Nebraska Health Insurance: Find Affordable Plans

If you live in Nebraska, you have several affordable health care insurance programs to choose from. Employers provide many Nebraska residents with health insurance; however, you might also be eligible for Medicare or other programs. You can also shop for your own plan on the federal Health Insurance Marketplace.

This guide will show you the cheap health insurance options in Nebraska, the range of prices you can expect, and how you can enroll in a plan.

• Health Insurance Marketplace: If you’re unhappy with your current health care insurance (or you don’t have any) you can select an ACA-compliant plan at the Nebraska section of Healthcare.gov. In 2021 two companies provide statewide health care plans on the Health Insurance Marketplace for Nebraska. All plans are ACA compliant, which means they cover pre-existing conditions, mental health, and other essential health care.
• Open enrollment: Regular open enrollment for the ACA Marketplace lasts from November 1 through January 15.
• Special enrollment: If you need to sign up outside of the open enrollment window, you’ll need a qualifying event to enroll. Qualifying events include getting married, having a baby, losing or changing jobs, and moving to a new state. You have 60 days from the time of the event to sign up for a new plan or make changes to your current plan.
• Off-market plans: If you do not wish to use the ACA Marketplace to purchase a health care plan, you can buy off-exchange plans through a broker, insurance agent, or private company. Under the ACA, however, all full plans (including those not offered on the ACA Marketplace) need to provide full coverage, including pre-existing conditions and mental health care.
• Expanded eligibility: In 2018, Nebraska expanded Medicare coverage under the ACA to include almost all adults between the ages of 19 and 64. Although the program began with basic and primary versions, as of October 1, 2021, all Medicare recipients will receive the same coverage.
• Coverage types: Most residents of Nebraska receive their healthcare through their employer (56.8%). Next comes Medicare at 14.2% and then Medicaid at 12.6%. Nongroup insurance (these are plans that are sold off-exchange or are short-term insurance plans) account for 6.9%. Military insurance covers 1.6% of Nebraskans. Currently, 7.9% of residents are uninsured.

Nebraska uses Healthcare.gov for ACA-compliant plans. Although you’ll buy Affordable Care Act plans through the federal site, the state oversees various aspects of those plans. If you’d like to purchase a plan from the exchange, visit HealthCare.gov to create an account.

Once you have an account, you can apply for health insurance. The Health Insurance Marketplace checks your eligibility for Medicaid and uses the information you provide to determine if you qualify for an Advanced Premium Tax Credit. Make sure you have the full name, birth date, and Social Security number of every person in your family who needs coverage before you start the application process.

The application will ask you several questions related to your income and family, including the following:

• Are you single or married?
• How many tax dependents will you claim on your current return?
• How much income will your household make this year?
• Do you want to see if you can get help paying for coverage?

After entering the required information, you’ll be able to view a list of available plans, including monthly premiums, annual deductibles, and coinsurance requirements. HealthCare.gov also allows you to make side-by-side comparisons of up to three plans at a time. Once you pick a plan, you’ll be able to complete the enrollment process.

• Ambetter from Nebraska Total Care
• Blue Cross and Blue Shield of Nebraska
• Medica
• Oscar

There are some important considerations when shopping for individual coverage, whether for yourself or multiple people. These considerations include:

• Medical needs
• Preferred plan type
• Premium affordability
• Individual vs. family deductibles

Insurance for individuals in Nebraska

If you’re buying a plan for yourself, the choices are less complex. If you have minimal health concerns and need few or no prescriptions, you should look for a plan that provides a low-monthly premium and a high deductible. If, on the other hand, you have a chronic health condition and need to make regular visits to a doctor or a specialist, you should investigate a plan that offers a higher monthly premium but a lower deductible which will help reduce your out-of-pocket costs.

There are several different kinds of plans from which you can choose:

• HMO: If you’re healthy, make few doctor visits, and don’t need many prescriptions, a Health Maintenance Organization plan (HMO) could be your best choice. These are the least expensive plans. However, they do come with restrictions: you’re required to pick a primary care physician, you’ll need to get a referral to see a specialist, and you can only use the plan’s in-network medical providers.
• PPO: On the other hand, if you have a chronic health condition requiring you to see one or more specialists regularly, a Preferred Provider Organization (PPO) plan could fit the bill. You can use out-of-network providers with a PPO, and you won’t need to get a referral to see a specialist. You also won’t need to name a primary care physician.
• POS: A Point of Service Plan (POS) works like a hybrid of an HMO and a PPO. You’ll need a referral to see a specialist, but you can use an out-of-network medical provider.

