Your Complete Nevada Medicare Guide for 2026
Navigating Medicare in Nevada doesn't have to be overwhelming. This comprehensive guide provides everything Nevada residents need to know about Medicare for 2026, including updated costs, enrollment deadlines, plan options, and local resources throughout the Silver State.
Key 2026 Medicare Updates for Nevada
- • Part B premium: $190/month (estimated)
- • Part B deductible: $270 (estimated)
- • Part A deductible: $1,720 per benefit period (estimated)
- • Annual Enrollment Period: October 15 - December 7, 2025
- • Coverage begins: January 1, 2026
Whether you're approaching 65, new to Nevada, or reviewing your current Medicare coverage, this guide addresses the unique aspects of Medicare in Nevada, from the urban centers of Las Vegas and Reno to the rural communities across our vast state.
2026 Medicare Enrollment Deadlines
Initial Enrollment Period (IEP)
Your Initial Enrollment Period is a 7-month window surrounding your 65th birthday:
- • 3 months before your birth month
- • Your birth month
- • 3 months after your birth month
Example: If you turn 65 in June 2026, your IEP runs from March 1 through September 30, 2026.
Annual Enrollment Period (AEP) for 2026
The Annual Enrollment Period for 2026 coverage runs from October 15 through December 7, 2025. During this time, you can:
- • Switch from Original Medicare to Medicare Advantage (or vice versa)
- • Change Medicare Advantage plans
- • Add, drop, or change Part D prescription drug coverage
Medicare Advantage Open Enrollment Period
From January 1 through March 31, 2026, current Medicare Advantage members can:
- • Switch to a different Medicare Advantage plan
- • Return to Original Medicare with or without Part D
Special Enrollment Periods (SEPs)
You may qualify for a Special Enrollment Period if you experience qualifying life events such as:
- • Moving to a new service area in Nevada
- • Loss of employer coverage
- • Qualifying for Extra Help with prescription costs
- • Plan contract termination
2026 Medicare Costs in Nevada
Part A (Hospital Insurance) Costs
Most Nevada residents qualify for premium-free Part A if they or their spouse worked and paid Medicare taxes for at least 40 quarters (10 years).
2026 Part A Costs (Estimated)
- • Premium: $0 (with 40+ work quarters) or up to $578/month
- • Deductible: $1,720 per benefit period
- • Hospital stay: $0 for days 1-60, $430/day for days 61-90
- • Skilled nursing: $0 for days 1-20, $215/day for days 21-100
Part B (Medical Insurance) Costs
Part B covers doctor visits, outpatient care, medical supplies, and preventive services.
2026 Part B Costs (Estimated)
- • Standard premium: $190/month
- • Annual deductible: $270
- • Coinsurance: 20% of Medicare-approved amount
Income-Related Monthly Adjustment Amount (IRMAA)
Higher-income Nevada beneficiaries pay more for Part B and Part D based on their modified adjusted gross income from two years prior (2024 income for 2026 premiums).
| 2024 Income (Single) | 2024 Income (Married) | 2026 Part B Premium |
|---|---|---|
| ≤ $108,000 | ≤ $216,000 | $190 |
| $108,001 - $136,000 | $216,001 - $272,000 | $305 |
| $136,001 - $170,000 | $272,001 - $340,000 | $420 |
| $170,001 - $506,000 | $340,001 - $772,000 | $535 |
| ≥ $506,000 | ≥ $772,000 | $650 |
Medicare Advantage Plans in Nevada for 2026
Medicare Advantage (Part C) plans combine Part A, Part B, and usually Part D into one comprehensive plan. Nevada residents have access to plans from major insurers including:
Top Medicare Advantage Insurers in Nevada
- • Humana: Extensive network coverage in Las Vegas and Southern Nevada
- • UnitedHealthcare: Statewide coverage with strong provider networks
- • Anthem Blue Cross Blue Shield: Wide acceptance throughout Nevada
- • Aetna: Growing presence in urban areas
- • Health Plan of Nevada (HPN): Local insurer with deep Nevada roots
- • Senior Dimensions (HPN): HMO plans tailored for Nevada seniors
Types of Medicare Advantage Plans Available
Health Maintenance Organization (HMO)
- • Lower premiums and out-of-pocket costs
- • Primary care physician required
- • Referrals needed for specialists
- • Network restrictions except emergencies
Preferred Provider Organization (PPO)
- • Higher premiums but more flexibility
- • No PCP requirement
- • No referrals needed
- • Out-of-network coverage available
2026 Medicare Advantage Benefits
Many Nevada Medicare Advantage plans include additional benefits beyond Original Medicare:
- • Dental coverage (cleanings, X-rays, sometimes major work)
- • Vision care (exams, glasses/contacts allowance)
- • Hearing aids and exams
- • Fitness benefits (gym memberships, Silver Sneakers)
- • Over-the-counter allowances ($50-150 quarterly)
- • Transportation to medical appointments
- • Meal delivery after hospital discharge
Medigap (Medicare Supplement) Insurance in Nevada
Medigap policies help cover the "gaps" in Original Medicare, including deductibles, copayments, and coinsurance. Nevada follows federal Medigap regulations with some state-specific provisions.
