Medicare Advantage Plans in Nebraska
Key Takeaways
- Medicare Advantage plans in Nebraska provide Original Medicare coverage, along with more benefits like hearing, vision, and dental coverage.
- Medicare Advantage plans may help you control healthcare costs with caps on out-of-pocket spending.
- Many Medicare Advantage plans also include prescription drug coverage.
Offered through private health insurance companies, Medicare Advantage can provide a range of benefits and coverage on top of what’s included under Original Medicare (Parts A and B). As of 2024, there are 44 plans available in Nebraska, and 98.9% of Medicare-eligible residents live in ZIP codes where they have access to at least one.
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Nebraska Medicare Advantage Plan Coverage
Medicare Advantage plans in Nebraska provide comprehensive healthcare coverage to Medicare beneficiaries in the state. Private health insurance companies offer these plans, and they can set their own coverage options and costs under rules established by the federal Medicare program.
Also called Medicare Part C, Medicare Advantage plans provide extensive healthcare coverage that includes all the same benefits as Original Medicare, along with some additional benefits. Medicare Advantage plans in Nebraska cover:
Part A benefits, including:
- Inpatient hospital care
- Inpatient rehabilitation services
- Inpatient psychiatric care
- Skilled nursing facility care
- Some nursing home care
- Some home health care
- Hospice care
- Doctor’s appointments
- Telehealth appointments
- Medically necessary care
- Outpatient hospital care
- Preventative services
- Lab tests, X-rays and screenings
- Durable medical equipment
- Ambulance services
- Some chiropractic care
- Hearing services
- Vision services
- Dental services
- Fitness memberships
- Prescription drug coverage
NE Medicare Advantage Plan Costs
Original Medicare has standard monthly premiums for Parts A and B. In 2024, the Medicare Part B premium starts at $174.70 and can increase based on your income. The Part A premium is based on your work history; if you or your spouse worked 10 or more years, you probably won’t have to pay a premium for Part A.
Why are Original Medicare’s premiums important to Medicare Advantage plans in Nebraska? You will generally need to pay these premiums in addition to your Medicare Advantage plan premium.
The good news?
Each Medicare Advantage plan provider can set its own monthly premiums, and they are often low. In 2024, the average Medicare Advantage plan premium in Nebraska is $15.31 per month. 98.9% of Medicare-eligible residents have access to a plan with a $0 premium. Some Medicare Advantage plans may even help pay your Part B premium.
Annual Deductible
Before your coverage begins, you’ll need to meet your annual deductible. This is the amount you’ll pay out of pocket before your insurance plan begins paying a portion of covered services. While the Original Medicare Part B deductible for 2024 is $240, Medicare Advantage plans can set their own deductibles.
Copayments and coinsurance
Finally, take some time to learn more about your copayments and coinsurance options with each plan. Copayments are a flat fee you pay to your provider whenever you access care. For example, you may pay $10 each time you visit your primary care provider. Coinsurance, on the other hand, is a percentage of the bill. For example, your plan may cover 80% of your doctor’s services, and you’ll need to pay the rest. A 20% coinsurance can add up fast, and you may have high out-of-pocket costs.
Original Medicare pays 80% of most covered healthcare services. You’ll pay a 20% coinsurance each time you access healthcare. Medicare Advantage plans set their own copayments and coinsurance and can establish an out-of-pocket maximum.
Before enrolling in a Medicare Advantage plan, check the plan’s copayment and coinsurance rates for the services you access the most. A GoHealth licensed insurance agent can help you compare plans and review out-of-pocket costs.
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Medicare Advantage Plan Eligibility & Enrollment in Nebraska
If you’re enrolled in Original Medicare, you are eligible for a Medicare Advantage plan. You can enroll in a Medicare Advantage plan if:
- You’re currently enrolled in Original Medicare Part A and Part B.
- You live in the coverage area of the Medicare Advantage plan you’re considering.
Original Medicare eligibility
Before enrolling in a Medicare Advantage plan, you’ll need to enroll in Original Medicare. All U.S. citizens and permanent residents age 65 and older are eligible for Original Medicare.
Adults younger than 65 may also qualify for Original Medicare. Are you receiving Social Security Disability benefits? If you’ve received disability benefits for 24 months, or you have a chronic health condition such as end-stage renal disease, you can qualify for Original Medicare coverage and Medicare Advantage plan coverage.
Medicare Advantage plan enrollment
To enroll in a Medicare Advantage plan, all you need is your Medicare number. If you need help, a licensed insurance agent can help you switch to a Medicare Advantage plan.
One of the first times to enroll in a Medicare Advantage plan is during your Initial Enrollment Period (IEP). This enrollment period typically opens in the months before you turn 65. The IEP is a seven-month period that includes your birthday month, plus three months before and after you turn 65.
If you enroll in Original Medicare at the start of your IEP, you can switch to Medicare Advantage during your Initial Coverage Enrollment Period (ICEP). This period opens at the same time as your IEP, but closes after whichever of the following happens last:
- The last day of the month before your Parts A and B covered begin, or
- After three full months after you’ve turned 65.
- Medicare’s Open Enrollment Period runs from October 15 to December 7. During this period, you can enroll in a Medicare Advantage plan or a Part D plan. You can also switch between Medicare Advantage plans and enroll in a plan with benefits that match your healthcare needs.
- The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. This period is for anyone who already has a Medicare Advantage plan. During this period you can switch to a new Medicare Advantage plan. You can also switch back to Original Medicare. However, during this period you can’t enroll in a Medicare Advantage plan for the first time.
- A Special Enrollment Period (SEP) can be triggered by life events such as moving to a new city or losing employer coverage. You’ll have a few months to explore your options and enroll in a new Medicare Advantage plan. If your plan changes, you’ll also may qualify for an SEP so you can find a new plan in your area.
Are There Nebraska Medicare Advantage Plans With Prescription Drug Coverage?
Most Medicare Advantage plans in Nebraska include prescription drug coverage. This makes it easy for you to fill prescriptions and enjoy lower healthcare costs. Each Medicare Advantage plan has a list of covered medications, called a formulary. It also indicates the cost of copayments for each medication. Before enrolling in a Medicare Advantage plan, you can check the formulary for your medications and find a plan that offers you the prescription drug coverage you need.
Sources
- FACT SHEET. CMS.gov
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.