Nebraska is home to the most river mileage in the nation, the Oregon Trail landmark Chimney Rock, and its capital, Lincoln, has been rated one of “the happiest cities to live in” for the past two years. With obscure museums such as Chevyland USA, the Union Pacific Railroad Museum, and a fur trading museum, various sites celebrate Nebraska industries and culture. Nebraska also features the world’s largest hand planted forest, and many other open areas of land, including 87 state parks scattered throughout the state.
Residents of Nebraska have several of the nation’s top health insurance companies to choose from as well as a reputable local entity. Companies offering individual plans in Nebraska include Celtic, Coventry, Humana, IHC Group, and UnitedHealthcare. To view pricing options and plan availability in your area, enter your zip code below and take a few moments to compare between companies. If you need any further assistance, feel free to call us at 888 803 5917, and we will be happy to guide you through any health insurance questions you may have.
Though Nebraska is still in the top 20 as rated by UnitedHealth Foundation’s annual rankings at #16, Nebraska has decreased in overall health over the past ten years. The state was evaluated on many factors, including smoking, which is fairly prevalent at 24% of all adults, obesity, diabetes and other statistics. For obesity, the entire country has been increasing, and now Nebraska has 376,000 obese adult residents. Diabetes also grew among the adult population, now affecting 105,000 people. There is a high level of binge drinking in Nebraska, not just based on college attendees, which affects nearly 19% of all adults in the state.
Some of the reasoning behind Nebraska’s higher ranking is the moderately low level of air pollution, as well as a relatively small uninsured population at 12% of all Nebraskans. This is a vast improvement from other states, with an average of 16%, so at the very least Nebraska utilizes its health care. Residents also use a good amount of prenatal care, and there is a somewhat low occurrence of cancer-related deaths. In order to increase the quality of health of Nebraska, being aware of nutrition and engaging in healthy activities is key. Health insurance companies and the Department of Human Services usually also offer ideas and programs for wellness and disease prevention if you need assistance getting in the right mindset.
Health Insurance Plans
- Basic PPO plans from Celtic in Nebraska come in coverage/coinsurance options of 70/30 or 80/20 after meeting the deductible. Individual deductibles vary from $2,500 to $7,500 depending on the plan you select. Though these plans are designed to save money, you still receive upfront in-network benefits such as doctors office visits for a $30 copay, as well as prescription coverage and vision care. Once the deductible is met, you can receive hospital care with an additional deductible for each service such as emergency room visits, outpatient surgery and hospitalization.
- Preferred plans are comprehensive PPOs with a more broad set of benefits than basic plans. With the choice of either 80% or 100% coverage after deductible, these plans give you access to many services for either 20% coinsurance or no cost in-network. From the start date of your plan, you can see a PCP or a specialist for a very low copay of $15, and have access to $10 generic prescription drugs. There is a separate deductible for brand name and non-formulary drugs. These plans also cover vision care, and of course preventive services for no cost.
- Saver HSA plans are high deductible health plans with the opportunity to open a health savings account connected to a great amount of coverage. With Saver HSA plans, you pay either 20% coinsurance or nothing once you meet the deductible with in-network providers. Whether seeking care for illness or injury with a primary care doctor or specialist, buying prescriptions, or require hospitalization, you are covered at the chosen amount. One of the great benefits of HSA plans is financial control and responsibility that receives tax benefits. The funds from your HSA can be used towards any qualified medical cost, are not taxed, and even can be deducted from income tax.
- Spectrum plans offer low copayments on a variety of services including doctor’s office visits, various levels of prescriptions, emergency room and urgent care, and chiropractic. Deductible options are $1,500 and $3,500 for individuals and twice as much for families. Both plans offer 90% coverage after you reach your annual deductible amount, covering the remainder of hospital and facility services and medical equipment not available for a copay. Primary care office visits are available for a $20 copay and $40 for specialists.
- HealthGear plans are an extra affordable option, though most all CoventryOne plans are very reasonable. These plans are available with deductibles of $2,500, $3,500, or $5,000, and offer immediate benefits such as primary care visits for $40. Since this is a value option, there is a limit of either 2, 3 or 4 physician office visits for non-preventive care, depending which plan you have. After deductible, your plan will cover 60%, 70% or 80% of in-network covered expenses, including hospitalization and outpatient surgery. Generic drugs are covered for a $15 copay, and other types of prescriptions are not available.