Available Medigap Plans in Nevada for 2026
Nevada residents can choose from standardized Medigap plans A, B, D, G, K, L, M, and N. Plans C and F are no longer available to new Medicare beneficiaries who became eligible after January 1, 2020.
Most Popular Medigap Plans in Nevada
Plan G - Most Comprehensive
Covers everything Plan F covered except the Part B deductible. Average Nevada premium: $140-200/month
Plan N - Lower Premium Option
Similar to Plan G but with copays for some doctor visits. Average Nevada premium: $110-160/month
High-Deductible Plan G
Lower premiums with a $2,870 deductible (2026). Average Nevada premium: $45-65/month
Nevada's Birthday Rule
Nevada has a "birthday rule" that allows Medigap policyholders to change to an equal or lesser benefit plan within 60 days after their policy anniversary date without medical underwriting. This unique provision provides flexibility not available in most states.
Top Medigap Insurers in Nevada
- • AARP/UnitedHealthcare
- • Anthem Blue Cross Blue Shield
- • Mutual of Omaha
- • Cigna
- • Aetna
Part D Prescription Drug Coverage for 2026
Medicare Part D helps cover the cost of prescription drugs. Nevada residents can get Part D coverage through standalone Prescription Drug Plans (PDPs) or Medicare Advantage plans that include drug coverage.
2026 Part D Cost Structure
Coverage Phases (Estimated)
- 1. Deductible: Up to $615 (varies by plan)
- 2. Initial Coverage: You pay copays/coinsurance until total drug costs reach $5,280
- 3. Coverage Gap: You pay 25% of costs for both brand and generic drugs
- 4. Catastrophic Coverage: After $8,550 in out-of-pocket costs, you pay minimal amounts
Top Part D Plans in Nevada
- • Wellcare Classic
- • SilverScript Choice
- • AARP MedicareRx Preferred
- • Humana Basic Rx Plan
- • Cigna Secure Rx
Nevada Pharmacy Networks
Major pharmacy chains participating in Medicare Part D:
- • CVS Pharmacy
- • Walgreens
- • Smith's Food & Drug
- • Walmart Pharmacy
- • Albertsons/Sav-on
- • Costco Pharmacy
Medicare by Nevada County - 2026 Guide
Clark County (Las Vegas, Henderson, North Las Vegas)
- • Population 65+: 380,000+
- • Medicare Advantage plans: 40+ options
- • Average MA premium: $0-45/month
- • Average Medigap Plan G: $145-195/month
- • Major hospitals: Sunrise, UMC, Valley Health System, St. Rose Dominican
Washoe County (Reno, Sparks)
- • Population 65+: 85,000+
- • Medicare Advantage plans: 25+ options
- • Average MA premium: $0-40/month
- • Average Medigap Plan G: $140-185/month
- • Major hospitals: Renown Health, Saint Mary's, Northern Nevada Medical
Rural Nevada Counties
Rural counties face unique Medicare challenges including:
- • Fewer Medicare Advantage options (5-10 plans)
- • Higher Medigap premiums (10-20% above urban rates)
- • Limited specialist access
- • Greater reliance on telehealth services
- • Critical Access Hospitals in many communities
Rural County Specifics:
- • Carson City: 15+ MA plans, Carson Tahoe Health
- • Douglas County: 12+ MA plans, Carson Valley Medical Center
- • Lyon County: 10+ MA plans, South Lyon Medical Center
- • Elko County: 8+ MA plans, Northeastern Nevada Regional Hospital
- • Nye County: 8+ MA plans, Desert View Hospital
Choosing Between Original Medicare and Medicare Advantage
Original Medicare + Medigap + Part D
Best for Nevada residents who:
- ✓ Want maximum flexibility in choosing doctors
- ✓ Travel frequently or are snowbirds
- ✓ Have specific specialists they want to keep
- ✓ Can afford higher monthly premiums for predictable costs
- ✓ Live in rural areas with limited MA networks
Medicare Advantage
Best for Nevada residents who:
- ✓ Want lower monthly premiums
- ✓ Desire extra benefits (dental, vision, hearing)
- ✓ Are comfortable with network restrictions
- ✓ Don't mind getting referrals for specialists
- ✓ Live in urban areas with robust networks
Cost Comparison Example
| Coverage Type | Monthly Premium | Annual Estimate |
|---|---|---|
| Original Medicare + Medigap G + Part D | $190 + $165 + $35 = $390 | $4,680 |
| Medicare Advantage (with Part D) | $190 + $25 = $215 | $2,580 |
Nevada Medicare Enrollment Assistance
Nevada State Health Insurance Assistance Program (SHIP)
Free, unbiased Medicare counseling available statewide:
- • Phone: 1-800-307-4444
- • Las Vegas Office: 3320 W. Sahara Ave., Suite 100
- • Reno Office: 445 Apple St., Suite 104
- • Carson City Office: 3416 Goni Rd., Building D-132
Social Security Offices in Nevada
- • Las Vegas: 1250 S. Buffalo Dr.
