Medicare and Medicaid in Nevada

If you're new to this, start with how Medicare and Medicaid work together. Nevada's other offices are on Medicare help in Nevada.

With Medicare and full Nevada Medicaid, the state pays the $202.90 a month Medicare costs you and most of your copays. Medicaid also pays for care Medicare does not, like help at home and rides. In Nevada, full Medicaid at home is mostly for people with very low income. Maybe you were told no because your Social Security is a little too high. That's the Nevada rule at work, and a savings program may still help. The Division of Social Services (DSS) decides, and you apply at accessnevada.nv.gov.

You may qualify if

• You're 65 or older, or have a disability, and live in Nevada.
• Your countable income is under $1,030.40 a month for one person on their own. If you need nursing home level care, the limit is $2,982.
• Your savings are under $2,000, or $3,000 for a couple. Your home and usually one car don't count.

Not sure you qualify? Apply anyway, because one DSS form checks you for Medicaid, the Medicare Savings Programs and food help at once. If you would rather not do it alone, a Pair Team advocate can check with you in one call.

Ways to get Medicaid help in Nevada when you have Medicare

These limits are from Social Security and DSS. The $2,982 is three times the 2026 SSI amount, the DSS rule for this care.

Why is Medicaid harder to get at 65 in Nevada?

Medicaid is harder to get at 65 in Nevada because the state ties it to SSI. It also has no spenddown, a program that counts your medical bills against your income. In California and New York, one person 65 or older can have $1,836 a month. In Nevada, income over the SSI amount usually rules out full Medicaid, unless you need nursing home level care.

Do I get Medicaid automatically with SSI?

You don't get Nevada Medicaid automatically with SSI, because Nevada makes its own Medicaid decision. Social Security lists Nevada as one of eight states that work this way. Once you're approved for SSI, apply with DSS too. See SSI in Nevada.

What if I need nursing home level care?

If you need nursing home level care, Nevada Medicaid can pay for it with income up to $2,982 a month. To get that care at home, ask the Aging and Disability Services Division (ADSD) about the Frail Elderly waiver. It's for people 65 and older, and services depend on the money the state has, ADSD says. In a nursing home, you keep $154 a month for personal needs, DSS says. See Medicaid home care in Nevada.

Do I have to join a health plan?

You don't have to join a health plan, because people 65 and older stay on regular fee-for-service Medicaid, Nevada Medicaid says. Health plans spread to every county on January 1, 2026, but only for other groups.

How to apply

1. Get your papers together. DSS will want your Medicare card, your Social Security letter, a photo ID and your latest bank statements.
2. Apply online at accessnevada.nv.gov, or fill out form 2920-EM, the Application for Assistance. It comes in English and Spanish on the DSS site. Mail it or bring it to a DSS office.
3. Call if you need help. DSS is at 1-800-992-0900, or 775-684-7200 in the north and 702-486-1646 in the south. DSS doesn't require an in-person interview, its manual says.
4. Wait for the answer. DSS has 45 days to decide, or 90 if it has to decide about a disability.
5. Ask about back months. Medicaid can pay bills from up to three months before you applied.

If you are turned down

You have 90 days from the date on your notice to ask for a hearing in writing, the DSS manual says. Hearings are held by phone for now, and the hearings office is at 702-486-1910. If DSS is cutting your Medicaid, ask within 10 days after the cut takes effect to keep it while you wait.

What a Pair Team advocate does

In Nevada, a lot of our Medicaid calls are about the gap between SSI and everything else. This is what we do:

• Figure out in one call if full Medicaid, the Frail Elderly waiver or a Medicare Savings Program fits.
• Help you fill out form 2920-EM or apply on Access Nevada, then call DSS until you have an answer.
• Help you set up help at home and Medicaid rides in Nevada.
• Help with what usually comes with it: food, power bills and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

My Social Security is just over the SSI amount. What can I do?

If your Social Security is just over the SSI amount, apply for QMB, which pays the $202.90 and your Medicare copays. One person can have up to $1,350 a month in Social Security and still get it, because DSS takes off $20 first.

I lost SSI when my Social Security went up. Do I lose Medicaid?

You may not lose Medicaid when you lose SSI. DSS has a group for people who lost SSI but would still qualify if some of their income didn't count. Ask DSS to check you for it before your Medicaid ends.

Is there a program that gives me Medicare and Medicaid from one place?

A program that gives you both from one place, the Program of All-Inclusive Care for the Elderly (PACE), isn't in Nevada yet. A 2025 state law paid to start it, and Nevada Medicaid's tentative plan is to open enrollment in early 2028.

Do I get Extra Help with prescriptions?

Yes, with Medicaid or a Medicare Savings Program you get Extra Help automatically, Medicare.gov says. You don't need a separate form.

Who do I call about my Medicaid card or a bill?

For your card or a bill, call Nevada Medicaid at 1-866-569-1746. For your application or renewal, call DSS at 1-800-992-0900. For free Medicare advice, call the Medicare Assistance Program (MAP) at 1-800-307-4444. MAP and Pair Team don't sell plans.

Sources

• General Medical Information, Nevada Division of Social Services
• Income Limit Charts, Nevada Division of Social Services
• Apply for Assistance (Medicaid), Nevada Division of Social Services
• Medical Assistance Manual, Nevada Division of Social Services
• Administrative Adjudications Unit, Nevada Division of Social Services
• Statewide Managed Care Program, Nevada Medicaid
• Program of All-Inclusive Care for the Elderly, Nevada Medicaid
• Contact Nevada Medicaid, Nevada Health Authority
• Waiver for the Frail Elderly, Aging and Disability Services Division
• Medicare Assistance Program, Aging and Disability Services Division
• Supplemental Security Income in Nevada, Publication 05-11106, Social Security Administration
• SI 01715.020 List of State Medicaid Programs for the Aged, Blind and Disabled, SSA Program Operations Manual
• SSI Federal Payment Amounts for 2026, Social Security Administration
• Medicaid, Medicare.gov
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS