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Medicaid is a crucial program for low-income individuals and families, ensuring access to essential healthcare services. For residents of Las Vegas, Nevada, understanding Medicaid eligibility, benefits, and the application process is essential for securing healthcare coverage. If you're a Las Vegas resident or considering Medicaid for yourself or your family, this guide will walk you through the essential details to help you navigate the process.

What is Medicaid?
Medicaid is a government-funded program designed to provide health insurance for individuals and families with limited income. The program is jointly administered by federal and state governments, and each state runs its own Medicaid program within federal guidelines. In Nevada, Medicaid provides a broad range of health services for qualifying individuals, including doctor visits, hospital stays, preventive care, prescription medications, mental health services, and more.

Medicaid Eligibility in Las Vegas
To qualify for Medicaid in Las Vegas, individuals must meet specific income and residency requirements, among other criteria. Medicaid eligibility is determined based on various factors, including:
1.    Income Level: Nevada uses a "modified adjusted gross income" (MAGI) to determine eligibility. The income limits depend on the individual’s household size and other factors, but in general, those whose income falls at or below 138% of the Federal Poverty Level (FPL) may qualify.
2.    Age and Disability Status: Children, pregnant women, individuals with disabilities, and seniors may qualify for Medicaid based on specific needs or income levels. Pregnant women, for example, may be eligible for Medicaid if their household income is under 138% of the FPL, while children under 19 can qualify at a higher income level.
3.    Residency: Applicants must be residents of Nevada. Individuals who are undocumented are typically not eligible, but U.S. citizens or lawful permanent residents may apply.
4.    Other Factors: Special groups like individuals in long-term care, foster children, or those receiving Supplemental Security Income (SSI) are also eligible for Medicaid in Nevada.

Benefits of Medicaid in Las Vegas
Medicaid in Las Vegas covers a broad range of services, including but not limited to:
•    Routine and Emergency Medical Care: Medicaid covers visits to doctors, specialists, and hospitals.
•    Mental Health Services: Medicaid includes therapy, counseling, and psychiatric services, ensuring that individuals with mental health needs are supported.
•    Prescription Medications: Medicaid provides coverage for necessary prescriptions, making medications affordable for those in need.
•    Preventive Services: Regular screenings, vaccines, and other preventive measures to keep individuals healthy.
•    Dental and Vision Coverage: Medicaid in Nevada offers limited dental and vision care, especially for children and those with certain conditions.
•    Long-term Care: Medicaid covers long-term care needs, such as nursing home stays or in-home health services for elderly individuals or those with disabilities.
•    Transportation Services: If needed, Medicaid will help with transportation to and from medical appointments.

How to Apply for Medicaid in Las Vegas
Applying for Medicaid in Las Vegas is straightforward, and there are several ways to apply:
1.    Online Application: Visit the Nevada Health Link website (www.nevadahealthlink.com) to apply online. This is the quickest and most convenient way to apply for Medicaid in Nevada.
2.    In-Person Application: You can also visit a local Division of Welfare and Supportive Services (DWSS) office to apply in person. Staff can assist you with the process and answer any questions.
3.    Phone Application: You can apply over the phone by calling the Nevada Medicaid helpline at 1-800-992-0900.
4.    Through a Navigator or Broker: Navigators are trained professionals who help individuals understand their healthcare options. They can help you apply for Medicaid and answer any questions about eligibility.
Make sure to have the necessary documents on hand when applying, such as proof of income, residency, identification, and any medical records if applicable.

Renewal and Maintenance of Medicaid Coverage
Once you are enrolled in Medicaid, you must maintain your eligibility. Nevada Medicaid requires that you renew your coverage every 12 months. It’s essential to update your information, such as changes in household income or family size, as it may impact your eligibility or the benefits you're entitled to.

Medicaid Alternatives and Other Healthcare Resources
In some cases, individuals may not qualify for Medicaid in Las Vegas, but there are alternative programs that can help cover healthcare costs, such as:
•    The Nevada Check Up Program: This is a state-run program for uninsured children under 19 years of age. Children who do not qualify for Medicaid but are still within certain income limits can receive affordable healthcare coverage through Nevada Check Up.
•    Marketplace Health Insurance Plans: If you don’t qualify for Medicaid, you may still be able to purchase health insurance through the Health Insurance Marketplace. The Nevada Health Link offers a marketplace where you can explore plans that may provide coverage at a reduced cost depending on your income.

Conclusion
Medicaid plays a vital role in ensuring that residents of Las Vegas have access to healthcare services, regardless of their income. Understanding Medicaid eligibility, benefits, and the application process is the first step in securing health coverage. If you or your family are struggling with healthcare costs, it’s worth exploring your eligibility for this valuable program. Whether you apply online, in person, or over the phone, Nevada provides several ways to access the Medicaid program and get the healthcare services you need.

