Available to residents of Washoe County, Storey County, and Carson City.
If you reside in Clark County and have Medicare AND Medicaid, the Enriched Duals Plan is outstanding, benefit-rich option you should consider. Enriched Duals Plan members enjoy thousands of dollars in extra benefits for a $0 premium when enrolled in both Medicaid and Medicare. In most cases, Medicaid covers the premium and copay amounts.
| Benefits Included | Pricing |
|---|---|
| PRIMARY CARE VISIT | $0 per visit |
| SPECIALIST VISIT | $0 per visit |
| ROUTINE LAB SERVICES | $0 per visit |
| URGENTLY NEEDED CARE | $0 per visit |
| OVER-THE-COUNTER BENEFIT | $200 Quarter |
| DENTAL COVERAGE | $2,000 Comprehensive Included |
| Doctors & Hospitals | Amount You Will Pay |
|---|---|
| Maximum Out-of-Pocket | $0 per year |
| Primary Care Office Visit | $0 per visit |
| Specialist Office Visits | $0 per visit |
| Urgently Needed Care | $0 per visit |
| Routine Lab Services | $0 per visit |
| Diagnostic Tests (X-ray, CT, MRI) | $0 per test |
| Emergency Room Care | $0 per visit |
| Ambulance Services | $0 per trip |
| Inpatient Hospital | $0 per stay |
| Outpatient Hospital Services | $0 per visit |
| Prescription Coverage | Amount You Will Pay for Preferred Medications |
|---|---|
| Coverage in the Gap | N/A |
| Rx Deductible | $0 Deductible per year |
| Preferred Generic (Tier 1) | Generic $0 - $4.90 |
| Non-Preferred Generic (Tier 2) | Generic $0 - $4.90 |
| Preferred Brand (Tier 3) | Brand $0 - $12.15 |
| Non-Preferred Brand (Tier 4) | Brand $0 - $12.15 |
| Specialty Drugs (Tier 5) | 33% coinsurance |
| Select Drug (Tier 6) | Not Covered |
| 90-day Retail / 90-day Mail Order | N/A |
The Extensive Duals Plan offers individuals that have Medicare Part A and Part B and also qualify for Medicaid in the state of Nevada additional benefits that are not covered on their existing programs. Senior Care Plus works with the Nevada Medicaid program to ensure coordination of member’s benefits. The plan’s premium is covered by Medicaid for most members, as well as many of the other out-of-pocket costs. The Extensive Duals Plan has a hearing benefit from NationsHearing® that includes a $0 hearing exam and a generous hearing aid benefit. NationsOTC® provides a $205 quarterly Over-the-Counter benefit with free two-day shipping. The Extensive Duals Plan has also a $2,500 first dollar comprehensive dental benefit from Liberty Dental. And once you enroll, you will have access to a Personal Assistant, who can help schedule appointments and navigate the healthcare system when you select a Renown Primary Care Provider (PCP). The prescription drug coverage included in the Extensive Duals Plan is comprehensive.
Above is a partial list of benefits and should not be construed as a complete list. Please refer to the Evidence of Coverage in the plan documents section above complete plan details. Out-Of-Network Providers: If you use an out-of-network provider, your share of the costs for your covered services may be higher. Out-of-network providers are under no obligation to treat members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
*Hometown Health /Senior Care Plus has been approved by the National Committee for Quality Assurance (NCQA) to operate a Special Needs Plan. Approval is based on Senior Care Plus Model Of Care. Contract H2960 2025
