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Nevada State Pharmacy Assistance Programs (SPAP)

Nevada Senior Rx, and
Nevada Disability Rx



:: Nevada Senior Rx Program
:: Important Note
:: Nevada Disability Rx

Nevada Senior Rx Program


Eligibility Requirements: You must meet the following requirements:
  • You must be a Nevada resident for at least one year.
  • Your income must not exceed limits for yourself (one person $27,701 annually) and your spouse (couple $36,927 annually).
  • You must be ineligible for Medicaid.
  • Applicant and spouse(if spouse is applying)must be age 18 through 61 with verifiable disability, or 62 years at the time of application.
  • Applicants who are eligible for Medicare Part D must enroll in a Medicare prescription drug plan and use that program as the first source of help with prescriptions. In addition, Part D beneficiaries who qualify for extra federal help with Part D costs (such as premiums, deductibles and co-payments)must apply for and, if approved, use that help. This is important because the federal help may cover more of the beneficiary's out-of-pocket costs than Senior Rx or Disability Rx can.
  • Beneficiaries with very low incomes and limited assets should contact the Social Security Administration at 1-800-772-1213 to find out more.
Important Notes: Senior Rx provides assistance with Medicare Part D expenses for members who ARE eligible for Part D and a cost-sharing benefit for members who are NOT eligible for Part D.

Nevada’s Senior Rx prescription program currently has a waitlist. The persons on the wait list with the lowest household income designated, receive priority for enrollment.

Senior Rx is funded with a portion of Nevada’s share of tobacco settlement funds and was passed into law during the 1999 legislative session. Senior Rx provides up to $5,100 in benefits per year depending on the member’s situation. Many of the program’s benefits are administered through a contracted pharmacy benefit manager (Catalyst Rx). Other benefits are coordinated directly with the Medicare Part D plans that serve as the first prescription drug resource for enrolled members.

Based on funding availability, the benefits are For those who are Not Medicare Eligible: No monthly premium, No deductible, Co-payments of $10 for generics or $25 for preferred brands, and Annual coverage limit of $5,100. For those who are Medicare Eligible: Help with monthly premiums for Medicare Part D Prescription Drug Plan (if not qualified for maximum help from Medicare with that expense). Help with prescription costs after reaching the Medicare Part D coverage limit

Enrollment for Nevada’s Senior RX Program is open.
  • You do not need to attach income, age, or disability verification to the application. However, you may be asked to provide such documentation at a later date.
  • Please include a copy of Medicare card and Medicare Part D card if Medicare eligible.
  • Married couples need to submit only one application for both spouses.
  • You will be notified of eligibility status within 30-45 days of receipt of your application unless the Department of Health and Human Services needs to request additional information to process your application.
Contact Information: Phone
(866) 303-6323
(775) 687-4210

Address
Nevada Senior Rx Program
Department of Health and Human Services
3416 Goni Road, Suite D-132
Carson City, NV 89706
: : Nevada Senior Rx Program


Nevada Disability Rx:
You must meet the following requirements:
  • You must be a Nevada resident for at least one year.
  • Your income must not exceed limits for yourself (one person $26,836 annually) and your spouse (couple $35,773 annually).
  • You must be ineligible for Medicaid.
  • You must be between the ages of 18 through 61 and have a verifiable disability.

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Important Note

Nevada Senior Rx:
The program is open with NO waitlist and are accepting applications. Married couples need to submit only one application for both spouses. Senior Rx provides up to $5,100 in benefits per year. For non-Medicare members, many of the most commonly prescribed drugs are available through Senior Rx for a co-pay of $10 for generics and $25 for preferred brands. For Medicare members, the state will offer assistance with Part D premiums, not to exceed the federal low-income benchmark, and will cover 100% of costs in the coverage gap.


Nevada Disability Rx


Eligibility Requirements: You must meet the following requirements:
  • You must be a Nevada resident must have lived continuously in Nevada for at least one year (12 consecutive months) prior to the date of application.
  • The maximum annual household income for singles is $27,292, and the maximum annual household income for married couples is $36,381 (effective July 1, 2013).
  • You must be ineligible for Medicaid.

  • You cannot receive full Medicaid benefits (prescription benefits) and Disability Rx at the same time.
  • You must be between the ages of 18 through 61 and have a verifiable disability.
Important Notes: The State provides assistance with Medicare Part D expenses for members who are eligible for Part D and a cost-sharing benefit for members who are not eligible for Part D.

The program has limited funding and currently has a waiting list. Married couples need to submit only one application for both spouses. Disability Rx provides up to $5,100 in benefits per year. For non-Medicare members, many of the most commonly prescribed drugs are available through Disability Rx for a co-pay of $10 for generics and $25 for preferred brands.

For Medicare members, the state will offer assistance with Part D premiums, not to exceed the federal low-income benchmark, and will cover 100% of costs in the coverage gap.
Contact Information: Phone
(866) 303-6323
(775) 687-4210

Address
Nevada Disability Rx
Department of Health and Human Services
3416 Goni Road
Building D, Suite 132
Carson City, NV 89706
: : Nevada Disability Rx

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Tips & Disclaimers
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA....
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to Medicare Part D IRMAA, just as are members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • When enrolled in a Medicare Advantage plan, you must have both Part A and B to enroll. Members may enroll in the plan only during specific times of the year. Contact the plan for more information.
  • For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Private Fee-for-Service plan is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Institutional SNP: "This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home."
  • Dual Eligible SNP: This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Chronic Condition SNP: "This plan is available to anyone with Medicare who has been diagnosed with <Chronic Condition>."
  • MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans don’t cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan.
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may also enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.


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