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Nevada Medicaid Eligibility

Nevada Medicaid helps more than 240,000 low-income residents pay for various medical and health care expenses. The Medicaid program is funded by state and federal governments. Medicaid services provide benefits such as wellness care, doctor's visits, prenatal care, emergency and surgical expenses, prescription drugs and more. Eligibility and other requirements for Nevada Medicaid are governed by the Nevada Division of Health Care Financing and Policy.

  1. Income Restrictions

    • Nevada Medicaid Eligibility is income based. This means that a recipient's income cannot exceed a certain percentage of the federal poverty level. In Nevada, Medicaid eligible individuals cannot have income that exceeds 133 percent of the federal poverty level. Individuals with a medical need, such as uninsured pregnant women, may be eligible for Medicaid if their income is between 133 percent and 185 percent of the federal poverty level.

    Eligible Groups

    • Federal law requires the state of Nevada to automatically provide Medicaid coverage to individuals who receive public assistance. Among the eligible groups of Medicaid recipients are low-income families with children, Supplemental Security Income recipients, infants born to Medicaid-eligible mothers, children under six with limited family incomes, and recipients of adoption and foster care assistance.

      Nevada Medicaid is also available to residents who exceed income requirements but have a medical need. Other Medicaid-eligible groups include uninsured women who have been diagnosed with breast or cervical cancer, disabled children who require home health care services and children between the ages of 18 and 21 who are out of foster care.

    Nevada Check Up

    • Nevada Check Up is the state's health insurance program for children of families who do not qualify for Medicaid because of their income but their income is still too low to afford quality health care coverage. Family income must be at or below 200 percent of the federal poverty level. The program covers physician, chiropractor and dental services as well as vision, hospital, ambulatory and emergency services.

    Considerations

    • Nevada Medicaid is available to residents who have other sources of health care coverage but some restrictions apply. Medicaid pays as a last resort. What this means is if a recipient is covered by other health insurance, that coverage will pay medical expenses first and Medicaid will pay any remaining balances after initial coverage limits have been exhausted. Prospective Nevada Medicaid recipients must disclose any and all sources of health care insurance on the application for Medicaid to ensure proper eligibility with state services and programs.

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