Health Insurance in Nebraska

Are you having trouble finding affordable health insurance in Nebraska? It’s a lot more complicated than it looks. But it doesn’t have to be. You actually have a pretty good number of options to choose from right now – more than ever before, in fact. It’s all a matter of understanding which options provide you with what benefits, and whether or not they can do so for you at a good value. We’re going to take a deeper dive into some of your options below to help you get a better understanding of your health care needs and the insurance products which can help you meet them.

Major Medical Insurance in Nebraska

The first and most popular opti –>on is major medical insurance through the ACA Health Insurance Marketplace. The ACA (short for the Patient Protection and Affordable Care Act) which was signed into law back in 2010. This law set up the Health Insurance Marketplace, an insurance exchange where people can fill out an application at HealthCare.gov in order to apply. Tens of millions of people have received life-saving medical care thanks to these efforts to get more Americans insured, and despite some controversy, it looks as though this will continue to be the law of the land for the foreseeable future. 

In order to qualify for coverage, you have to be a legal citizen of the US and you have to fill out an application on HealthCare.gov during the Open Enrollment period. Open Enrollment usually begins on November 1st if you want to apply for health coverage for the following year. For 2020 coverage, Open Enrollment ended December 15th, but you may be able to apply outside of the Open Enrollment period If you qualify for a Special Enrollment Period (SEP). For more information on Special Enrollment Periods, it’s strongly suggested that you visit the HealthCare.gov website to either read up on it or get in touch with a representative who can help you.

There are several reasons why major medical coverage through the ACA is the more popular option, one of the most important reasons being the guaranteed issue coverage. ACA insurance providers are not allowed to discriminate based on pre-existing conditions; if you apply for coverage, they have to sell you a policy. They also must offer you a fair price for your monthly premium, and they are only allowed to charge you more based on the following factors:

• Age
• Location
• Tobacco use
• Family/Individual status

ACA major medical coverage is also more comprehensive than most other available Insurance products. By law, these insurance policies have to include all 10 of the Essential Health and Wellness Benefits which are necessary for keeping people healthier for longer and reducing healthcare costs over the course of someone’s life time: 

• Ambulatory/outpatient services
• Emergency services
• Hospitalization
• maternity/newborn care
• Mental health and substance abuse
• Prescription drugs
• hab/rehab services and devices
• Lab tests
• Preventive and wellness services and chronic disease management
• Pediatrics (including oral and vision)

Finally, the income-based tax credits play a large role in making this type of health insurance affordable and available for the families who need it most. In Nebraska, if you are making between 138% and 400% of the determined federal poverty limit, then the odds are good that you will qualify for a subsidy. You can take a look at the chart below to see if your household, based on a combination of size and income, falls above or below this 138% threshold. If you make too much or too little, you won’t get a subsidy – which can make ACA Insurance prohibitively expensive for many families. There’s also the Medicaid expansion coverage gap to consider.

The Medicaid expansion coverage gap was a big problem for Nebraska residents who fell within the 100% to 138% income gap in previous years. In this gap, Nebraskans who made too much money to qualify for Medicaid had to choose either to purchase a full price ACA policy or to go without. But Nebraska finally agreed to accept federal funding to expand the Medicaid program for eligible homes and families within the last few years. This coverage will go into effect for the 2021 health coverage year, but qualifying enrollees won’t be able to join Medicaid until the 2020 Open Enrollment period begins in October. For more information on Medicaid in Nebraska, as well as information on whether or not you can qualify for a plan, visit the ACCESSNebraska website.

Short Term Health Insurance in Nebraska

If you are still stuck in the Medicaid expansion coverage gap for the time being while you wait for the new laws to take effect, if you don’t qualify for a subsidy for some other reason, or you simply don’t want to get your health insurance through HealthCare.gov, you might want to consider a short-term health insurance plan in Nebraska. There are some shortcomings with these compared to the ACA, but that doesn’t mean they aren’t worth taking a look at.

One of the best things about getting short-term health insurance is the fact that these plants can cost up to one-third less compared to an unsubsidized ACA plan. You may have the option to customize your coverage depending on the plan you buy and the provider you get it from. Speaking of getting it, you don’t need to go through the ACA or HealthCare.gov in order to apply – just find a provider in your area and approach them for more information about how to purchase a short term insurance plan. Lastly, you can have a little piece of mind knowing that there are some stiff consumer protections in place for people who purchase and use short-term health insurance. If your insurance provider tries to deny you your benefits or refuses to pay out a claim for an unjust or illegal reason, you can take them to court. There’s no guarantee you’ll win your case, but you at least have the option to get the money you’re owed. 

