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Medicare Advantage Plans in Nebraska For 2022

For new Original Medicare beneficiaries or those who are already enrolled in Medicare Part A and Part B and who are looking for a new policy, a Medicare Advantage plan in Nebraska for 2022 just might fit the bill. Of course, you’ll probably want to learn more about Medicare Advantage plans in Nebraska before you sign up for one, but we’re here to help with that. After checking out this guide to Medicare Advantage plans, you can use our website to look for quotes or can call and talk to one of our licensed insurance agents about your plan options.

What is Medicare Advantage in Nebraska?

Medicare Advantage in Nebraska is an alternative way to get complete Medicare coverage. People eligible for Medicare benefits can purchase a Medicare Part C plan from a private insurance company. The plan provider is required by U.S. federal law to provide, at least, the same benefits that Original Medicare does.

Through a Medicare Advantage plan in Nebraska, enrollees pay a monthly premium for a plan that bundles Medicare Part A (inpatient hospital insurance), and Medicare Part B (outpatient medical insurance) benefits together into one plan.

Here are some other features of Medicare Advantage plans in Nebraska:

  • Medicare Part C enrollees must continue paying their Part B premiums for eligibility in Medicare Advantage.
  • Medicare Advantage plans in Nebraska are quickly gaining popularity as the coverage of choice.
  • Require beneficiaries to use healthcare providers and suppliers within a network.
  • Medicare Advantage Prescription Drug plans (MAPDs) also include prescription drug coverage.
  • Most Medicare Advantage plans in Nebraska have extra benefits like vision, dental, and hearing care coverage and/or wellness club memberships.

What is the Best Medicare Advantage plan in Nebraska for 2022?

Most network freedom: Medicare Advantage PPO plans

  • PPOs give Medicare beneficiaries more options for network providers.
  • PPO enrollees don’t need referrals from their primary care physicians.
  • Monthly premiums are between $0 and $100.00.

Lower out of pocket costs: Medicare Advantage HMO plans

  • Most HMOs have $0 monthly premiums.
  • HMO enrollees require referrals. This helps keep costs down.

Low income or chronic health conditions: Medicare Advantage D-SNP

  • D-SNPs, or Dual Eligible Special Needs Plans, provide benefits for those with low income or who have conditions such as end-stage renal disease.
  • Enrollees have both Medicare and Medicaid coverage. These plans help with costs like copayments, premiums, and deductibles.

What Medicare Advantage plans are available in Nebraska?

Plans available in Nebraska vary according to your service area, but throughout the state there are:

  • Local HMOs: 7
  • Local PPOs: 7
  • Regional PPOs: 0

What’s changing with Medicare Advantage in Nebraska for 2022?

Enhancements to the Beneficiary Real Time Benefit Tool for Medicare Part C:

  • Make comparisons of prescription drug plans and formularies; compare benefits, copays, and cost-sharing options for available plans
  • Figure out which plan is the most cost-effective
  • Know the costs for their prescription drugs before going to the pharmacy

The addition of another preferred specialty tier in formularies will result in:

  • Lower drug prices
  • Lower cost-sharing

Changes in the rating system for Medicare Part C and Part D plan quality so it:

  • Encourages more frequent updates in star rating
  • Changes the calculation and regulation of quality bonus payment ratings

Changes in pharmacy performance reporting requirements

These changes will require Medicare prescription drug plan providers to clarify evaluation measures and results in regards to their networks.

Application of opioid provisions in the SUPPORT act requiring Medicare prescription drug plans to:

  • Inform beneficiaries of risks concerning opioid use
  • Provide information about alternative pain treatment plans that exclude opioid drug use.
  • Give beneficiaries information about safe disposal methods for controlled substances such as opioids

Codification of existing Medicare Part C and Part D program policy for supplemental benefit requirements

These changes should help reduce the administrative workload for PACE organizations.

How much does Medicare Advantage in Nebraska cost?

Eligible beneficiaries in Nebraska can find HMO plans with $0 monthly premiums. In some service areas, there may also be PPOs with zero premiums, although these are less commonly found.

Medicare Advantage plans in Nebraska that have prescription drug coverage carry an average monthly premium of $20.41, and the average annual deductible is $157.53.

If you live in Nebraska, you can ask a licensed insurance agent for details about plans available to you.

When can you enroll in a Nebraska Medicare Advantage plan?

You can enroll in a Medicare Advantage plan in Nebraska during the following periods:

1. The Initial Enrollment Period

At 65:

  • If you are receiving Social Security retirement benefits when you turn 65, the Social Security Administration automatically enrolls you in Medicare Part A and Part B. You can switch to Medicare Advantage during this enrollment period.
  • Your seven-month Initial Enrollment Period starts three months before the month of your 65th birthday. It includes the entire month of your birth date, and it ends three months after that.

Below age 65:

  • If you are receiving Social Security disability benefits
  • If you have end-stage renal disease or ALS
  • Your individual Initial Enrollment Period starts three months before the 25th month of receiving disability benefits. It includes that entire month, and it ends three months after that.

