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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
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
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  • 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 the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. 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 state 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 Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (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.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (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.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare 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 do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D 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 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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