Medicare Advantage Reno Basics

Advantage plans are available to people who qualify for Medicare Nevada. These plans are different from Medigap Supplement Reno plans. Medicare Advantage plans are available at different times of the year depending on your eligibility. Before someone can get an Advantage plan, they need to meet a few standard requirements. First, the member must have both Part A and Part B, also known as Original Medicare. People who have both of these parts under the age of 65 can get a Medicare Advantage Reno Health Insurance plan. Medigap plans are not available to people under the age of 65 in Nevada.

The plan rates and benefits are based on where you live. Each county has different plan options. These plans will usually have slightly different benefits or costs.

Part A

Part A is commonly referred to as ‘Hospital Care’. This part includes hospital care, skilled nursing facilities, and hospice care. Most people can get Part A when they turn 65. Some people can get Part A if they have a disability. To get Part A, people must apply through the Social Security Administration. People who want a Medicare Advantage Reno plan need to be enrolled in Part A. This is one of the few requirements to qualify for a plan.

Part B

Besides Part A, the other element of Original Medicare is called Part B. Part B is commonly called ‘Physician Care’. Part B covers doctors, outpatient care, and home health care. This category also includes Preventative Services. Just like Part A, most people qualify for Part B at 65. Some people can get Part B before 65 if they have a disability. The Social Security Administration helps consumers get Part B.

If you have coverage through a job and qualify for Part A and Part B, you need to consider your options. Medicare Advantage Reno plans have pros and cons just like coverage through a job. It is important to talk to a broker about when you can get a plan and which policy works best for you.

Part C

Once enrolled in Part A and Part B, a consumer can now get a Medicare Advantage Reno plan. Advantage plans are commonly known as Part C. Medicare Advantage Reno plans include all benefits and services covered under Part A and Part B. Private healthcare companies offer these plans to people who qualify for both Part A and Part B. Most of these plans include Part D drug coverage. Some plans will cover added benefits as well.

Finding a quality plan is easy since there is a Star Rating system. This Star Rating system helps people find a plan that is rated well. Each year, the Star Rating for each plan can change.

Medicare Advantage Reno plans usually cover local doctors only. Some plans will cover doctors outside of the state. Unlike Medigap plans, Medicare Advantage Reno plans cover doctors chosen by the private healthcare company. Each year, the doctors list changes. These same rules apply to pharmacies and other facilities. It is important to review these changes each year to make sure the plan covers your preferred doctors.

Some people may qualify for both Medicare and Medicaid. Medicaid is a function of the Welfare system in Nevada. Medicaid will help cover the out of pocket expenses or premiums with your Medicare Advantage Reno plan. To see if you qualify for Medicaid, please visit a Division of Welfare and Supportive Services office. Their website can be found here.

Part D

Part D is commonly known as drug coverage. These plans cover outpatient drug costs. Most Medicare Advantage Reno plans cover Part D at no extra cost. Medicare Advantage Prescription Drug Plans, or MAPD plans, are policies that include both Part C and Part D. These plans are available each year during the Annual Enrollment Period.

Medicare Advantage Reno Plans and Added Benefits

Some Medicare Advantage Reno plans have added benefits. These benefits may include dental, vision, hearing, no cost gym memberships, and more. Some plans also include these additional benefits at no extra cost. Other plans will charge higher premiums to get additional benefits. Each health care company offers different benefits. It is important to understand these differences.

Annual Open Enrollment

The Medicare Advantage Reno Open Enrollment Period begins on October 15th and ends on December 7th. People can shop for plans during this time. They can also get new plans during this time. Each year, healthcare companies change benefits and offer new plans. It is important to review your options during this time. When you find the right plan for your needs, you should apply during this timeframe. The coverage will start on January 1st. Most people shop for plans during the Open Enrollment Period each year. Sometimes, people can get plans with a qualified life event. These special circumstances help people change plans mid-year. To learn more about these rules you can read more on our website here or read more on Medicare’s website.

Medicare Advantage plans do not ask health questions when people apply. Medigap plans, unlike Part C plans, can ask health questions and deny coverage.

Broker Assistance

A Health Insurance Broker can help you find a Medicare Advantage Reno plan at no extra cost to you. Each year, they will guide you through the process. They will also assist you in searching for doctors and drugs. Most importantly, brokers are available during the year to answer questions or help with claim issues.