2. Annual Election Period (AEP)

During the Annual Election Period, you can sign up for a new Medicare Advantage plan, switch to a different Medicare Advantage plan, go back to Original Medicare Part A and Part B, and/or enroll in a stand-alone Medicare Part D plan.

AEP runs from October 15 to December 7 every year. Any changes you make during this period start on January 1.

3. The Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period you can return to Original Medicare Part A and Part B, or sign up for a different Medicare Advantage plan. Any changes you make start on the first day of the month following your changes.

4. Medicare Special Enrollment Periods

People who qualify for special enrollment can sign up for a Medicare Advantage plan, Medicare Part D plan, or they can make changes to existing health care plans.

To be eligible for special enrollment, one or more of the following situations must apply to you:

  • You are moving from one service area to another.
  • You are moving back to the U.S. after living abroad.
  • You are moving into or out of skilled nursing or long-term care facility.
  • You are being released from prison.
  • You are no longer eligible for Medicaid, or you have become dual eligible for both Medicare benefits and Medicaid services.
  • Your Medicare Advantage coverage ends or does not renew the plan you are enrolled in.
  • You wish to switch your coverage to a Medicare Advantage plan from Original Medicare Parts A and B together with a Medigap plan.

5. The five-star Special Enrollment Period

If there is a Medicare Advantage plan with a five-star rating available in your service area, you can upgrade your coverage to the five-star plan.

6. The Special Enrollment Period for Medicare “Extra Help” programs

Beneficiaries who are in Medicare’s Extra Help program or have coverage through Medicaid, can change coverage during one of the following enrollment periods:

  • January – March
  • April – June
  • July – September

When can I make changes to my Medicare Advantage plan?

It is most common for beneficiaries to make changes to their Part C coverage during the Annual Election Period (AEP). Anyone who doesn’t have the option to use a Special Enrollment Period, according to the Centers for Medicare and Medicaid Services, is locked into their plan for a period of 12 months.

Are Medicare Advantage plans in Nebraska “bad”?

In Nebraska and other states, Medicare Advantage plans are high-quality, comprehensive insurance plans. In fact, Medicare Part C health insurance is quickly gaining popularity and becoming the top coverage option for Medicare beneficiaries all across the country.

The following statistics highlight the bright future that Medicare Advantage in Nebraska has:

  • The total number of lives with Medicare Advantage coverage in Nebraska: 42,832.
  • The number of people enrolled in Local HMO plans: is 27,377.
  • The number of people enrolled in Local PPOs: 9,399
  • The number of people enrolled in Regional PPOs: 0
  • The percentage of Medicare beneficiaries enrolled in a Medicare Advantage plan in Nebraska: 15 percent.
  • The total number of lives enrolled in Medicare Advantage plans nationwide: over 26 million.
  • The percentage of Medicare beneficiaries who are enrolled in Medicare Advantage nationwide: 42 percent.

Common Questions on Medicare Advantage in Nebraska

Are there disadvantages to Medicare Advantage?

  • Network restrictions based on plan type: All Medicare Advantage plans are tied to networks that limit the choice of physicians, medical facilities, pharmacies, and suppliers. HMOs have a more limited list of providers to choose from than PPOs, and they often require referrals from primary care physicians to see specialists.
  • Less financially predictable: Medicare Advantage plans typically have much lower premiums than Medigap plans do. However, you may have more out-of-pocket costs every time you use your plan, and these costs can add up over time.
  • Requires more member involvement: Members must confirm that they are staying in the network, paying their copays and Medicare bills along the way, and they must do their own research and make changes to their plan annually to ensure they have the best coverage for their health care needs.
  • Less long-term stability: These types of plans renew annually, and there are often changes to benefits, networks, prescription drug coverage, coinsurance, and premiums. Beneficiaries must pay attention to what coverage they have and need. On the other hand, Medicare Supplement plan benefits are standardized and don’t change.

What are the four types of Medicare Advantage policies available in Nebraska?

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS)
  • Special Needs Plans (SNP)

Who are the top three Medicare Advantage plan providers?

The top three insurance companies based on enrollment are:

  1. United Healthcare
  2. Humana
  3. Blue Cross Blue Shield

What are Medicare SNPs?

SNPs provide Medicare benefits to people who have a limited income or pre-existing health conditions such as end-stage renal disease.

Do Medicare Advantage plans include prescription drug coverage?

A large number of Medicare Advantage plans in Nebraska include additional coverage for prescription drugs included in one plan.

Do Medicare Advantage plans cover the SilverSneakers program in OK?

Because this is a very popular benefit, many plans include coverage for SilverSneakers or similar programs. If this matters to you, you should confirm that your plan includes it.

Related Topics

Nebraska State Links

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.   

Key Take Aways
  • In Nebraska, PPO Medicare Advantage Plans are very popular for many Medicare beneficiaries.
  • You can make changes to your Advantage plan each year during the Annual Election Period.
  • You must continue to pay your Medicare Part B Premium with most Medicare Advantage plans.