Nevada Medicaid
Last verified: June 2026
Informational resource — not affiliated with Nevada
Federal Medicaid changes are being implemented in Nevada in 2025 and 2026
What is Nevada Medicaid?
Nevada Medicaid is the state's health coverage program for low-income residents. It is administered by the Nevada Health Authority (NHA), specifically through the Division of Health Care Financing and Policy (DHCFP). As of 2025, approximately 750,000 Nevadans are enrolled — representing more than 23% of the state population. Nevada expanded Medicaid under the Affordable Care Act in 2012, making it one of the earlier expansion states.
All Nevada Medicaid members receive coverage through managed care. DHCFP contracts with several Managed Care Organizations (MCOs) that coordinate medical, behavioral health, and other services for enrolled members. Available health plans vary by county. Per the Nevada Medicaid member resources, current MCOs operating in Nevada include Anthem Blue Cross Blue Shield, Health Plan of Nevada (HPN) (part of UnitedHealthcare), SilverSummit Healthplan (Centene), and Molina Healthcare of Nevada. Not all plans operate statewide — members are assigned or can choose a plan available in their county.
Nevada Medicaid includes a companion program — Nevada Check Up — which covers children in families who earn too much for standard Medicaid but still fall within CHIP income limits. The two programs share an application process through Access Nevada.
Who qualifies for Nevada Medicaid?
Nevada uses MAGI (Modified Adjusted Gross Income) income rules for most eligibility categories. There is no asset test for standard Nevada Medicaid — savings accounts, a vehicle, and home equity do not affect eligibility for adults, children, or pregnant women. Per Nevada Health Link, income limits are based on household size and FPL percentages that update annually. The following are approximate 2026 thresholds:
- Adults ages 19–64 (ACA expansion): at or below 138% FPL — approximately $1,884/month for a single person in 2026
- Children under 19: up to 200% FPL — approximately $2,730/month for a household of 1
- Pregnant women: up to 185% FPL — approximately $2,525/month for a household of 1
- Nevada Check Up (CHIP): children at 133%–200% FPL whose families earn above the Medicaid limit
- Seniors 65+ and people with disabilities: non-MAGI income and asset rules apply
- Long-term care (nursing facility): 300% of the SSI Federal Benefit Rate
Source: Nevada Health Link (nevadahealthlink.com); Nevada Medicaid member information at nevadamedicaid.nv.gov. Income thresholds are approximate 2026 figures based on HHS Federal Poverty Level guidelines. Verify current limits at Access Nevada (accessnevada.nv.gov) or call 1-800-992-0900.
Nevada's provider shortage problem — a known challenge
Nevada ranks among the states with the most significant Medicaid provider shortages, particularly outside the Las Vegas metro area and in rural and frontier counties. Finding primary care and specialist providers who accept Nevada Medicaid can be difficult — especially in areas like Elko, Winnemucca, and Ely, where the nearest in-network specialist may be several hours away.
This is not just anecdotal. Nevada consistently scores poorly on per-capita physician supply in Medicaid, and the DHCFP has cited network adequacy as an ongoing concern in annual reports to the legislature.
Members who cannot find an in-network provider can request an out-of-network exception through their MCO, or contact DHCFP directly at 1-800-992-0900. Nevada Medicaid also contracts with federally qualified health centers (FQHCs) statewide — use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate one near you.
How Nevada Medicaid is structured
Nevada Health Authority / DHCFP
The state agency responsible for policy, eligibility rules, and oversight of managed care contracts. Website: nevadamedicaid.nv.gov. Policy questions and appeals go through this agency.
Division of Social Services (DSS)
Determines Medicaid eligibility and processes applications through the Access Nevada portal. Annual renewals are managed by DSS. Apply and renew at accessnevada.nv.gov.
Managed Care Organizations (MCOs)
Deliver covered services through contracted provider networks. Each MCO offers a member ID card, provider directory, and member services phone line. Contact your MCO for referrals, prior authorizations, and benefits questions.
Nevada Medicaid topics
How to apply
Income limits
Dental coverage
Seniors and long-term care
Medicaid renewal
CHIP
What does Nevada Medicaid cover?
Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.
The national benefits overview lists required and commonly optional services. Check the Nevada Medicaid website for the current state-specific benefit package.
How to apply
Most people can apply online through Nevada's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.
Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). Nevada must follow that federal timeline.