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Nebraska Health Insurance

Nebraska Medical Insurance Overview

The overall health of the residents living in Nebraska is quite good and the state offers a wide variety of options for insurance coverage for its residents.  In this state, there are only 10 percent of the population without insurance benefits, which is a really low percentage compared to the rest of the nation.

In the state of Nebraska, residents can enjoy insurance coverage through a variety of means.  Included are group health plans, individual policies and through the use of state-funded programs.  Health insurance in the state of Nebraska is offered based on the medical needs of the applicant.  With the current political climate of healthcare in the United States, it is estimated that Nebraska’s residents as well as the rest of the country are likely to see benefits from increased health coverage.  Below is the most current information regarding the overall health and insurance status of those who live in Nebraska.

Nebraska’s Health Care Issues
As of 2014, the state of Nebraska is ranked in 10th place when compared to the rest of the states in the United States.  This ranking is down from 15th place as of 2012, which shows a marked improvement for the residents overall.  It is one of the healthiest states in the entire country, but there are some weak points that it still needs to overcome.  Below is a short list of the strengths and weaknesses of the state:

Strengths:

  • High rate of graduates from high school
  • Low prevalence of babies born with low birth weights
  • Few poor mental health days

Weaknesses:

  • High prevalence of excessive drinkers
  • Significant disparity in health status by level of education
  • Low rate of adolescents who have been immunized against TDAP

Understanding Nebraska’s Uninsured Population
Only ten percent of the people in Nebraska are uninsured, which is a slight decrease since the year 2012.  While the cost of healthcare is quite high, there are many people in the state who don’t take advantage of state-funded programs.  With regard to the uninsured portion of the state’s residents, the Kaiser Family’s website breaks down the non-elderly uninsured population by age group.

In the state of Nebraska, 4 percent of children between birth and age 18 are not covered under insurance.  In addition, of those aged 19 to 64, 14 percent have no insurance coverage whatsoever.

With the country still seeing the benefits due to the Patient Protection and Affordable Care Act, the number of uninsured persons living in Nebraska is expected to decrease.

Group Health Plans
Group coverage is available through employer-sponsored policies in the state of Nebraska.  As of 2014, the number of residents covered under group plans was 53 percent.  HMOs and private insurance providers in the state of Nebraska are regulated by the Department of Insurance.

Regulations have been put in place so that employers can easily offer insurance coverage to their workers, but for smaller companies, it can still be difficult.  Getting insurance through the workplace requires payments to be deducted from your paycheck automatically, so the financial aspect is one worth exploring in detail.  It can prove to be quite expensive to obtain insurance coverage in this manner, so many workers in the state of Nebraska don’t have coverage at all.

Despite the expense, your employer should be the first place you look for insurance benefits if you work in the state of Nebraska.

Signing Up
There is usually an enrollment period of which you can utilize to get coverage through your employer’s health benefits package.  This period of time is usually the same time frame every year and it is the only time of which you can sign up for coverage unless you have a qualifying life event (marriage, adoption, birth of a child, etc).  Before you take the leap to obtain insurance coverage through the workplace, be sure to do a great amount of research so that you know the coverage options available to you.

Consider the following factors when making the decision to get coverage under a group health plan:

  • What type of coverage do you need?  What plan would best suit your medical needs?
  • Is there affordable coverage?
  • Do you have any future potential health risks that will require a more comprehensive policy?
  • Are you responsible for covering your spouse or dependents?
  • Do you need special coverage because of a pre-existing condition?

Pre-Existing Condition Exclusion Periods
If you are signing up for coverage under a group health package and you have a pre-existing medical condition, you may have to wait through a period of time called an exclusion period.  Under this exclusionary period, you are still covered for medical services that are unrelated to your medical condition and as a result, you are still required to pay the monthly premiums associated with coverage.

Take all of the following factors into account when considering coverage if you have a pre-existing medical condition:
Dependents under the age of 19 are not subject to exclusion periods.
Your medical records can be scrutinized by the insurance provider for a period of six months prior to enrollment if you have a pre-existing condition.
Predisposition to disease or a condition does not count the same as having a pre-existing condition.

Affiliation or Waiting Periods
HMOs and private insurance companies all require those who enroll into the plan to wait through an affiliation period.  This time period is required so that employees don’t get larger health expenses covered and then quit their jobs.  Affiliation periods usually take two months time, but it can be three months if you sign up late.  You are not required to make your monthly premium payments during the affiliation period.

