular services annually: |
|---|---|
| Eye exams | You can visit an eye specialist each year to protect and stay informed about your overall eye health. |
| Prescription glasses | If you need glasses, you can request a pair each year, depending on how your sight changes. |
| Medically necessary eye surgery | Issues like glaucoma may require correction from eye surgery. |
| Surgery | A procedure may require either inpatient or outpatient care, depending on the procedure’s invasiveness. Nevada Medicare covers the following surgical services: |
|---|---|
| Transportation | You can arrange a ride to and from your surgical appointment. |
| Hospital stay | If you have an inpatient procedure, you can rely on Medicare to cover your stay’s expenses. |
| Required drugs | Some surgeries don’t require drugs to ensure the patient stays safe throughout the procedure. However, Medicare will cover the cost of drugs for procedures that do. |
| Follow-up appointments | Many surgeries require follow-up appointments to ensure the patient’s recovery. Your Medicaid program should support those appointments. |
| Surgical complications | In the event you experience a complication following your surgery, you can use Medicaid to assist with the rehabilitation treatment. |
| Hospital | Whether you undergo surgery or encounter an emergency, you may need to stay in the hospital to ensure your stability. Your Medicaid program will assist with the following types of hospital stays: |
|---|---|
| Emergencies | Medicare coverage helps with all types of health emergencies. |
| Inpatient | If you need to stay in the hospital for a night, you can request reimbursement from your Medicare program. |
| Outpatient | Medicare also covers outpatient hospital visits where you enter and exit the emergency room on the same day. | Outside of extreme emergencies, speak with your doctor about a referral to make the reimbursement process happen more quickly. |
Your mental health is integral to your physical health. The following Medicaid resources will help you flourish:
| Sexual Health | Protecting your sexual and reproductive health influences your overall health. Medicare provides extensive resources for individuals who want to control their sexual health proactively. |
|---|---|
| Birth control access | Take control of your reproductive health throughout your life with birth control prescriptions and products. |
| Family planning guidance | Discover ways to responsibly start and prepare for growing your family. |
| Maternity care | Throughout and following your pregnancy, you need consistent, quality care to ensure the health of you and your infant. Medicare ensures you have labor and delivery, prenatal appointments, ultrasounds, and other necessities covered. |
| STD prevention | Sexually transmitted diseases like HIV can ruin your health in various ways. Protect yourself and your partner with reliable prevention methods. |
| Specialist Services | A specialist often understands their area of study better than a traditional doctor. Access the following specialist services to improve your quality of life: |
|---|---|
| Speech and hearing services | Enhance the way you communicate with professional speech and hearing assistance. |
| Physical and occupational therapy | After a traumatic medical event or injury, a physical therapist can help you readjust to your healing body. |
| Psychiatric services | Maintain balance with discussion and other treatment methods. |
| Midwives | Request a midwife to guide you through your pregnancy journey. |
Although Nevada Medicaid offers a great starting point to comprehensive healthcare, you’ll stumble into limitations. Other types of private insurance, such as life insurance, can help pay for medical costs Medicaid will not cover, especially in the event of your passing.
Insurdinary helps you bypass those limitations with quotes from diverse policy carriers willing to work with your government assistance. We believe everyone deserves access to all facets of healthcare — not just the ones the government identifies as medically necessary.
Shop for third-party providers that fit your Medicaid coverage requirements and budget today.
Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following:
