Enriched Duals Plan 2025

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Enriched Duals Plan

Available to residents of Washoe County, Storey County, and Carson City.

$0/mo

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.

Questions?  Call us at 775-982-3158

Benefits IncludedPricing
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
Co-payments listed are for preferred facilities.

Plan Information

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 CoverageAmount 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 OrderN/A
Evidence of Coverage Updated (10/17/24)
Summary of Benefits Updated (10/01/24)
Benefits at a Glance Updated (10/01/24)
Over-the-Counter Catalog Updated (10/08/24)
Dental Benefits at a Glance Updated (09/30/24)
Amount you will pay is listed as “in-network / out-of-network”.

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Summary

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.

Enroll Today

Enroll Today