Types of Alternate Resources

Our Benefits Resources office assists patients with obtaining health insurance, as well as to inform patients of other benefit programs. Applying for alternate resources is mandatory for a number of our FTHC programs. Even if you believe you are over income, patients will still need to apply for all alternate resources and our Benefit Resources staff can assist with that. We can help you with applications and renewals, as well as answer any questions you have about your application and on-going cases. Some of the services and programs that we coordinate and work with include:

  • Nevada Medicaid and Nevada Check-Up
  • Nevada Supplemental Nutrition Assistance Program (SNAP)
  • Nevada Temporary Assistance for Needy Families (TANF)
  • CMS Connecting Kids to Coverage (CKC)
  • Medicare
  • IHS Catastrophic Health Emergency Fund (CHEF)

Nevada Medicaid

Medicaid provides free health care coverage for low-income Nevadans, including:

  • Adults between age 19-64 whose household income is at or below 138% of the Federal Poverty Level (FPL)
  • Children under age 19 whose income is at or below 205% of the FPL
  • Pregnant Women whose household income is less than 165% of the FPL
  • Parents or Caretakers with income at or below 138% of the FPL
  • Supplemental Security Income recipients
  • Certain Medicare beneficiaries

Nevada Check-up (formerly Nevada CHIP)

Nevada Check-Up provides medical and dental benefits for children from birth to 18 years old. To qualify, your income must be at or below 205% of the Federal Poverty Level. In some situations, a small premium, on a quarterly basis, may be required.

Supplemental Nutrition Assistance Program (SNAP)

The SNAP Program helps low-income Nevadans buy nutritious food from local retailers. The amount of SNAP benefits issued to each household size is based on the U.S. Department of Agriculture’s Thrifty Food Plan, which is an estimate of how much it costs to buy food to prepare nutritious, low-cost meals.

Temporary Assistance to Needy Families (TANIF)

The TANF Program is designed to help families achieve self-sufficiency by job preparation, work opportunities and support services. The programs provides assistance to needy families.

Medicare

Medicare is health insurance for:

  • People 65 or older
  • People under age 65 who are disabled as determined by the Social Security Administration
  • People of any age with End-Stage Renal Disease (ESRD); permanent kidney failure requiring dialysis or a kidney transplant

Medicare Part A (Hospital Insurance)

Medicare Part A helps pay inpatient care. This includes hospitals, rehabilitation hospitals, critical access hospitals and skilled nursing facilities (not custodial care or long-term care). It also helps cover hospice and home health care when you meet conditions for coverage of these benefits.

Medicare Part B (Medical Insurance)

Medicare Part B helps cover medically necessary care like doctor’s services and outpatient care. The program provides for 18 preventative services. Medicare Part B is optional. You can still use a FTHC Provider or can seek a non-Tribal/IHS for medical care. Either way, your health care provider will bill Medicare for you. The covered services include:

  • Diabetes Screening Tests, and possibly supplies
  • Glaucoma Screening,
  • Counseling to Prevent Tobacco use
  • Cancer Screenings,
  • Cardiovascular disease
  • Clinical lab & Diagnostic Tests
  • Outpatient care
  • A one-time Welcome to Medicare Visits
  • An Annual Wellness Visit
  • Durable medical supplies
  • Ambulance Services
  • Flu shots

Medicare Part C (Medicare Advantage Plan)

Medicare Part C can be chosen through Medicare Advantage Plans. These are plans that are approved by Medicare and are run by private health insurance companies. The plans are part of the Medicare program and are sometimes referred to as MA Plan, Medicare Part C or HMO. You must have both Part A and Part B of Medicare to enroll in a Part C Plan. You generally must receive all of your care from a Part C Plan. The Medicare Advantage Plan coordinates your medical care and provides coverage for:

  • Medicare Part A services (except hospice coverage)
  • Medicare Part B services
  • Usually includes Medicare Prescription Drug coverage (Part D)
  • It may offer extra coverage to you for extra cost for services not covered under Medicare Part A and Part B like vision, hearing, dental or health and wellness programs.

Medicare Part D (Prescription Drug Coverage)

Medicare Prescription Drug Part D plans help cover the cost of prescription drugs. You have to be enrolled in a Part D Prescription Drug Plan to get this coverage. These plans are approved by Medicare and are run by private health insurance companies. You can continue to utilize the FTHC Pharmacy with your Part D plan. There are two ways to get Medicare Prescription Drug Coverage (Part D)

  • Medicare Prescription Drug Plan:
    • Please contact the Benefits Office to determine if the FTHC participates in the Part D program and/or to help you decide which Part D plan to choose.
  • Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. Contact your Indian Health Care Provider for additional information.

Why is it important to enroll in an I.H.S. Medicare Prescription Drug Coverage Plan (Part D) when you already get your prescriptions free at the FTHC? By enrolling in a Part D Plan that works with the FTHC, the Part D plan helps cover prescriptions drugs you get from us. This helps off-set our costs for purchasing the medication and allows to provide more services and coverage at the FTHC.

Connecting Kids to Coverage (CKC)

The CKC Program to increase Medicaid and Children’s Health Insurance Program (CHIP) outreach and enrollment efforts. The FTHC runs a CKC office at its facility to help assist patients with enrollment efforts and conducting public outreach and awareness at various events in the Fallon, Lovelock, and Yomba Tribal communities.

Nevada Health Link

Nevada Health Link is the State of Nevada’s clearinghouse for health care plan under the Affordable Care Act. Nevada Health Link can help you find a plan that fits your needs and budget. You cannot be denied due to a pre-existing medical condition.  Plan costs are based on the household’s taxable annual income, how many people are in the household, the place of residence and if anyone in the household uses tobacco. Applicants may be eligible for tax credits and other financial assistance with their selected plans.

For more information about Nevada Health Link please go to https://www.nevadahealthlink.com.

For more information about health coverage for American Indians/Alaska Natives please go to https://www.healthcare.gov/american-indians-alaska-natives/.