- • Henderson: 1170 Harvard Way
- • North Las Vegas: 4340 Simmons St.
- • Reno: 1170 Harvard Way
- • Carson City: 1170 Harvard Way
Online Resources
- • Medicare.gov: Official Medicare website
- • MyMedicare.gov: Personal Medicare account
- • Nevada Division of Insurance: doi.nv.gov
- • Nevada Aging and Disability Services: adsd.nv.gov
Protecting Yourself from Medicare Fraud in Nevada
Common Medicare Scams in Nevada
- • Calls claiming to be from Medicare asking for personal information
- • Offers for "free" medical equipment or services
- • New Medicare card scams
- • COVID-19 related Medicare fraud
- • Genetic testing scams at senior centers
Protect Your Medicare Number
Guard your Medicare card like a credit card:
- • Never give your Medicare number over the phone unless you initiated the call
- • Medicare will NEVER call you unsolicited
- • Be suspicious of "free" offers
- • Review your Medicare Summary Notices carefully
Report Medicare Fraud
- • Nevada Senior Medicare Patrol: 1-877-841-2345
- • Medicare Fraud Hotline: 1-800-MEDICARE
- • Nevada Attorney General: 702-486-3132
Special Programs for Nevada Medicare Beneficiaries
Extra Help with Prescription Drug Costs
Low-income Nevada residents may qualify for Extra Help (Low-Income Subsidy) which provides:
- • Reduced or eliminated Part D premiums
- • Lower prescription copayments
- • No coverage gap (donut hole)
- • No late enrollment penalty
Medicare Savings Programs in Nevada
Qualified Medicare Beneficiary (QMB)
Pays Part A & B premiums, deductibles, coinsurance, and copayments
Income limit: $1,275/month (individual), $1,724/month (couple)
Specified Low-Income Medicare Beneficiary (SLMB)
Pays Part B premiums only
Income limit: $1,529/month (individual), $2,068/month (couple)
Qualified Individual (QI)
Pays Part B premiums (limited funding)
Income limit: $1,719/month (individual), $2,324/month (couple)
Nevada Medicaid for Dual Eligibles
Some Nevada residents qualify for both Medicare and Medicaid, providing comprehensive coverage with minimal out-of-pocket costs. Contact Nevada Medicaid at 1-877-543-7669.
Key Takeaways for Nevada Medicare 2026
Essential Action Items
- 1. Know Your Enrollment Periods: Missing deadlines can result in lifetime penalties
- 2. Compare Coverage Annually: Plans change every year - review during AEP
- 3. Consider Total Costs: Look beyond premiums to deductibles, copays, and max out-of-pocket
- 4. Check Provider Networks: Ensure your doctors and hospitals are covered
- 5. Review Drug Coverage: Verify your medications are on the formulary
- 6. Utilize Free Resources: Nevada SHIP provides unbiased counseling
- 7. Understand Nevada's Birthday Rule: Unique opportunity for Medigap changes
- 8. Protect Against Fraud: Guard your Medicare number and report suspicious activity
Making the Most of Medicare in Nevada
Medicare provides essential health coverage for Nevada's growing senior population, but navigating the system requires understanding your options and making informed decisions. Whether you choose Original Medicare with supplements or a Medicare Advantage plan, the key is selecting coverage that matches your health needs, budget, and lifestyle.
Nevada's unique features - from the birthday rule for Medigap to the varying coverage options between urban and rural areas - make it especially important to work with local resources who understand our state's specific Medicare landscape.
Remember that Medicare decisions aren't permanent. You have opportunities each year to review and change your coverage during the Annual Enrollment Period. Stay informed, ask questions, and don't hesitate to seek help from Nevada's free counseling services.
Ready to Get Started?
Take the next step in your Medicare journey:
- • Call Nevada SHIP at 1-800-307-4444 for free counseling
- • Visit Medicare.gov to compare plans
- • Contact a licensed Nevada Medicare broker for personalized assistance
- • Review this guide with family members or trusted advisors