Nebraska Medicare Guide

Get free support from our licensed Nebraska Medicare Advisors. Schedule a free consultation or give us a call at (888) 604-0055 to get started.

This guide will help you understand what you need to know about Medicare in Nebraska to make informed decisions and get the most value from Medicare.

Use this table of contents to jump to specific sections:

• A Snapshot of Medicare in Nebraska

• Medicare Eligibility and Enrollment Steps

• Nebraska Medicare Advantage Plans

• Nebraska Medicare Supplement Plans

• Nebraska Medicare Part D Plans

• Get help paying for Medicare in Nebraska

A Snapshot of Medicare in Nebraska

There are 361,000 Nebraska Medicare beneficiaries, making up 18% of the state’s total population. The majority of beneficiaries are on Medicare due to their age, but about 11% are on Medicare due to a disability. 12% of Nebraska’s Medicare enrollees also receive Medicaid benefits. When it comes to Original Medicare vs. Medicare Advantage (which we’ll explain more later), 76% of Nebraska beneficiaries stay on Original Medicare and 24% choose to enroll in a Medicare Advantage plan. 

Nebraska Medicare Eligibility and Enrollment Steps

Eligibility is the same for all US citizens. If you’re 65 or older, you are eligible for Medicare. You’re also eligible if you have certain disabilities like ALS or End-Stage Kidney Disease.

Medicare Enrollment Steps

1. Enroll in Original Medicare (Part A & Part B) 

Most people age into Medicare and can enroll during their Initial Enrollment Period (IEP). Your IEP is unique to your birth month. It starts three months before the month you turn 65 and ends three months after. Some people choose to delay Part B enrollment because they’re still working and receiving employer coverage. If you do delay Part B enrollment, just be sure you’re eligible for a Special Enrollment Period once you stop working to avoid a late enrollment penalty. 

2. Compare additional coverage options

Medicare beneficiaries have options. One big decision to make is between Original Medicare and Medicare Advantage. If you choose to stay on Original Medicare, you have the option to add a Medicare Supplement plan and/or a prescription drug plan to help cover some of what Original Medicare doesn’t. If you want to enroll in a Medicare Advantage plan, you’ll have different options to choose from, and each covers different doctors, prescriptions, and benefits. We explain the pros and cons of Medicare Advantage and Original Medicare below so you can make the right decision for your unique health and financial needs. We’re also here to help! Call us at (888) 604-0055 to speak with a licensed Nebraska Medicare advisor who can help you understand your options and provide personalized advice. 

3. Get the most value from your Medicare

We recommend that Medicare beneficiaries review their Medicare insurance coverage each year. This helps ensure you get your healthcare needs met and always receive the best value from Medicare. Medicare Advantage and Part D (prescription drug) plans change every year, and your healthcare needs may too! During the Medicare Open Enrollment Period, which occurs every year between October 15 - December 7, you can change your Medicare Advantage and Part D plans without consequence. This is the perfect time to be sure you’re still on the best plan for your specific needs.

Nebraska Medicare Advantage Plans

There are 28 Medicare Advantage plans available in Nebraska, but pricing and availability vary by county. For example, Douglas County,  NE has 23 Medicare Advantage plans from six different insurance companies. Dakota county has 15 plans from four insurance companies. 

Medicare Advantage plans must provide at least the same coverage as Original Medicare. Most Medicare Advantage plans also provide Part D (prescription drug) coverage and a selection of additional benefits, which may include:

• Dental

• Vision

• Hearing

• Flex cards

• Fitness perks

• Transportation

• Meals

Medicare Advantage plans offer some of these added benefits and charge low or no premiums. Note: you do still need to pay your Part B premium when enrolled in an Advantage plan. 

With all these extras and low added premiums, you may be wondering why everyone isn’t enrolled in a Medicare Advantage plan. These plans also have their disadvantages, including:

• Limited networks

• Preauthorization requirements (and denials)

• Higher out-of-pocket costs (compared to Original Medicare + Medicare Supplement)

Nebraska Medicare Supplement Plans

Medicare Advantage plans replace Original Medicare, but Medicare Supplement plans pair with them. Medicare Supplement (also called Medigap) was created to help fill the gaps in Original Medicare coverage. These plans help cover the 20% of costs that Original Medicare doesn’t, significantly reducing out-of-pocket costs. In addition to lowering your out-of-pocket costs, Medigap plans also don’t have limited provider networks. You can see any doctor who accepts Medicare, which is about 90% of doctors nationwide. You also won’t need to get prior authorization for covered services.

There are ten types of Medigap plans, labeled by letters A through N. Each plan of the same letter (e.g., all Plan Ns) are identical in coverage, even if pricing is different between insurance carriers. 

When you enroll in a Medigap plan matters! The best time to enroll is during the first six months that you have Part B coverage. This is called your Medigap Open Enrollment Period and during it you are guaranteed acceptance into any Medigap plan. Insurance carriers aren’t allowed to ask you questions about your health history and cannot deny you coverage. Outside of the Medigap Open Enrollment Period (and a handful of other guaranteed issue periods with special criteria), insurance carriers can ask you questions about your health history. You may be denied Medigap coverage or charged a higher price.

Nebraska Part D Plans

Original Medicare does not include prescription coverage, but Medicare Part D does. You can get Part D coverage either by enrolling in a Medicare Advantage plan that includes it or through a stand-alone Part D plan. There are 24 stand-alone Part D plans available in Nebraska, with an average monthly premium of $33.29 (the third lowest average in the country). 

Even if you don’t need prescription coverage when you first enroll in Medicare, we recommend getting Part D coverage to ensure you don’t have to pay a late enrollment penalty later on!

If you have questions about your Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Nebraska Medicare Advisors or give us a call at (888) 604-0055. 

Get help paying for Medicare in Nebraska

There are three government programs for low-income individuals that can help you pay for Medicare-related costs.

Nebraska Medicaid and Medicare Savings Programs

Medicaid is a joint federal and state program that each state operates a little differently. Medicaid eligibility is determined by your available income and resources. Nebraska’s Medicaid program is run by the Department of Health and Human Services under the name, ACCESSNebraska. ACCESSNebraska has two levels of Medicare Savings Programs that help individuals with Medicare costs. These programs provide beneficiaries with help paying their Part B premiums. In some cases, people qualify for additional help with Medicare deductibles, coinsurance, and copayments. 

ACCESSNebraska has a few other programs that can assist those on Medicare. Learn more here.

Medicare Extra Help

If you have limited income and resources, you may be eligible for Extra Help. Extra Help is a federal program that helps pay for costs associated with prescription drug coverage. Extra Help is also commonly called the Part D Low Income Subsidy (or LIS). 

You automatically qualify for Extra Help if you:

• Receive full Medicaid coverage from Nebraska

• Nebraska pays your Part B premium

• Are eligible for Supplemental Security Income (SSI)

If you don’t automatically qualify for Extra Help, you can learn more about the program here or talk to one of our licensed Nebraska Medicare Advisors to get free support with your application.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

• You are 65 and older, blind, or have a disability

• You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.