Medicaid

12/29/2021

Medicaid

Announcements

To all Medicaid Enrollees - Managed Care Organization changes are coming!

Effective January 1, 2022, Medicaid enrollees may be switched to one of four MCOs. Enrollees that are switched, will have 90 days to choose a different MCO. After that 90 days, enrollees will be locked in until January 1, 2023.

Pandemic Emergency Assistance Fund (PEAF)

The Nevada Division of Welfare and Supportive Services (DWSS) has been given the opportunity through the American Rescue Plan Act (ARPA) of 2021 Pandemic Emergency Assistance Fund (PEAF) to further assist needy Nevada families impacted by COVID-19.https://dwss.nv.gov/TANF/TANF_PEAF_Program_Info/

Pandemic Electronic Benefits Transfer (P-EBT) Program

Delay in P-EBT Card Delivery!! Due to the high volume of returned mail, card delivery was not completed by the anticipated October 14th date. Staff is currently sorting returned mail, updating addresses, and resending cards to the intended recipients. This will add up to 6 weeks to card delivery time if your child's P-EBT card has been returned by USPS.

Nevada Medicaid

Medicaid will provide low cost yet quality health care services to low-income Nevadans. It is a form of state and government funded free or affordable health insurance. Some examples of what is covered includes medications, doctor visits, physicals, hospital expenses, and more. It also pays for substance abuse needs, such as alcohol or drug additions. This is the state's version of the general Medicaid program.

Information regarding Medicaid can be found on the Division of Welfare and Supportive Services site or call 1-877-543-7669. To apply for Medicaid online visit Access Nevada. Once you have an Access Nevada account and your eligibility has been determined by DWSS, you can link your Access Nevada account to your eligibility case to report a change of address or income, request a new Medicaid insurance card, or cancel coverage.

Access Nevada is the one stop portal for residents of the State of Nevada to apply for assistance, report changes in household circumstances, check the status of their case, receive online communications, and other account management tools.

Nevada Check Up

The Mission of the Nevada Check Up program is to provide low-cost, comprehensive health care coverage to low income, uninsured children (birth through 18) who are not covered by private insurance or Medicaid; while (1) promoting health care coverage for children; (2) encouraging individual responsibility; and (3) working with public and private health care providers and community advocates for children.

Authorized under Title XXI of the Social Security Act, Nevada Check Up (NCU) is the State of Nevada's Children's Health Insurance Program (CHIP).

The Children's Health Insurance Program was established by Congress to provide access to affordable health insurance for children in working, low-income families. The enabling legislation for CHIP, included in the Balanced Budget Act of 1997, funded the program for a 10 year period. Congress provided funding extension until 2009 when through the Children's Health Insurance Program Reauthorization Act (CHIPRA) Congress provided for continuation of the Program. In 2010 the Patient Protection and Affordable Care Act (Health Care Reform) enacted maintenance of effort requirements for continuation of eligibility standards for children until October 1, 2019.

The NCU program began providing services to Nevada's children on October 1, 1998.

NCU delivers the basic Medicaid State Plan for health benefits, with some minor exceptions. The Medicaid provider network and Medicaid-contracted HMOs (in the urban areas of Nevada) provide the covered services to eligible children. NCU enrollees are mandated to receive treatment under an HMO in the urban areas of the state. You can find more information on the Medicaid benefit plan and the contracted HMOs on the Nevada Division of Health Care Financing and Policy website.

The Division of Health Care Financing and Policy manages the Nevada Check Up program's health policy benefit. The Division of Welfare and Supportive Services manages the eligibility for program enrollment. Families may apply for their children through Division of Welfare and Supportive Services (DWSS) website below, or in person at a DWSS office. Office locations are listed on the DWSS website under, "Contact DWSS".

Like Medicaid, CHIP is a joint federal-state program, with funding from both sources, and it is implemented by each state.

Premium Information:

The only cost to the Nevada Check Up enrollee is a quarterly premium. Enrollees are not required to pay co-payments, deductibles, or other charges for covered services. Premiums are determined by family size and income.