So that’s the good news about short-term health insurance in Nebraska. But there are some other aspects of short-term health insurance you should familiarize yourself with before you make a decision. For starters, Short-term health insurance in Nebraska follows federal rules, which means you can only purchase insurance for a year at a time and renew it annually for a maximum of three years. But the renewal process and the application process both involve medical underwriting, Which means that you don’t have any protections like you would with guaranteed issue health insurance. Your short-term health insurance provider can choose to reject you for coverage if they feel you are sick or have too many pre-existing conditions. They can also charge you a higher monthly premium for basically any reason they see fit. Your short-term health insurance policy will come with annual and lifetime benefit caps, but no limits on your total out-of-pocket costs – and many of those costs will start but not be limited to a $5,000 deductible that you must meet before your insurance company starts paying out your medical claims.

Having said all that, people who are in relatively good health and don’t need much medical care could find a good value with short-term health insurance. And if you happen to suffer a medical emergency that you weren’t expecting, having this insurance in your back pocket can be a great way to protect yourself from a mountain of unexpected medical debt that you otherwise wouldn’t be able to pay for.

Christian Health Plans/Health Share Plans in Nebraska

Do you remember the individual mandate? It was a law that mandated qualifying individuals and families purchase major medical coverage through the ACA, through their employer, or to pay a tax penalty for going without. Back when people were desperate to avoid the tax penalty but couldn’t afford or didn’t want ACA coverage, Christian health plans were a popular alternative. They aren’t comprehensive enough and don’t have enough consumer protections to qualify as major medical coverage – however, the religious nature of a Christian health plan gave members a religious exemption to the individual mandate.

Now that the individual mandate is no more, there’s not as much of an urgent need for people to flock to these policies. Regardless, you may still find them an attractive alternative to ACA coverage. To help get a better idea of how Christian health plans work, it’s useful to know what they have in common with short-term health insurance:

• No guaranteed issue
• Unlimited out-of-pocket costs
• Lifetime and annual benefit caps
• No guaranteed Essential Health Benefits
• Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
• Not considered to be a “real” health insurance plan by major organizations and care providers

But that’s where the commonalities stop, and the differences begin. You won’t be able to take a Christian health plan provider to court if you feel they have denied you your benefits for any sort of unjust reason; technically, there isn’t even a legally enforceable contract between you and your provider, so you have to hope that they will honor the promises they make in your member agreement with no legal recourse to enforce them if they don’t. The jargon is a little bit different, because you pay a “monthly shared amount” instead of a monthly premium and a “personal responsibility amount” or an “unshared amount” instead of co-pays, deductibles, or coinsurance. Lastly, there are the participation guidelines you will need to follow. You will have to declare a specific faith in order to sign up for one of these plans, and usually that faith is a Christian one. You may also have to give up any tobacco use and adopt other biblically inspired lifestyle changes. But their participation guidelines you must follow will vary from plan to plan and state-to-state, so it’s important to discuss these issues with your Christian health plan provider before you officially sign up. 

Fixed Indemnity Plans in Nebraska

If none of the options so far have seemed that appealing, you might want to think about a fixed indemnity plan. A better use of a fixed indemnity plan, though, is to supplement your major medical or short-term health insurance coverage; not to replace it. This is because fixed indemnity plans only pay out a fixed amount of financial benefit per day, week, month, visit, or incident. They don’t pay out a percentage of your total medical costs the way major medical health insurance is supposed to. They also have lifetime and annual benefit caps just like short-term health insurance or a Christian health plan. And there is medical underwriting involved, so there’s a chance you could be charged exorbitant rates or rejected for coverage if you have problems with pre-existing conditions. 

There are different types of fixed indemnity plans you may be able to purchase as a Nebraska resident. The most popular are hospital indemnity plans, of course, but there might be some doctor visit indemnity plans or even dental indemnity plans available if you look around in your area hard enough. If you are relatively healthy and don’t anticipate needing much medical care, a fixed indemnity plan can at least give you some peace of mind and a minimal amount of protection from unexpected out-of-pocket medical costs – but it is still the least comprehensive of all of the options we have discussed so far. That’s why most people use it as a supplement as opposed to a replacement for major medical coverage.

Discount Cards in Nebraska

There are different resources available for Nebraska residents who need help with prescription drugs and other medical costs. Medical discount cards are one way to help reduce your out-of-pocket costs either for free, or for a small fee. There are free services like the Nebraska RX card which can give you pharmacy coupons and help you save upwards of 80% off your prescription drug costs at no cost to you. There are also programs which work similarly to something like the AAA Club where you pay an annual or monthly membership fee and get a discount card in the mail. Then you display that discount card when you get medical services or make medical purchases to get a discount at the register. But these programs are not insurance, and anyone who tells you otherwise is likely trying to scam you. So buyer beware when it comes to medical discount cards.

These cards don’t have any qualification requirements, other than a membership fee. You need to do your research on both the company selling the discount card, the discounts they claim you will be eligible for, and the providers they claim to be working with. If everything checks out, then a good, reputable medical discount card can be a great way to help take the edge off of your total medical costs. But if the amount of money you spend on your membership fees is greater than the amount of money you save in discounts, a medical discount card may not be right for you.