Las Vegas Medicare Pros

See why thousands of Las Vegas seniors trust us when it comes to to their Medicare insurance.  

Have A Question? Ask Our Agents!

Live In Vegas? So Do We! 🙂

Honest Advice About Medicare In Las Vegas

Our agents are your neighbors, and for the past 18 years they have been helping locals get the most out of Medicare at the lowest cost possible.

We spend the time to truly understanding your prescription and medical needs, and then take our vast knowledge of all the programs available in Las Vegas and present you with options that would fit your personal situation the best....and all this guidance at no cost to you.

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What Our Clients Say About Us

Steven Bowie

Lilah was everything I could ask for in a health insurance expert. She was kind, patient, and understanding with my many, many questions. She arrived promptly and was polite to me and my wife, and when she explained these really complicated terms and plans about Medicare like original medicare and medicare advantage plans in a really “everyman”-friendly way, I knew I made the right decision to trust her and this company’s services. Really believe that my decision to choose the medicare advantage plan through private insurers is the best way to keep my family safe.

Sarah Gardin

Thank you so much to Brigitte for all of her help with Medicare! At first, I was so intimidated by everything to do with these different parts and plans, I didn’t even know where to start by myself! Asking Brigitte was the best help I could ask for. She was bright but calm and collected as she explained all these plans that could set my health up for life. Highly recommend!

Medicare can be separated and understood in four different parts: Part A, Part B, Part C, and Part D.

 

Once you determine your eligibility for Medicare, you may decide which Medicare benefits to choose from: Original Medicare (which includes Part A or Part B), or the Medicare Advantage Plan, which is often secured through a private insurance company that is in partnership with the federal government (otherwise known as Part C). Medicare Part D is the prescription drug plan of Medicare and it is important to get, at risk of future, financial penalties. While the cost of your prescription drug plan can vary from person to person, it is optional but highly advised to avail of at the same time as your main plan.

 

Understanding your own personal insurance coverage for Medicare is of the utmost importance as there are certain complications and restrictions that come with when and how you are able to access your medicare plan and care.

 

For example, Original Medicare covers nearly all doctors and hospitals for in the United States, while there may be some connecting restrictions when it comes to the Medicare Advantage Plan. However, the Medicare Advantage Plan may also cover particular benefits that are not available with Original Medicare such as dental care, among others. This plan can also have network restrictions so, for example, if you are in need of your medicare plan in Las Vegas, you may need to look up a doctor that is supported by your network. Medicare Advantage Plans also have a higher cost, due to these additional Medicare benefits.

 

Everyone in Las Vegas and all over the United States, who is enrolled with the medicare program, either Original Medicare or Medicare Advantage Plan, will receive a card that is red, white, and blue. It will state your Medicare number, the beginning of both your hospital (Part A) and medical (Part B) health insurance. If you, however, choose the Medicare Advantage Plan, you will receive this same card with your coverage but you must also present the card that proves your private, medicare advantage plan.

 

This Medicare card serves or these cards serve as your official identification within the Medicare system and you must keep this Medicare information to yourself and only trusted doctors or trusted medical professionals in official capacities. One must know that official government offices or trusted, legitimate professionals will never ask for your Medicare numbers or any sensitive, Medicare-related information over the phone.

As Medicare is a federal program, and Las Vegas falls under that jurisdiction, one may qualify for this health insurance program, either original medicare or medicare advantage plans, if you are one of the following:

 

  • You are or are older than 65 years of age and a citizen or legal, permanent resident who has continuously lived in the United States for at least 5 years, and you have been paying Medicare taxes for at least 10 years
  • You have a disability and have been receiving disability benefits continuously over the last 2 years
  • You have been diagnosed with End-Stage Renal Disease (permanent kidney failure that requires either dialysis or a kidney transplant)

 

One may apply for your Medicare coverage, advantage plans, and drug plan at the same time that you apply for your retirement benefits. You automatically begin your Medicare coverage on the first day of the month after you turn 65 years old. However, if your birthday falls on the first of the month, the coverage automatically begins on the first of the month before you turn 65.

Applying for Original Medicare or Medicare Advantage Plans for your health insurance requires an intimate knowledge of not only the Medicare process and eligibility that comes with the plans but also your location, which in this case is in Las Vegas, Nevada.

 

Your decision on where and how to receive your Medicare benefits, including pharmacies for your prescription drug drug plan and access to emergency medical services, are highly important and you must be fully informed of your coverage to avoid penalties and out-of-pocket fees.

 

You may apply for Medicare through your local Social Security office, register online or through the phone. Additionally, customer service for medicare through an authorized, professional agent can give you some peace-of-mind.