Individual Health Plans
In the state of Nebraska, there are individual policy options available to people who can’t get coverage through a group or state-funded program.  Individual health plans are usually quite expensive when compared to group plans because they lack the employer’s contribution to the premiums.  It is harder to obtain health coverage under an individual plan because the insurance provider will require a physical for you to pass along with the completion of a health questionnaire.

Nebraska Health Benefits Exchange
Despite being awarded a $1 million grant toward researching a health benefits exchange, the state of Nebraska opted to setup a federally-managed benefits exchange after legislation to do so failed.

The state of Nebraska is exploring its options regarding the plan management functions of its benefits exchange, despite not having entered into a partnership with the federal government.

For all insurance coverage in Nebraska, insurers are regulated by the Department of Insurance.

Nebraska State Insurance Programs
In Nebraska, if you cannot obtain health benefits through a group or individual plan, the state has some programs that can be free or of little cost for a multitude of services.  Eligibility typically depends on your income level, gender and health status.

Below, we have listed out each available program provided by the state of Nebraska.

Nebraska Comprehensive Health Insurance Pool (NECHIP)
NECHIP offers coverage to qualified residents of Nebraska for hospital stays, doctor’s visits, prescription medications, surgery and more.  If you are not insured and are not eligible for Medicaid or Medicare and have exhausted COBRA coverage, you may be able to apply for coverage under NECHIP.

Pre-Existing Condition Insurance Plan (PCIP)
This is a program that offers benefits to people with pre-existing medical conditions.  There are a great deal of benefits associated with PCIP, but along with those come high premium costs.

Medicaid
Medicaid is a nationwide program that offers health coverage to people with low incomes.  The premiums can range from zero and higher depending on your income.  Provided under the Medicaid program are doctor’s visits, hospital care services and immunizations.

Kids Connection Program (KCP)
This is for children who are 19 and younger that have a significantly lower income overall.  Under KCP, you can get help with ambulatory services, hospital stays, doctor’s visits, health checks and more.

Women-Infant-Children (WIC)
The WIC program offers a variety of resources to pregnant women and new mothers for providing proper nutrition to their infants and children.  Under WIC, women can get nutritional food products, breastfeeding advice and infant care information.

Every Woman Matters (EWM)
This program covers women between the ages of 40 and 74 and provides breast and pelvic exams, pap smears and mammograms.  Under EWM, you can be covered under Medicaid or an HMO.

Nebraska Colon Cancer Screening Program (NCCSP)
This is a program dedicated to men and women over the age of fifty-years-old.  Covered under NCCSP are colon cancer screenings and educational resources for healthy living as well as colonoscopies and FOBT Kits.

Indian Health Services
Indian Health Services provides medical services to those who belong to Indian tribes living in the state of Nebraska.  Covered under IHS are emergency room visits, in-patient services, outpatient services, physical therapy and pediatric care services.

VA Medical Benefits Package
The VA Medical Benefits Package was established to offer comprehensive medical benefits to military veterans who have served out their active duty requirement or at least 24 months of service in a row.  In order to be eligible for coverage, you must have been a vet who has received an honorable discharge from the service.

Medicare, Medicare Prescription Drug Program
Medicare is available to disabled citizens, seniors over 65 and those suffering from end-stage renal disease.  In order to qualify for the Medicare program, you must have worked in a job that was covered by Medicare for over ten years.

Health Insurance Info, Counseling, and Assistance Program
This is a counseling service offers to disabled citizens and seniors to offer advice on the Medicare and Medicaid services available in the state of Nebraska.

Partnership for Prescription Assistance
The PPA is a free service that provides consumers with access to 475 programs that are all geared toward helping with the financial aspects of getting prescription medications.

National Association of Mental Illness (NAMI) Helpline
The NAMI Helpline is a nationwide program that is staffed by volunteers who offer mentally ill patients informational resources on treatment options and counseling.

HIPAA and Conversion Health Plans
The Health Insurance Portability and Accountability Act was enacted in 1996 and offers regulations regarding private insurers nationwide.  Under HIPAA, private insurance companies cannot limit group health coverage to enrollees based on the presence of a pre-existing medical condition.  It also governs the length of time you can be subjected to wait for exclusion or affiliation periods.

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