The main difference between an off-exchange plan and one offered on the ACA Marketplace is that you can earn premium tax credits on the Marketplace if your income is between 100% to 400% of the Federal Poverty Level. These benefits are not available on off-exchange plans. If you select a Silver plan on the Marketplace, you may also qualify for cost-sharing reductions (CSRs), which would lower your out-of-pocket costs.

Insurance for families in Nebraska

Questions about health can be more complex when dealing with a family. Your children may be healthy, but what if you or your spouse have a chronic health condition like asthma, hypertension, or diabetes. It’s important to sit down with an agent or a representative of a healthcare company who can help you navigate these issues and find the plan that provides you with the best health care and suits your budget.

Another consideration for family plans is that many plans have an individual deductible and a family deductible. An individual deductible applies to each person covered by the plan, while the family deductible applies to the entire family. If one of your family members is hospitalized or undergoes an expensive surgery, it’s possible to meet the family deductible before every person on the plan has met their individual deductible.

When comparing insurance plans in Nebraska on Healthcare.gov, you’ll find that the plans are broken into tiers based on metals: Bronze, Silver, Gold, and Platinum. All plans offered on Healthcare.gov provide the same ACA-compliant health care. The difference is how you’ll pay for that health care.

• Bronze plans are a good choice if you’re healthy and don’t make many visits to the doctor.  These plans feature low monthly premiums but high deductibles. Bronze plans also have a high coinsurance payment of 40% each time you use your plan. If you don’t make many visits to the doctor, a Bronze plan is a good cheap health insurance choice to keep costs to a minimum. The most affordable Bronze plan in Nebraska has a monthly premium of $414.

• Silver plans offer you the most tax credits and potential benefits. They have a lower coinsurance payment of 30% and lower deductibles but a higher monthly premium. However, if your income is between 100% and 400% of the federal poverty level, you can get significant savings on a Silver plan. Once all these benefits are calculated, a Silver plan can often be less expensive than a Bronze plan. The lowest-priced Silver plan in Nebraska (before any potential benefits) is $549 per month.
• Gold and platinum are designed for those who make many trips to a doctor or specialist and need regular medications. They have low deductibles, and their coinsurance payments are only 20% for a Gold plan and 10% for a Platinum plan. However, be prepared to pay heftier monthly premiums. The most affordable Gold plan in Nebraska is $579 per month.

In 2018, voters in Nebraska approved the expansion of Medicare under the Affordable Care  Act to include adults between the ages of 19 and 64. Nebraska residents also have access to CHIP, a program designed to aid children from low-income families without health care and who don’t qualify for Medicaid.

Medicaid in Nebraska

If you belong in the Medicaid expansion group (individuals aged between 19 and 64 and whose income is less than 138% of the federal poverty level), there are two packages available: basic and prime. As of October 1, 2021, all recipients of Medicare in Nebraska will receive equal coverage. Some of the services provided include doctor’s visits, ambulance services, family planning, chiropractor services, and much more.

You might also be eligible for Medicaid in Nebraska if you fall into one of the following categories:

• 65 years of age or older
• A former foster care youth
• A parent or caretaker of any individual with a disability aged 18 or younger
• A pregnant woman
• An individual 18 years of age or younger
• An individual under 65 years who has a disability

Whether you qualify for Medicaid depends upon your income which is calculated as a percentage of the federal poverty level. For pregnant women, it’s 202%, for parents, it’s 63%, while for seniors and people with a disability, it’s 100%.

Resources can also be considered when determining eligibility for Medicare. Your home, one vehicle, and machinery or equipment used to operate a business will never be counted against you. Resource limits to receive the full subsidy for an individual are $9,090, while for a couple, it’s $15,160. Children under the age of 18 and eligible pregnant women don’t face resource limits.

Children’s Health Insurance Program (CHIP)

CHIP is an expansion of Medicare designed to aid children from low-income families without health care and who don’t qualify for Medicaid. Families can make up to 213% of the federal poverty limit and qualify for CHIP. They shall receive the same services under CHIP that Medicaid recipients in Nebraska receive, including preventive care, regular doctor visits, immunizations, hospitalizations, dental care, ambulance services, and many more.

If you are aged 65 or older or have a qualifying disability, you’re eligible to enroll in Medicare, the federal government’s health care insurance program for eligible Medicare beneficiaries.

