NAC439.769. Eligibility for coordination of benefits.

A person with a disability who is eligible for Medicare Part D may be eligible for assistance with out-of-pocket expenses for prescription drugs and pharmaceutical services. The availability of such coverage is subject to the availability of funding and legislative approval of state subsidies that are intended to maximize federal benefits and, to the extent possible, minimize out-of-pocket expenses for prescription drugs and pharmaceutical services. Eligibility for such coverage is subject to requirements that are similar, but not identical, to the requirements for the Traditional Disability Prescription Program, including, without limitation, all the following requirements:

     1. An applicant must be at least 18 years of age but not more than 61 years of age.

     2. An applicant must have a verifiable disability.

     3. An applicant must have an annual income that is less than the amount set forth in NRS 439.745.

     4. An applicant who is eligible for Medicare Part D must enroll in Medicare Part D and a prescription drug plan or Medicare Advantage plan with prescription drug coverage.

     5. An applicant who is eligible for any federal subsidy under Medicare Part D must apply for and use any such subsidy before requesting such coverage through the Disability Prescription Program.

     6. An applicant who is not eligible for full Medicaid in this State must meet a 1-year residency requirement as set forth in NRS 439.745.

     7. An applicant who is enrolled in full Medicaid in this State is not required to meet the 1-year residency requirement for a subsidy approved by the Legislature. Depending upon the technical aspects of the coordination of benefits, the Department may allow such an applicant to receive such coverage without actually enrolling in the Disability Prescription Program.

     (Added to NAC by Dep’t of Health & Human Services by R157-05, eff. 11-17-2005)