Turning 65 in Nevada with Medicare & Medicaid
If you are turning 65 in Nevada and eligible for Medicare, I have created a straightforward 12-step checklist to help you navigate the process. However, if you are receiving Medicaid prior to turning 65, there are some additional steps you will need to follow to ensure a more smooth transition.
In Nevada, when you turn 65, you will no longer qualify for the traditional version of Medicaid used by individuals and families and will need to transition to a different version of the program for individuals who are Medicare beneficiaries.
There are a few programs that operate within the state that are managed by the state or designed at the federal-level and administered by the state. These programs are:
• Medical Assistance for the Aged, Blind, and Disabled (MAABD)
• Medicare Savings Program (QMB, SLMB, QI, QDWI)
• Extra Help (Low Income Subsidy)
While the state and federal government are well aware of the date you were born and when you are turning 65, they sadly do not automatically enroll you into the programs you qualify for; this in turn creates a lot of frustration for some during the transition when things don't work as expected, simply because they didn't know they need to do something else to get setup differently.
The Nevada state welfare office does send out letters 45-days in advance of your 65th birthday to notify you that you need to apply. However, a lot of folks these days don't read their mail because they get so much junk, missing the letter alltogether.
If you don't get ahead of this process sooner than later, it may create some unnecessary hardship and administrative frustration. Here are a few examples:
If you qualify for a Medicare Savings Program that will cover your Medicare Part B premium, but never applied for the program, then you likely see see $174.70 (in 2024) automatically deducted from your Social Security check when you turn 65. And, you can't call the state welfare office last minute to apply and get it resolved; it may take them up to 120 days to get that remedied and automated with Social Security.
The other issue is prescription drug coverage. There are a handful of prescription drugs that are incredibly expensive, even with Medicare coverage. You may qualify for Extra Help (Low Income Subsidy) to help pay for the cost of your prescriptions. However, if you wait to the last minute, you may not be setup when you transition over to Medicare, creating some financial difficultiies that need to be worked through to get your medication.
Finally, if you qualify for both Medicare & Mediaid, this will open up several new Medicare Advantage plans that are not available to Medicare beneficiaries that don't have Medicaid. These plans often include several extra benefits that can be real lifelines in the community (e.g. transportation, groceries, etc.).
So, to make a long story short, you want to get ahead of all this as soon as possible, and I want to share some of the tricks I know to help you do that outlined below.
1. Enlist the help of a licensed insurance agent focused on Medicare
For many the process of navigating these programs can be really overwhelming, especially if you don't have an advocate like family or friends to help.
Working as an independent, licensed insurance agent, I've gained a lot of experience in navigating various programs with my clients, including Medicaid, Medicare Savings Programs, and Extra Help.
If you need help in this area and are based in Nevada, you can contact my office at 702-905-1800, and I'm more than happy to help.
2. Apply for Extra Help (Low Income Subsidy)
The first thing you should do is submit an application for Extra Help. This application is available online and can be done in about 15 minutes.
The reason this is important is that this application will immediately trigger a notification to the Nevada state welfare office to have you screened for all the other programs offered in the state.
I recommend submitting this application 90 days before the month of your 65th birthday (e.g. if you turn 65 in April, then submit your application in January). This application will be submited to the Social Security Adminstration for review and approval. They will then forward the application to the Nevada state welfare office for additional screening.
3. Call the Nevada state welfare office
While step #2 above will kick-off a process to notify the the Nevada state welfare office, it's also a good idea to call them too. The state welfare office can only make modifications to your profile in 90-day intervals, so their timing is a little different from other programs (e.g. if you're birthday is in April, then you can call them in February to apply for programs).
When you call, you need to let them know that you are currently receiving Medicaid and are turning 65 soon and that you will need to re-apply for the appropriate programs you qualify for. They will then screen you again with a few income questions and start the processes they need to complete on their side.
Here are the numbers to call:
Toll Free (800) 992-0900
Northern Nevada (775) 684-7200
Southern Nevada (702) 486-1646
Be prepared for the wait on hold. It takes about 45 minutes to an hour to reach someone. However, to help speed up the process through their voice response unit, you will need to select these phone prompts:
• Press 1 for English (unless otherwise)
• Press 3 for other options
• Press 2 for Medical programs, including Medicare
• Press 4 to speak with a representative
• Press 2 to enter your Social Security number
• Press 5 for other questions
After you go through the prompts, this should put you in the queue to speak with the right person.