Medicare in Las Vegas and Henderson

Medicare is a health insurance program of the United States federal government. In Nevada, thousands of residents of Las Vegas and Henderson rely on Medicare for hospital care, doctor visits and, in many cases, prescription drugs.

Choosing well helps you avoid surprises with doctors, hospitals and prescriptions. As a licensed agent in Nevada, Sara Salazar compares options with you.

• Part A — Hospital: inpatient hospital care, skilled nursing facility care, hospice care and some home health care. If you or your spouse worked and paid taxes for at least 40 quarters (about 10 years), you don't pay a premium. The 2026 deductible is $1,736 per benefit period.
• Part B — Medical services: doctor visits, outpatient care, durable medical equipment and many preventive services. In 2026 the standard monthly premium is $202.90 and the annual deductible is $283.
• Part C — Medicare Advantage: plans from Medicare-approved private insurers that include Parts A and B, and almost always Part D. They may have a provider network and require prior authorization for certain services.
• Part D — Prescription drugs: you get it as a separate plan alongside Original Medicare, or it comes within a Medicare Advantage plan. Out-of-pocket spending on covered drugs is capped at $2,100 in 2026 and $2,400 in 2027.
• Medigap (Medicare Supplement): private insurance that pays part of Original Medicare's deductibles and copays. It does not work with Medicare Advantage.

If your drug costs are high at the start of the year, all drug plans offer the Medicare Prescription Payment Plan: it spreads what you pay out of pocket into monthly payments over the year. It is voluntary and free, but it does not lower the total cost. Sources: Medicare.gov, CMS (2026 premiums), CMS (Part D caps) and Prescription Payment Plan.

The most important decision is choosing between Original Medicare (with a Part D plan and, if you want, a Medigap policy) and a Medicare Advantage plan. Before comparing plans, it helps to have on hand:

• A list of your doctors and hospitals: check that they are in the plan's network.
• A list of your medications with their doses: each plan has its own list of covered drugs.
• How much you can pay each month in premiums and how much in out-of-pocket costs (deductibles and copays).
• Whether you often travel outside Nevada: not all networks cover you the same way outside the area.

• If you have been receiving Social Security for at least 4 months before turning 65, you get Parts A and B automatically. Your card arrives by mail about 3 months before.
• If you don't receive it, you sign up yourself on the Social Security website (ssa.gov). Do it during your Initial Enrollment Period: the 3 months before your birthday month, that month and the 3 months after.
• If you are still working with coverage from your employer, you can generally delay Part B without a penalty. You have 8 months to enroll after the employment or group coverage ends, whichever happens first. COBRA does not extend that deadline.
• Note: if your employer has fewer than 20 employees, Medicare usually pays first and you may need Part B starting at 65. Check this before delaying it.
• Once you have Parts A and B, you choose how to get your coverage: Original Medicare with Part D (and Medigap if you want) or a Medicare Advantage plan.

Source: Medicare.gov — when coverage starts.

• Initial Enrollment Period: 7 months around your 65th birthday.
• Annual Enrollment Period: from October 15 to December 7. You can switch from Original Medicare to Medicare Advantage or the other way around, change Advantage plans, and join, switch or drop a drug plan. New coverage starts January 1.
• Medicare Advantage Open Enrollment Period: from January 1 to March 31, only if you already have a Medicare Advantage plan.
• General Enrollment Period: from January 1 to March 31, for people who did not sign up for Part A or B when they were first eligible. Coverage starts the following month.
• Special Enrollment Periods: when your situation changes, for example if you move or lose your current coverage.

Sara helps you determine whether you are in a valid period before the deadlines pass.

• Part B: your premium goes up 10% for each full 12-month period you could have enrolled and didn't. For example, with a 24-month delay the 2026 premium would be $243.50 instead of $202.90. In general, you pay it for as long as you have Part B.
• Part D: if you go 63 days in a row or more without creditable drug coverage, the penalty is 1% of the national base premium ($38.99 in 2026) for each month without coverage, and it is added to your premium for as long as you have Medicare drug coverage, even if you change plans.

Source: Medicare.gov — how to avoid penalties.

Your Medigap Open Enrollment Period lasts 6 months and starts the first month you have Part B and are 65 or older. During that time the insurer cannot deny you the policy because of prior health problems.

In addition, Nevada has a birthday rule: each year, starting on the first day of your birthday month and for at least 60 days, you can switch to another Medigap policy with equal or lesser benefits without medical underwriting (NRS 687B.352).

• Extra Help: lowers the premium, deductible and copays for your drugs. In 2026 the limits are $23,940 in annual income and $18,090 in resources for one person, or $32,460 and $36,100 for a couple.
• Medicare Savings Programs (QMB, SLMB and QI): they can pay your Part B premium and, in the case of QMB, also deductibles and copays. In Nevada you apply through the Division of Welfare and Supportive Services (DWSS).
• Free counseling: Nevada's State Health Insurance Assistance Program (SHIP) is the Nevada Medicare Assistance Program (MAP), at 1-800-307-4444.

Sources: Extra Help and Medicare Savings Programs on Medicare.gov.

Available plans and doctor networks vary by county and ZIP code. An agent who knows the Clark County market can explain which hospitals and specialists accept each option in your area.