Nevada Medicaid Office

Nevada Medicaid office (Nevada Health Authority)

Nevada moved its Medicaid program into the State of Nevada Health Authority during a 2024 cabinet restructure. The Authority runs the programs and pays the bills; a separate agency — the Division of Social Services (DSS), formerly DWSS — handles eligibility determinations. Day-to-day member services run through one phone line with three regional numbers.

How to reach Nevada Medicaid

• Apply, renew, or check status — accessnevada.nv.gov, the unified DSS benefits portal.
• Member services — toll free 1-800-992-0900; (702) 486-1646 in the South; (775) 684-7200 in the North.
• Email for renewal documents — RenewMyMedicaid@dss.nv.gov.
• Email for general benefits questions — Medicaid@nvha.nv.gov (Nevada Health Authority).
• Update your address — dhcfp.nv.gov/UpdateMyAddress.

Other Nevada Medicaid lines

• Estate Recovery — (775) 687-8416 or mer@nvha.nv.gov.
• Non-Emergency Medical Transportation broker — 1-844-879-7341 (arrange rides at least three days in advance).
• Personal Care Services — (800) 525-2395.
• Report member fraud — Northern Nevada (775) 448-5211; Southern Nevada (702) 486-1875 (anonymous calls accepted).
• Report provider fraud (DHCFP SUR Unit) — (775) 687-8405.

Address, income, household, marital, and insurance changes go to DSS by email (welfare@dwss.nv.gov) or in person at a local DSS office — not to the Nevada Health Authority.

Who qualifies for Nevada Medicaid?

Nevada DSS determines eligibility for both Medicaid (the adult and family Medicaid program) and Nevada Check Up (NCU), the state's CHIP brand for children whose family income is above the children's Medicaid limit. Once enrolled, the member's first task is choosing or being assigned a managed care organization.

Two programs, one application

• Nevada Medicaid — covers low-income adults, parents and caretaker relatives, children, pregnant individuals, older adults, and people with disabilities. Nevada took the ACA expansion, so adults 19–64 with household income at or below 138% of the federal poverty level qualify on a MAGI basis.
• Nevada Check Up (NCU) — the state CHIP, for children under 19 whose family income is above the children's Medicaid limit. NCU charges quarterly premiums and requires premium payments to stay current.
• Emergency Medicaid Only (EMO) — limited coverage for non-citizens who would otherwise meet Medicaid eligibility but for immigration status; covers emergency services only.

Managed care assignment is mandatory in Clark and Washoe counties

Recipients living in urban Clark and Washoe counties must be enrolled in a Managed Care Organization. First-time recipients choose their plan when they apply; households that don't choose are auto-assigned. The household has 90 days from enrollment to switch plans for any reason. After 90 days, the household is locked in until the next annual open enrollment unless they can show "good cause" as defined by CMS to the Local Medicaid District Office.

What you must report to DSS

Members must report the following changes to DSS by email or at a local DSS office — failure to report can result in losing coverage or repaying medical costs:

• Change in income
• Change in residency or moving
• Getting other health insurance coverage
• Acquiring additional assets
• Getting married
• A family member dies
• Pregnancy or having a baby
• A child becoming emancipated
• Becoming an inmate of a public institution or ward of the state

If you're denied coverage or a service

If Medicaid or NCU denies a service, ends an enrollment, declines to authorize a benefit, or cuts a benefit, the member can file an appeal. Members enrolled in an MCO must complete the MCO's internal appeal first; if that appeal does not succeed, the member can request a Fair Hearing from Medicaid/NCU by filing the Fair Hearing request form with DHCFP.

Nevada Medicaid income limits

Nevada does not publish a single Medicaid income chart on its consumer-facing pages — the prescreening happens inside the Access Nevada portal. The percentage-of-FPL framing below is stable; dollar thresholds update every January when the federal poverty level resets.

MAGI-based income tests (no asset limit)

Non-MAGI categories (income + resources)

Older adults (65+), people who are blind, and people with disabilities qualify through a separate non-MAGI track with both income and resource (asset) limits — typically $2,000 individual / $3,000 couple in resources, with the home, one vehicle, and certain burial reserves excluded. Long-term services and supports (LTSS) applicants face additional functional eligibility (level-of-care) requirements.

Annual renewal cycle

DSS rechecks the eligibility of every Nevada Medicaid member each year. The renewal date is generally the anniversary of when coverage started. The household may be automatically renewed based on information DSS already has, or it may receive a renewal packet in the mail about two months before the renewal date. Renewal status and date are visible to the member after logging in to the Access Nevada benefits portal.