- Torch plans are offered in deductibles ranging from $1,000 to $5,000, and cover 80% of major medical services after deductible. As soon as your plan starts, you can receive non-preventive physician services for a $30 copay with a PCP, and $60 if you require a specialist. Preventive care is covered in full when using in-network doctors and facilities, and is also an immediate benefit. These plans also offer prescription drug coverage for $10 generics, as well as brand names and non-formulary for a copay after meeting a simple $100 deductible.
- TorchLight plans have high deductibles ranging from $2,000 to $10,000 for individuals, and cover 60% of in-network care after meeting the deductible. These plans offer multiple services before deductible for a copay, including physician’s visits, generic prescriptions, and urgent care. For higher level prescriptions, there is a $500 pharmacy deductible separate from your regular annual amount. After meeting this, brand name drugs are $40 and non-formulary are $75.
- Prism plans are comprehensive, high deductible plans with the option of opening a health savings account. These plans offer 100% coverage after deductible on all types of care when using the CoventryOne PPO network. Deductible options for individuals are $2,500, $3,500 or $5,000, and double the cost for those with dependents. These plans cover hospital care, doctor’s office visits, pharmacy, home health care and more in full after you have paid enough out-of-pocket to meet your deductible of choice. You may also use non-network care for 40% coinsurance after deductible.
- Copay plans in Nebraska are available in Portrait Share 80 and Autograph Share 80 Plus Rx types. These plans are each a great choice for different reasons. Portrait Share 80 plans have deductibles of $1,000 and $2,500, and Autograph Share 80 plans are either $5,000 or $6,000 for individuals. Portrait plans allow for unlimited doctor’s office visits for non-preventive care, accessible as soon as your plan begins. Hospital services are covered at 80% by both plans after reaching the deductible amount when using network providers, and they both include prescription coverage.
- 100% After Deductible plans are offered in Monogram and Autograph Total Plus Rx HSA options for Nebraskans. These plans are comprehensive and cover all qualified in-network services for no charge after deductible. Monogram plans have a sole deductible of $7,500, and Autograph plans have a variety to choose from, between $1,500 and $5,000 for individuals. Both plans cover prescription drugs, and the Autograph Plan is eligible for opening a health savings account connected to your plan for ultimate control over health care spending.
- HSA options from CoventryOne in Nebraska are offered in Autograph Total HSA and Autograph Total Plus Rx HSA plans. Both plans give you the ability to use tax-favored money to pay for cost sharing and meet your deductible, or save for the future. All types of services are covered in full after you meet the deductible, including physician’s office visits, prescriptions, hospital stays, surgery, home health care and more. Autograph Total HSA deductibles range from $2,000 to $5,200 for individuals, and twice as much for families.
- Freedom Choice plans offer the choice between 70% or 80% coverage for in-network services after you meet the deductible, and a wide range of individual deductible options from $1,500 to $20,000. All Freedom Choice plans have a $50 copay for office visits with a primary care doctor or specialist, and prescription coverage subject to a separate deductible. Once the deductible is met, you can receive coverage on hospital stays, chiropractic, surgery, outpatient services, emergency care and more.
- Freedom HDHP plans are eligible for use with a health savings account and come in a variety of high deductibles. Depending on the deductible you choose, you can pay 20% coinsurance or be covered in full after meeting the deductible amount for in-network services. Preventive care is available at no cost when using in-network providers as soon as your plan starts. Individual deductible options range from $2,000 to $10,000. All of these plans cover prescription drugs, and also give you the option of using out-of-network care.
- Copay plans are available in Copay Select and Copay Select Value options in Nebraska in deductibles ranging from $1,000 to $10,000 for individuals. These plans both offer great coverage on a wide variety of benefits, and instant benefits for a copay. Doctor’s office visits are a $35 copay for the first four visits, covered at 70% afterwards by the Value plan. After meeting the deductible, Select plans offer either 70%, 80% or 100% coverage on in-network care, and Value plans cover 70%. Value plans only offer generic prescriptions, and the Select plans cover all tiers with a $500 deductible.