For more information on Medicaid in Las Vegas, you can visit the Nevada Medicaid website or speak with a local navigator who can help guide you through the process.

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Who is eligible for Medicaid WEARC
The Medicaid Waiver for the Elderly in Adult Residential Care (WEARC) in Nevada has been replaced by the Home and Community-Based (HCB) Elderly Waiver, which offers similar benefits.

Eligibility Criteria:
•    Age: Applicants must be 65 years or older.
•    Functional Need:  Applicants must require a nursing facility level of care or be at risk of requiring such care within 30 days without waiver services.
•    Income Limit:  As of 2025, the monthly income limit for a single applicant is $2,901.
•    Asset Limit: A single applicant's countable assets must not exceed $2,000.

Application Process:

• To apply for the HCB Elderly Waiver in Las Vegas, contact the Aging and Disability Services Division (ADSD) Regional Office.

• Applications can also be submitted through Access Nevada, the state's online portal for Medicaid services.

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Additional Information:
Enrollment in the waiver program is limited, and waiting lists may exist. It's advisable to apply as early as possible and to consult with a Medicaid planner if your income or assets exceed the eligibility limits.

Get to know Medicaid
Medicaid is a public health insurance program in the United States that provides free or low-cost health coverage to individuals and families with limited income and resources. It is jointly funded by the federal and state governments but is managed by individual states, meaning eligibility rules, benefits, and coverage options can vary from state to state.
Key Features of Medicaid:
1.    Eligibility:
o    Income-Based: Primarily for people with low incomes, including children, pregnant women, parents, seniors, and individuals with disabilities.
o    Other Criteria: In many states, eligibility is also based on family size, age, and other factors.
o    The Affordable Care Act (ACA) expanded Medicaid eligibility in many states to include adults with incomes up to 138% of the federal poverty level.
2.    Services Covered: Medicaid covers a wide range of health services, including:
o    Doctor visits
o    Hospital stays
o    Preventive care (e.g., vaccines, screenings)
o    Prescription drugs
o    Mental health services
o    Long-term care (nursing homes and home health care)
o    Dental and vision care (varies by state)
3.    Costs:
o    Medicaid is generally free for enrollees, though some states charge minimal premiums, co-payments, or cost-sharing for certain services, depending on income and state rules.
4.    Dual Eligibility:
o    Some individuals are eligible for both Medicaid and Medicare (another federal health insurance program, primarily for seniors and people with disabilities). This is known as "dual eligibility."
5.    State Differences:
o    Each state administers its own Medicaid program within federal guidelines. As a result, the name of the program, eligibility rules, and specific benefits can differ.
Medicaid plays a vital role in providing health care to vulnerable populations and is one of the largest sources of health insurance in the U.S.

How to apply for Medicaid
For more detailed information, refer to the Nevada Medicaid Brochure provided by the Division of Welfare and Supportive Services.
To apply for the Medicaid Waiver for the Elderly in Adult Residential Care (WEARC) in Las Vegas, follow these steps:
1.    Contact the Aging and Disability Services Division (ADSD):
o    Phone: Call your local ADSD Regional Office to inquire about the application process and obtain necessary forms.
o    Online: Visit the official ADSD website for more information.
2.    Complete the Application:
o    Paper Application: Fill out the required forms provided by ADSD. Ensure all sections are completed accurately.
o    Supporting Documents: Gather necessary documents such as proof of income, residency, and medical evaluations.
3.    Submit the Application:
o    Mail: Send your completed application and supporting documents to the appropriate ADSD office.
o    In-Person: You may also submit your application directly at an ADSD office.
4.    Await Assessment:
o    After submission, your application will be reviewed to determine eligibility. This may involve an in-person assessment to evaluate your care needs.
5.    Notification:
o    You will receive a notification regarding your eligibility status. If approved, a case manager will be assigned to coordinate your services.
Please note that enrollment in the WEARC program is limited, and there may be a waiting list. As of late 2014, the average wait time was approximately 90 days. 

Paying for Senior Care
For more detailed information, visit the official webpage for the program. 
If you need assistance with the application process or have questions about eligibility, consider reaching out to a Medicaid planner or a local Family Resource Center for guidance.
Here are some ADSD Regional Offices in Las Vegas you can contact:
ADSD Las Vegas Regional Office
Las Vegas, NV
Provides information and assistance on aging and disability services, including the WEARC program. 
ADSD Henderson Office
Henderson, NV
Offers support and resources for elderly and disabled individuals seeking Medicaid waivers. 
These offices can provide personalized assistance with your application.