Premiums are charged for participation in Nevada Check Up. American Indians who are members of federally recognized Tribes and Alaska Natives are exempt from premiums. Quarterly premiums are either $25, $50 or $80, based on gross income, and are charged per family (not per child). Quarterly premiums are due the first day of each January/April/July/October for the month in which enrollment begins (e.g. the quarterly premium would be due on the first day of April for enrollment beginning the April/May/June quarter). There is a 15 day grace period for quarterly premium payments. The Division of Health Care Financing and Policy (Medicaid) sends premium, late and final notices to inform eligible families of their responsibility for payment. If payment is not received by the end of the grace period, children will be disenrolled effective the first day of the following month.

  • Premiums are $25, $50, or $80 and are charged per family, not per child.
  • Premiums are billed quarterly and are due every January 1, April 1, July 1, and October 1.
  • Premium payments are NOT accepted over the phone or online.
  • Only checks or money orders are accepted - NO CASH.
  • Timely Payments must be mailed to:

Nevada Check Up

P O Box 847346

Los Angeles, CA 90084-7346

  • Late Payments may be paid in person at the following locations Monday thru Friday 8:00am-4:45pm.


Carson City

1000 E Williams St., Suite 118
Carson City, NV 89701

Phone: (775) 684-3660

Elko

1010 Ruby Vista Dr., Suite 103
Elko, NV 89801

Phone: (775) 753-1191

Las Vegas

1210 S. Valley View Blvd.
Las Vegas, NV 89102

Phone: (702) 668-4200

Reno

745 W. Moana Ln., Suite 200
Reno, NV 89509

Phone: (775) 687-1900

Non-payment of premium will result in a 90 day sit-out period.

  • If payment is received during the 90 day sit-out, coverage may be reinstated provided payment is received prior to the cutoff date. Clients should call DHCFP if the cutoff date is unknown.
  • If payment is received after the 90 day sit-out, a new application is required.

Programs available through Access Nevada 

SNAP

A federally funded program to help low-income families buy nutritious food from authorized retailers, also known as "Food Stamps" or "Supplemental Nutritional Assistance Program".

TANF

TANF is designed to provide Temporary Assistance for Needy Families to care for dependent children in their own homes or in the homes of relative caregivers. TANF provides Financial and Support Services such as CHILD CARE, TRANSPORTATION and Other Services. 

Medicaid

The Medicaid Program is a federal program administered by the state. Its purpose is to help meet the cost of medical services for individuals receiving public assistance payments, and individuals and families with low income. The program objective is to provide medical and related services to assist individuals to attain or retain an optimal level of health care.

There are several Medicaid-related programs for which DWSS determines eligibility. These programs include coverage for low income individuals, families, children, specialized households, and the elderly and disabled.

You can also shop for a Qualified Health Plan through the health insurance marketplace and select the program that best fits your needs and your income. You may qualify for financial assistance from the federal government for your health plan purchase.

Child Care Assistance

The Child Care Program assists low-income families, families receiving temporary public assistance and those transitioning from public assistance in obtaining child care so they can work. Other services include Resource and Referral for parents seeking child care and consumer information on the aspects of quality child care. Resource and Referral services are available to all Nevada families at no cost.

* If you are applying for Child Care Assistance your application will be forwarded to Las Vegas Urban League if you are applying from Southern Nevada, Clark and Nye County. All other counties applications will be sent to The Children's Cabinet.

WIC

WIC provides nutritious foods, nutrition education, breastfeeding support, and referrals to health and other social services to participants at no charge.

WIC serves income eligible pregnant, postpartum and breastfeeding women, and infants and children up to age 5 who are at nutrition risk.

* If you are applying for WIC Assistance your application will be forwarded to the Nevada WIC State Office in Carson City, Nevada.

Victims of Crime

The Victims of Crime Program "VOCP" can assist victims of violent crime and their families cope and recover from the physical, emotional and financial impact of violent crime, by helping pay expenses related to the crime such as: 

  • Hospital and Ambulance Bills
  • Medical and Dental Treatment
  • Mental Health Counseling
  • Wage Loss
  • Funeral and Burial Expenses
  • Loss of Support for Dependents
  • Relocation Costs
  • Crime Scene Cleanup

The VOCP can help victims of violent crimes such as: 

  • Assault/Battery 
  • Robbery 
  • Sexual Assault 
  • Domestic Violence 
  • Physical Abuse 
  • Child Abuse 
  • Elder Abuse 
  • Homicide 
  • Drunk Driving

*VOCP functions as a payor of last resort. Victims with insurance coverage must exhaust available insurance before VOCP can take effect.

To apply for VOCP, please visit https://voc.nv.gov