Medicaid Costs and Coverage in Nevada

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The answers to, “How much is Medicaid in Nevada?” and, “What services are covered by Medicaid programs?” vary depending on a range of factors. Medicaid coverage provides a lot of different medical care at low or no cost. However, the types of Medicaid insurance covered by the programs, such as Nevada Check Up, depend on the particular situation of an applicant. Furthermore, residents should know what Medicaid programs do not cover as well, since the program excludes certain services. Additionally, Nevada Medicaid coverage requires that beneficiaries pay certain out-of-pocket costs, like deductibles or copayments, for certain types of medical services. Understanding what Medicaid covers and the potential costs of coverage are vital for residents seeking assistance from the program. Get more details about Medicaid cost estimates in Nevada and what services are covered by Medicaid by reading through the information provided on this page.

What services are covered by Medicaid in Nevada?

Medicaid coverage in Nevada includes benefits outlined by the federal government, with additional benefits provided by the state. Medicaid is funded with money provided by both the state and federal governments. A majority of that the money helps lower Medicaid price estimates and comes from the national level. The cooperation and combination of funds creates flexibility for each state to extend assistance to more potential beneficiaries or, in some cases, to not provide coverage.

Medicaid coverage benefits can either be required by all states to implement or optional, which may or may not be adopted by the state. For instance, the 2010 Affordable Care Act introduced an expansion of Medicaid to cover more individuals, and this provision is now an option, since Nevada lawmakers chose to accept the Medicaid expansion. Often, what Medicaid covers in a state depends on local resources and needs, leading to the exclusion of certain provisions. Regardless of whether or not a service is mandatory or optional, there may be costs associated with the service. Some types of Medicaid insurance cover mandatory services, which include, but are not limited to:

  • Inpatient and outpatient care.
  • Services from a primary care physician.
  • Pediatrician visits.
  • Transportation to and from medical centers.
  • X-Rays.
  • Birth control and family planning.
  • Dental care.
  • Doctor visits.
  • Emergency room visits.
  • Eye exams and eyeglasses.
  • Hearing tests.
To review more services covered by Medicaid, download our guide.

Nevada Medicaid coverage extends to include assistance for families suffering from mental health issues and substance abuse problems. Mental health services are those techniques, therapies or treatments provided to an individual with an acute, clinically identifiable psychiatric disorder or a chronic psychiatric disorder. Such coverage from Medicaid and Nevada Check Up includes:

  • Inpatient alcohol and substance abuse detoxification services.
  • Psychiatric evaluations.
  • Medication management.
  • Psychological testing.

Crisis intervention.

What services are not covered by Medicaid in Nevada?

When considering how to apply for Medicaid benefits, ask, “What does Medicaid not cover?” as well. Understanding services not covered by Medicaid removes any expectation from potential beneficiaries. Resources are limited, so state and federal officials prioritize some services and ignore elective services almost entirely. Some Medicaid coverage does not extend to such services as:

  • Cosmetic procedures.
  • Occupational, speech or respiratory therapy.
  • Any rentals through on-demand services in hospital rooms.
How much does Medicaid cost in Nevada?

Medicaid cost estimates in Nevada aim to be as low as possible, since the program is designed to help low-income applicants. However, it is important to note that, in some cases, additional costs may occur. Before applying to receive Medicaid coverage, potential benefices should be aware of such potential costs. For instance, household members requiring emergency services or those requesting preventative services may face some out-of-pocket expenses. Additionally, certain Medicaid recipients may be exempt from such extra costs as well.

Medicaid cost estimates are low, because the program receives substantial funding and strives to keep costs minimal for the needy families seeking assistance. Additionally, in cases where copayments are due, Medicaid coverage caps the maximum amount a beneficiary may be charged. Officials determine limits for Medicaid benefit costs based on the income level and size of a household. Applicants deemed eligible for Medicaid receive notifications in the mail regarding possible costs, maximum limits and other vital details. Furthermore, health care providers involved with the Medicaid program may choose to charge less than the maximum limit, but it is at their discretion to do so. However, providers cannot charge more than the maximum limit for Nevada Medicaid coverage established by officials.

In some cases, the answer to “How much does Medicaid cost?” is not even a penny. Specific exemptions keep beneficiaries from paying copayments, altogether. For example, the costs for Medicaid benefits for recipients under the age of 18, pregnant women or those living in nursing homes typically receive such exemptions. Potential beneficiaries should note that Medicaid coverage in Nevada extends across many services, providing them at a low-cost. While many require copayments, other services do not. For instance, chemotherapy, emergency services, home health services and a range of aid provided to the elderly or the disabled do not incur copayments.

To read more about the costs and coverage associated with Medicaid, download our free guide.