- High Deductible plans from UnitedHealthOne are offered with 20% coinsurance or 0% after deductible with Plan 80, Saver 80, and Plan 100. At the most comprehensive, Plan 100 covers all hospital and physician services, including pharmacy benefits, in full once you meet the deductible. Plan 80 is almost identical, though you pay 20% coinsurance for the same services, and instead of prescription coverage you can choose a discount card. Saver 80 plans have no coverage for prescriptions or physician services, but offer the basics for emergency and hospital care for a low monthly rate.
- HSA plans can include coverage on 70% or 100% of your covered medical expenses after deductible, and the option of using a health savings account. HSA 100 plans offer total in-network coverage for office visits, hospital care and more. Deductibles for individuals span from $2,500 to $5,000 under the HSA 100 plan, and the HSA 70 plan ranges from $1,250 to $5,000. HSA 70 plans offer reduced monthly premiums and high cost sharing, while 100 plans require the opposite. Both plans give you access to an expansive network of providers throughout the state and the country.
Public Health Options
In Nebraska, many programs exist to help provide health services to uninsured and underinsured individuals. Funded by the state and federal government, such programs include health insurance coverage through Medicaid and CHIP. Medicaid is offered to low-income families, children, pregnant women, and disabled and elderly persons in the state. A variety of plans are offered to give free or low cost insurance to qualifying individuals, and it is extremely beneficial to apply if you think you might be able to receive it. For a guide to who qualifies, read our article on Medicaid Eligibility by State. Other services include disease prevention, family planning, nutritional assistance, and care for children and aged persons. A full list of programs can be accessed through the Nebraska Department of Health and Human Services.
- Nebraska Medicaid: medical insurance for residents of Nebraska who meet certain income level and demographic requirements.
- Kids Connection: the Children’s Health Insurance Program for children 0 – 18 without health insurance coverage in Nebraska.
- Nebraska Reproductive Health: family planning services for Nebraska residents of all ages, genders and income levels.
- Immunization: providing access for all Nebraskans to vaccines for preventable illnesses.
Health Insurance Laws
The private Nebraska health insurance market and the individuals they insure are protected by several important laws to be aware of. One of the most crucial points is how persons with pre-existing conditions are regarded. In Nebraska, pre-existing conditions are defined by the prudent person standard, which is more loose than other states. This means if you have had a past illness that could potentially have used medical attention, even if you did not receive any, before signing up for insurance – you have a pre-existing condition. After an insurer decides you have such a condition, they are permitted to deny you a plan or take you on as a new client for an increased rate.
Insurance companies in Nebraska also have the right to add an exclusion period to your plan for any length of time, as there is no limit. Therefore, they will opt out of covering any care related to the condition for as long as they want. They are also allowed to attach an elimination rider to your plan, giving them the ability to never pay for any treatment of that kind. Despite the broad definition and strict rules for such individuals, there is an alternative as provided by the Affordable Care Act. The Pre-Existing Condition Insurance Plan offers health coverage to qualifying adults who need insurance in Nebraska.
Nebraska PCIPs are run by the U.S. Department of Health and Human Services as opposed to the state. They provide basic health insurance without discrimination for a low monthly rate, in order to offer a better deal than private companies after special adjustments. These plans are temporary, as the ACA has made the law effective as of January 2014 stating all private insurers must accept adults with pre-existing conditions. At the end of 2013, PCIPs will become inactive, and recipients must switch to a major company individual plan or a state exchange.
A regulation that greatly helps the policy holder is the guaranteed renewability provision. Under HIPAA, this law requires insurance companies to offer renewal on the same plan a consumer has had for the preceding year as it is about to expire. This helps to avoid any coverage gaps, and also keeps both parties accountable for a person’s policy. Also, guaranteed renewal makes it possible for insured individuals to maintain their benefits even if they acquire an illness of some sort after their plan starts. As long as the consumer is paying on time and properly using their plan, they are eligible for this law’s effectiveness.