Beyond offering standardized Medicare Supplement (Medigap) Plans A-N, Nevada is one of the few states that has the Medigap Birthday Switching Rule and Innovative Medigap plans that include vision and hearing. Let’s review how Medigap plans work in the Silver State.
Who is eligible for a Nevada Medicare Supplement Plan?
Before we get into the Birthday rule and innovative plans, let’s review Nevada’s enrollment rules for seniors 65 and over and those under 65 on Medicare due to a disability:
65 and older: You have a six-month window once you are Part B eligible in which you have guaranteed acceptance. If you don’t have creditable insurance coverage (individual or employee insurance plan) before enrolling, you may not receive coverage for preexisting conditions for the first 6 months. If you try to enroll outside of your initial 6-month enrollment period, you will be usually subject to underwriting. This can result in a higher premium rate or outright denial.
Under 65: In Nevada, someone under 65 and Medicare-eligible due to a disability or End Stage Renal Disease (ESRD) does not have a guaranteed issuance right. If you are approved, you could be charged quite a bit more for the same plan as someone over 65.
Are there other Nevada Medigap guaranteed issuance scenarios?
There sure are! Nevadans can enroll in Medigap with guaranteed issuance without answering medical questions. Here are a few of those situations:
- When you turn 65, even though you qualified for Medicare before age 65
- Insurance provider committed fraud
- Moved away from your Medicare Advantage plan area
What are the differences between Nevada Medigap plans?
Below is a chart that compares coverage of standardized Medigap plans in Nevada:
| Benefits | A | B | D | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,632) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($240) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,060 | $3,530 |
*Medigap Plan G High Deductible is identical coverage as Plan G but requires a high deductible of $2,800.
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What is Nevada’s Medigap Plan G Innovative?
As you can see from the chart above, most Medigap plans do not include coverage for eyeglasses or hearing aids. Innovative G offers the same core benefits as standard Medigap Plan G with added extra benefits like hearing and vision coverage. Anthem Nevada offers Medigap Plan G Innovative. Currently, only 3 states offer Innovative plans such as these.
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What is Nevada Medigap SELECT?
While not very popular in terms of enrollment, Nevada Medigap SELECT offers the same coverage as a traditional Medigap plan but with a limited network of hospitals. This should NOT be confused with an HMO plan, which limits your doctors, specialists, and hospitals, and generally requires a referral to see a specialist. Medigap Select allows you to see any doctor in the country that accepts the Medicare assignment (80% of nationwide doctors take Medicare patients according to KFF).
Here’s the part where SELECT can hit you hard: if you went to an out-of-network hospital for a non-emergency, you have to pay the Part A deductible ($1,632). Not to worry! All emergency visits at a hospital are covered without charging you the Part A deductible.
The last tricky part of Nevada Medigap SELECT plans is while most doctors are covered, doctors have limited hospital privileges. If you have a non-emergency at in-network hospital, you will have to see a doctor that has privileges at the hospital.
Not all insurance providers offer Medigap SELECT. If you don’t like your Nevada Medigap SELECT plan in the 1st year, you can easily switch to any Medigap plan without medical underwriting.
Does tobacco usage increase your Nevada Medigap cost?
Tobacco usage can significantly increase your Nevada Medigap premium. This varies by the insurance provider and may not apply during your initial enrollment period. Contact us to review Medigap smoking rates.
Does gender affect Nevada Medigap rates?
Nevada insurance providers are able to charge different rates for men and women. Men are generally charged more than women in Nevada but this can vary by age, county, and insurance provider.
How much do Nevada Medicare Supplement plans cost?
There are many factors that go into your Nevada Medigap premium. These include gender, tobacco-usage, zip code, age, plan, insurance provider, and if you have guaranteed issuance. The fastest way to see how much Medigap costs is by getting an instant quote here.
Excess Charges In Nevada
When figuring out costs, keep in mind that pricier plans (like Plan G) might also pay for extra fees like excess charges. Sometimes, doctors who don’t take Medicare’s set prices may agree to them. If not, you could pay up to 15% more at your appointment. Learn all about it in our article: How To Avoid Medicare Excess Charges.
What is the Nevada Medigap Birthday Rule?
If you want to switch Medigap plans in most states, you must first answer health questions before a new insurance provider will accept you. This makes it nearly impossible for people with pre-existing conditions to switch insurance providers. If you have a Nevada Medigap plan, however, you have an annual 60-day annual open enrollment period each year that begins on your birthday month. You have guaranteed acceptance to any plan of equal or lesser benefits. This is the Nevada Birthday Rule. This means that NV residents are able to switch Medigap plans regardless of their health status or pre-existing conditions when they use the birthday rule. It’s a big deal that can save you a lot of money should your current Medigap price increase. Take a Look at Our Definitive Guide to the Medigap Birthday Rule for Each State.
If you live in NV and want help switching Medigap plans, give the team at Senior65.com a call as your birthday approaches. We can usually help you switch right over the phone. There is never a charge or hidden fee for our services.
Will I lose my Nevada Medigap plan if I move out of state?
Most likely not! As Nevada plans are standardized, you can likely keep your Medigap plan even if you move out of state. An exception to this rule is if you move to Massachusetts, you’ll have to enroll in a Massachusetts Medigap plan.
Don’t worry! If you have to enroll in a new state’s plan, you will have a guaranteed issuance period.
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Are there any Nevada Medigap discounts?
Yes, there are! To learn more about Nevada discounts click on the following links:
Discounts vary by state, county, and insurance providers so give us a call to review options in your area.
Next Steps
If you have any more questions or are ready to enroll in a Nevada Medigap plan, give one of our licensed agents a call at 800-930-7956.
Remember, our agents can NOT charge a fee for any services!