• Original Medicare is the basic Medicare program available to all seniors and the disabled. It includes Part A (hospice, home health care, hospitalizations) and Part B (mental health care, durable medical equipment, doctors’ visits) but does not include prescription drug coverage. If you require regular medications, you should purchase a Medicare Part D prescription drug plan. Original Medicare has no limits on out-of-pocket costs. The Medicare Part A deductible for inpatient hospital stays is $1,600 in 2023. Medicare Part B enrollees pay a standard monthly premium of $226 for 2023.
• Another option is a Medicare Advantage Plan, also known as Medicare Part C. These are private plans approved by Medicare. There are four types of Medicare Advantage Plans: HMO, PPO, Private Fee-For-Service, and Special Needs. Each plan is designed for different groups and offers different benefits and costs. All Medicare Advantage Plans cover vision, dental, and hearing, and some provide prescription drug coverage and gym memberships. In 2019 there were 18 Medicare Advantage Plans available in Nebraska. However, you can only select a Medicare Advantage Plan available in the county in which you live. As of 2023, there are 39 Medicare Advantage Plans available in the state, however, you can only select a plan that’s available in your county.

If you’re enrolled in Original Medicare and are concerned about out-of-pocket costs, you can purchase a separate Medicare Supplement Insurance plan. These plans help with deductibles, coinsurance, and copays. These plans will also provide you with travel insurance for trips outside the United States. They don’t cover vision, dental, hearing, or long-term care. Medicare Supplement Insurance Plans also will not work with any Medicare Advantage Plan.

Eligibility

• You must be a US citizen or a permanent resident who has lived in the U.S. for the past five years
• You must be at least 65 or have a qualifying disability
• You qualify if you have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), or have been on Social Security Disability Insurance or Railroad Retirement disability insurance for at least 24 months.

Enrollment

If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

• Initial enrollment: Your initial enrollment period starts three months before your 65th birthday and ends three months after your 65th birthday. If you’ve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
• General enrollment: Choose this enrollment period if you missed your initial enrollment period. The Medicare general enrollment period is January 1 to March 31. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D.
• Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from January 1 to March 31.
• Open enrollment: You can join, switch plans, or drop your coverage from October 15 to December 7 each year.
• Special enrollment periods: You may qualify for a special enrollment period if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

Medicaid resources

Nebraska provides resources for seniors, their families, or their caregivers to help answer questions about how to enroll in Medicare and which is the best plan to choose.

Senior Health, also known as the State Health Insurance Assistance Program (SHIP), provides free, unbiased, and confidential counseling on Medicare options for seniors, their families, or caregivers in Nebraska. You can call a trained, certified agent or arrange for a one-on-one visit. No counselor will ever try to sell you an insurance program.

Yes, short-term health insurance policies are available in Nebraska, and they follow federal guidelines in terms of length (364 days) and how many times you are allowed to renew (three times).

However, Nebraska also put in place several other requirements for short-term insurance plans:

• Describe any annual or lifetime financial limits that apply
• Give a clear comparison of how a short-term plan compares with an ACA-compliant individual market plan
• Inform anyone interested in a plan about the provider’s network, including maintaining a current website that shows all the network’s providers
• Provide a 10-day free look
• State whether a plan can be renewed, how to renew it, and the cost to renew

Short-term plans do not provide coverage for pre-existing conditions, pregnancy, or mental health care. They’re designed for people between jobs, who have missed the ACA open enrollment deadlines, or uninsured. Plans are normally only sold to individuals under 64 and in good health.

• 4 steps to getting covered in the Health Insurance Marketplace® | Last accessed December 22, 2022
• CMS.gov | Medicare Open Enrollment | Last accessed December 22, 2022
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• HealthCare.gov | Health Maintenance Organization (HMO) | Last accessed December 22, 2022
• HealthCare.gov | Point of Service (POS) Plans | Last accessed December 22, 2022
• HealthCare.gov | Preferred Provider Organization (PPO) | Last accessed December 22, 2022
• Healthcare.gov | Premium Tax Credit | Last accessed December 22, 2022
• HealthCare.gov | The ‘metal’ categories: Bronze, Silver, Gold & Platinum | Last accessed December 22, 2022
• KFF | Health Insurance Coverage of the Total Population | Last accessed December 22, 2022
• Medicare.gov | Medicare Advantage Plans | Last accessed December 22, 2022
• National Academy for State Health Policy | Nebraska CHIP Fact Sheet | Last accessed December 22, 2022
• Nebraska Department of Health and Human Services | Federal Poverty Levels for Nebraska | Last accessed December 22, 2022
• Nebraska Department of Health and Human Services | Insurance Programs | Last accessed December 22, 2022
• Nebraska Department of Health and Human Services | Medicaid eligibility | Last accessed December 22, 2022
• Nebraska Department of Health and Human Services| Medicaid Expansion in Nebraska | Last accessed December 22, 2022