If you live in Nebraska and are eligible for Medicare — or are nearing eligibility — you may be wondering about your options. Medicare is a national health insurance program for adults age 65 or older or people of any age who have certain disabilities.
Over the years, the program has expanded to include options you can purchase from private insurance companies to enhance or replace the coverage you get from the government.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Nebraska for the 2021 plan year:
- A total of 353,755 residents of Nebraska are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly increased in Nebraska compared to last year — from $12.68 in 2020 to $12.76 in 2021.
- There are 31 Medicare Advantage plans available in Nebraska for 2021, compared to 27 plans in 2020.
- About 96 percent of Nebraska residents with Medicare have access to buy a Medicare Advantage plan — 92 percent have access to plans with $0 premiums.
- There are 12 different Medigap plans offered in Nebraska for 2021.
Medicare is made up of different parts.
Original Medicare, the coverage you get directly from the government, includes parts A and B.
- Medicare Part A. Part A helps pay some of the costs of inpatient healthcare services you receive in a hospital, provides limited coverage for skilled nursing facility care and home health services, and covers hospice care.
- Medicare Part B. Part B helps pay for general outpatient care and medical supplies you get when you see a doctor or specialist.
Original Medicare isn’t 100-percent coverage. You still pay out of pocket when you see a doctor in the form of copays, coinsurance, and deductibles. And there’s no coverage at all for prescription drugs, long-term care, or dental or vision services.
However, there are Medicare plans you can purchase from private insurance companies that can add to or replace original Medicare.
Medicare Advantage in Nebraska
Medicare Advantage (Part C) plans offer an “all-in-one” alternative to original Medicare. These plans cover all the same benefits as original Medicare, plus additional coverage like prescription drug, dental, vision, and other benefits.
If Medicare Advantage sounds like a good option for you, there are a number of private insurance companies offering plans in the state of Nebraska. They include:
- Aetna Medicare
- BlueCross BlueShield of Nebraska
- Bright Health
- Medical Associates Health Plan, Inc.
Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Medicare supplement plans in Nebraska
Medicare supplement plans, sometimes called Medigap plans, add coverage to original Medicare. They help cover some of the costs of copays, deductibles, and coinsurance.
Many companies offer Medigap plans in Nebraska. In 2021, some of the companies offering Medigap plans throughout the state include:
We often think of Medicare as insurance for people age 65 or older, but you can enroll in Medicare if you are:
- age 65 or older
- younger than 65 and have a qualifying disability
- any age and have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
When can I enroll in Medicare Nebraska plans?
If your Medicare eligibility is based on age, your initial enrollment period begins 3 months before your 65th birthday and continues for 3 months after. It usually makes sense to enroll at least in Part A at this time, since you likely won’t need to pay anything for it, and Part A benefits will coordinate with any existing insurance coverage you have.
If you or your spouse continue working, and you still qualify for coverage through an employer-sponsored group health plan, you may elect to put off enrolling in Part B or any supplemental coverage at this time. In these circumstances, you’ll qualify for a special enrollment period later.
Additionally, there’s an open enrollment period each year from October 15 to December 7, during which you can apply for Medicare for the first time or switch plans. The general enrollment period for Medicare Advantage plans runs from January 1 through March 31 each year.
Tips for Enrolling in Medicare in Nebraska
Which type of plan works best for you depends on your situation and preferences. It can be helpful to keep in mind questions such as the following:
- What is the provider network like?
- Does the network include physicians and hospitals that I might need that are convenient to me?
- Will I need referrals if I need to see specialists?
- How much will this plan cost me, both in premiums and at the point of service when I seek care?
- Does the plan include coverage and programs that make sense for me?
These resources can be useful to help you learn more about Medicare Nebraska coverage options:
- More than 300,000 Nebraska residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have slightly increased for 2021 Medicare Advantage plans in Nebraska.
- There are also several Medigap plan options if you live in Nebraska and are looking for additional coverage.