For most cases, the most ideal time to enroll Medicare services is just before or after your 65th birthday. There is a time period that comes with Medicare coverage and you may start maximizing on your benefits within the three-month window of your 65th birthday.

 

For example, say that your 65th birthday is on the 16th of April. This means that your window of enrolment begins at January 16 and will remain open until July 16. Surpassing that date will incur penalties. If you miss your window, there is general enrolment that happens between January and March; the only problem with this is that if you miss your initial enrolment period, this could mean higher premium costs with Plan B for the rest of your life.

 

To know which Medicare services in Las Vegas are best suited for you before your enrolment, you must contact Medicare customer service to clarify your plans.

There are certain qualifications, however, that can avoid these particular, aforementioned penalties with your medicare health insurance in Las Vegas. For example, if you are over the age of 65 years old and you are still working in Las Vegas, and thereby covered by private insurance through your employer, you will not have to worry about the penalty for your plans with Part B premiums. If you are over 65 years old and still working, you may also apply for Part A as a backup, with no extra cos.

 

Low-income residents and households may also be eligible for a Social Security Medicare Savings Program as these are federally funded programs that are handled state-by-state. These Medicare programs can aid qualifying citizens of Nevada, including those residing in Las Vegas.

 

Low-income households also do not have to worry about premiums regarding their medicare program Part D plans that includes the coverage of a prescription drug that they may need in the future.

As stated, there can be grounds for out-of-pockets costs with Medicare, depending on the benefits chosen and the plans that are included in your coverage. There is basic coverage and there is additional coverage that you can avail of through private insurers.

 

Medicare Part A and Medicare Part B fall under the Original Medicare. Your specific coverage plan may vary, depending on the plans that your specific situation covers, but your plan should cover the benefits included with Plan A and Plan B. Plan A is hospital care while Plan B is medical.

 

When it comes to out-of-pocket costs with Medicare, it important to note what is and is not covered before you avail of medical services. For example, any hospital or medical care that is not included with the Original Medicare, such as dental, routine vision, and hearing care, is considered an out-of-pocket cost with certain insurance companies if you are not enrolled in the advantage plans. 

Medicare Part A covers hospital care. This includes the following:

 

  • Inpatient hospital care as prescribed by a Medicare doctor for both physical and mental illnesses
  • Skilled nursing facility care
  • Long term care hospital services

Medicare Part B covers medical care. Part B covers medically necessary services that work to diagnose and/or treat qualifying medical conditions, as well as preventive measures like flu vaccinations and other methods of early detections such as cardiovascular and cancer screenings, to determine the most effective treatments and plans for these conditions.

 

Generally, Part B covers most outpatient services such as a prescription drug, ambulance services, and the like. Unlike Medicare Part A, however, most people have to pay premiums for their Part B. These costs can change from year to year, and the amount that you have to pay may change depending on your situation. 

Medicare Part C is an advantage plan that you may avail through a private insurer. These plans are legally required to offer the same benefits as Medicare Part A and Part B, but also have the advantage of additional Medicare benefits that are not included in A and B such as dental, vision, and hearing care.

 

Medicare Part C is dependent on the insurance companies involved and the plans per insurance company can vary. There may be some additional deductibles or higher co-pays. Where Part A and Part B can mostly be availed through public hospitals in the United States, Part C is network-based and you may pay more to see doctors or hospitals outside of this Medicare network.

 

There are tools available to compare costs between Medicare plans, especially for those who enrol with Medicare advantage plans as this does constitute private insurance, so you may decide which of these plans is the best suited for you and your situation. A professional representative, who is well-versed on Nevada Medicare services, medicare advantage plans, and insurance companies, however, can take the guesswork out of the Medicare equation and give you the best plans for you and your family.

Medicare Part D covers prescription drugs. You are entitled to this plan when you are under Part A or B, and this part is available to you, regardless of your or your family’s income. Certain tiers when it comes to a particular sort of prescription drug that must check in with your coverage as the prescription drug that matches particular medical condition tend to vary in both use, effectivity, and cost.

 

While it is an optional part, the point of Medicare insurance like Part D and even the medicare advantage plan that is Part C is that these assets are there for you when you need it. If you are in need of prescription drugs from insurance companies and you do not have Part D, you may incur further financial penalties. The enrolment window for Part D is also limited, so availing this part of Medicare is something that most professionals who know the industry of insurance companies would advise.

 

The Medicare premiums that come with Part D are on a case-by-case basis as the amount deducted from your benefits (or premiums billed to you) are based on the prescription cost. Co-pays can even vary from pharmacy to pharmacy for the same drug, depending on the location.

 

Ask your insurance company representative for help to compare prices of prescription drugs and the prescription drug plan in your area.