How to apply for Nevada Medicaid

Nevada accepts Medicaid and Nevada Check Up applications through Access Nevada, the unified DSS benefits portal. A single application can also screen the household for SNAP, TANF, and other DSS programs. Beginning January 1, 2026, Nevada's managed care plans are available statewide — including rural counties for the first time — so a new application now leads to a managed care plan assignment everywhere in the state, not just in Clark and Washoe counties.

Five ways to apply or renew

• Online (fastest) — apply or renew at accessnevada.nv.gov. You can also upload a completed and signed annual renewal form through the portal.
• By phone — toll free 1-800-992-0900, (702) 486-1646 South, (775) 684-7200 North. Select your language, then Option 3 (Other), Option 2 (Medicaid Programs), Option 4 (Representative).
• By email — return your completed and signed form to RenewMyMedicaid@dss.nv.gov.
• In person — visit a local DWSS Resource Center to return your form or to get help completing it.
• By mail — to the address printed on the renewal letter you receive from DSS.

What happens after approval

DSS sends a Medicaid or Nevada Check Up ID card after the first eligibility determination. Each family member receives their own card with their name on it. Show the card to every health care provider and pharmacist before getting service; the card stays the same even if coverage stops and starts again. The NV Medicaid mobile app gives members electronic access to the card and most Medicaid correspondence.

Annual renewal

DSS rechecks eligibility each year. About two months before the renewal date, DSS either auto-renews the case using information on file or sends a renewal packet with a form to complete and return. The member can check the renewal date in the Access Nevada portal at any time.

Decision timing and retroactive coverage

Federal Medicaid rules give Nevada up to 45 days to decide a non-disability Medicaid application and up to 90 days for a disability-based application. Federal rules also allow retroactive coverage up to three months before the application month when the applicant had qualifying medical bills during that window.

What Nevada Medicaid covers

Nevada Medicaid and Nevada Check Up deliver most member care through five contracted managed care organizations and a carved-out dental administrator. Beginning January 1, 2026, the managed care contracts cover the entire state, including rural counties for the first time.

The five Nevada Medicaid MCOs (current roster)

Dental services are carved out and run through Liberty Dental Plan of Nevada (866-609-0418).

What Nevada Medicaid covers

• Doctor visits, specialists, urgent care, and hospital inpatient/outpatient services
• Maternity care — prenatal visits, labor and delivery, postpartum visits, home births and freestanding birth centers, doula services, and anesthesia
• Behavioral health — outpatient counseling, MAT (Medication-Assisted Treatment), psychiatric inpatient, residential treatment, peer-to-peer support, Applied Behavior Analysis for under-21 members with autism or Fetal Alcohol Syndrome
• Prescription drugs (some require prior authorization) and certain OTC drugs by prescription
• Pharmacist-provided services: family planning dispensing and HIV preventive measures (PrEP) by a pharmacist
• Dental — adults (Medicaid only): emergency, palliative, some prosthetic care, plus expanded benefits for qualified pregnant adults; children under 21: full coverage including some orthodontia
• Eye exams and eyeglasses (covered once every 12 months; member pays the difference for more expensive frames)
• Hearing tests and hearing devices (medically necessary)
• Chiropractic — limited to children under 21
• Non-Emergency Medical Transportation (NEMT) via broker 1-844-879-7341; not covered for Nevada Check Up or QMB/SLMB-only recipients
• Tobacco cessation — patches, lozenges, prescriptions, and counseling

EPSDT for children — the well-child schedule

Healthy Kids/EPSDT covers children under 21 on Medicaid and NCU. Nevada's published well-child cadence: newborn (as soon as possible after birth), then at 1, 2, 4, 6, 9, 12, 15, 18, 24, and 30 months, and every year from age 3 to under 21. EPSDT also covers dental exams and cleanings twice a year, fluoride and sealants, lead testing, vaccines, follow-up care for any health problem found during an exam, and free transportation to Medicaid-approved appointments (does not apply to NCU recipients).

Long-term services and waiver programs

Members who meet a nursing facility level of care can receive Adult Day Care, Attendant Care, Augmented Personal Care in group homes, Chore services, Emergency Response Systems, Homemaker Services, Home-delivered meals, and respite care through HCBS waivers administered by the Aging and Disability Services Division (ADSD). Waiver slots are capped; contact the ADSD District Office to apply.

Other state Medicaid pages