Finding Medicare Plans in Nebraska
Nebraska offers a lot of different Medicare options, but sorting through them all to find the right coverage can be overwhelming. We don’t think it should be. We’ll help you sort through the Medicare plans available in Nebraska to find the coverage that fits your needs and your budget.
What Is Medicare and What Does It Cover?
Medicare is a federal health insurance program that covers a variety of health care expenses. It is available for people 65 and older and certain people under the age of 65 with a qualifying disability or illness. Medicare doesn’t cover everything, and it isn’t intended to pay 100% of your medical expenses. Medicare beneficiaries typically pay a portion of their medical bills through coinsurance, copayments, and deductibles.
To see what’s covered, we’ll first look at the four parts of Medicare:
Original Medicare (Parts A and B)
Original Medicare is the federal component of Medicare and has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, hospice, skilled nursing facility care, and nursing home care (as long as custodial care isn’t the only care needed).
Part B (Medical Insurance) covers outpatient services and supplies, like mental health care, ambulance services, and durable medical equipment (e.g., canes, blood sugar monitors, and walkers). Part B also covers some services that prevent or detect illnesses at an early stage, like flu shots, cardiovascular screenings, and diabetes screenings.
Original Medicare doesn’t cover everything. Services generally not covered by Original Medicare include:
- Long term care (custodial care)
- Most outpatient prescription drugs
- Hearing aids
- Eye exams and eyeglasses
- Most dental care and dentures
- Routine foot care
- Cosmetic surgery
For this reason, there is a variety of Medicare plans available through Medicare-approved private insurance companies for more comprehensive coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans, offered by Medicare-approved private insurance companies, work as an alternative to the coverage provided by Original Medicare (Parts A and B). These plans provide the same coverage as Original Medicare and can also include additional benefits, like dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
You must be enrolled in both parts of Original Medicare to enroll in a Medicare Advantage plan. Premiums can start at $0 and increase depending on the level of coverage selected. You’ll continue paying your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans work alongside Original Medicare to provide coverage for prescription medications. Prescription drug coverage is not provided by Original Medicare nor Medigap plans. These plans, offered by Medicare-approved private insurance companies, separate medications into tiers. The higher the tier, the higher the copay/coinsurance. Each plan provides a drug formulary, so you can check which tier(s) your medications fall into. This allows you to compare plans and find the plan that provides the best value for your prescription needs.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans work to fill the gaps in Original Medicare (Parts A and B) coverage. Medigap plans are offered by Medicare-approved private insurance companies and work alongside your Original Medicare. These plans can help reduce your out-of-pocket costs by covering certain expenses, like deductibles, coinsurance, and copays.
Am I Eligible for Medicare Plans in Nebraska?
To qualify for Medicare, you must be eligible for Social Security benefits. Most people first become eligible for Medicare when they reach 65 years of age.
If you’re 65 or older, you may qualify for Medicare if:
- You are a citizen or permanent resident (having lived in the US for at least 5 years), and
- You or your spouse worked at a job that paid towards your Medicare through Social Security deductions for at least 10 years.
If you’re under 65, you may qualify for Medicare if you have:
- been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD)
- received Social Security Disability Insurance (SSDI) for at least 24 months
If you will be turning 65 in the next six months or are unsure about your eligibility, we’re here to help. You can view plans in your area online or talk to a licensed insurance agent by giving us a call.
When Can I Enroll in A Medicare Plan?
Medicare Advantage and Medicare Prescription Drug Plans
Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. Your IEP is a seven-month period that starts three months before your 65th birthday month.
Then you can make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs every year, from October 15th to December 7th.
Key Fact: The General Enrollment Period offers another chance to enroll in Original Medicare, in case you missed your IEP. This period occurs each year from January 1st to March 31st. If you choose to enroll in a Medicare Advantage plan, you can do so from April 1st to June 30th every year.
Medicare Supplement Plans
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. If you are enrolled in Medicare Part B, this period starts the same month as your Part B coverage. Once it has begun, this period continues through the following six months.
Important Note: If you enroll during this period, you’re guaranteed the Medigap plan of your choice. But if you miss this period, Medigap carriers can increase premiums or even deny you coverage entirely.
Special Enrollment Periods
If you’ve recently experienced a qualifying life event, you may be granted a Special Enrollment Period. A Special Enrollment Period allows you to enroll or make changes to your coverage outside of the normal times. Qualifying life events include moving out of your plan’s coverage area, moving into or out of a care facility, and more. Our licensed insurance agents can help determine if you qualify for a Special Enrollment Period.
How Do I Select a Medicare Plan?
We’ll help you sort through your options to find the coverage that’s right for you. You can compare plans side-by-side online by using the form below. You can also call the number above to speak with a licensed insurance agent.
Additional Medicare Resources in Nebraska
The Senior Health Insurance Information Program (SHIIP) provides free, unbiased education and assistance about Medicare for Medicare beneficiaries and their caregivers.
Qualified Medicare Beneficiaries (QMBs) can apply for financial assistance to help pay for certain Medical services and expenses, like premiums and deductibles. You must meet certain resource and income requirements to be considered qualified.
Sources: Medicare.gov; doi.nebraska.gov; dhhs.ne.gov