Many residents obtain their health insurance by signing up for Nebraska Medicare insurance coverage. This is a federal program that offers health insurance for people who are at least 65 years old, although those under 65 with certain disabilities may qualify as well. The Nebraska state government also offers various assistance programs to assist Medicare beneficiaries.
The basic coverage comes from Original Medicare, which has Part A and Part B. Medicare Part A covers inpatient care in hospitals, and also in critical access hospitals and skilled nursing facilities. Hospice care and some types of home health care are included as well.
Medicare Part B covers doctor services and outpatient hospital care, as well as some health care services not covered in Medicare Part A. These include the services of physical therapists and the use of durable medical supplies.
Medicare Part A does not typically require premiums, although in some cases it may be required. Medicare Part B does require premiums based on the beneficiary’s income, but it can be as low as $134 per month. That’s much more affordable than the average cost of premiums in Nebraska, which is $483 per month.
Both Medicare Part A and Part B may also require the beneficiary to pay for out-of-pocket expenses. These include deductibles, copays, and coinsurance costs.
Some private health insurance companies in Nebraska are authorized by Medicare to provide supplemental plans for Original Medicare. These plans can cover extra health care services that are not included by Original Medicare. Other plans may also cover the costs of deductibles and copays.
A more common supplemental plan provides Medicare prescription drug coverage. This helps cover the cost of prescription medications. This type of plan is also known as Medicare Part D.
Also known as Medicare Part C, these Medicare Advantage Plans can take the place of Original Medicare. These are also available from private carriers with the approval from Medicare. These plans provide the basic benefits that are included in Original Medicare, plus additional benefits such as coverage for health care services that are not covered by Medicare Part A and Part B. This can also include coverage for Medicare prescription drugs.
Nebraska offers various Medicare Savings Programs (MSPs) to help Medicare beneficiaries cover the cost of Medicare. These come with certain income and resource limits.
The first of these MSPs is for the Qualified Medicare Beneficiary (QMB), which covers the payment for Medicare premiums as well as copays, deductibles, and coinsurance. In Nebraska, those who are under 65 and are either blind or disabled may qualify for the QMB program as well. To be eligible for the QMB program, the individual must have a monthly income of less than $1,032. Married couples have a combined income limit of $1,392.
The other MSP is for the Specified Low-Income Medicare Beneficiary (SLMB). This SLMB program pays only for the premium of Medicare Part B. To qualify, an individual cannot earn more than $1,234 a month. A married couple cannot earn a combined income of more than $1,666.
These programs also have a limit on resources, which do not count the value of the home the beneficiary lives in and the car the beneficiary uses. Instead, for the most part, it factors in the savings and checking account and the value of their bonds and stocks. For an individual, the resources cannot total more than $7,560. Married couples have a resource limit of $11,340.
While not an MSP program, the Extra Help program can assist beneficiaries in paying for Medicare Part D coverage to help cover the cost of prescription medication. This is also known as the Low-Income Subsidy or LIS.
To qualify, an individual must earn less than $18,090 a year and have resources of less than $13,820. Married couples have an income limit of $24,360 per year and a resource limit of $27,600.
Medicare and health insurance, in general, can be complicated. The state of Nebraska acknowledges this problem by running the Senior Health Insurance Information Program (SHIIP). This program offers free and unbiased information and counselling so that Nebraska residents can make informed decisions regarding Medicare and health insurance.
Nebraska residents are encouraged to call SHIIP at 1-800-234-7119 to ask questions or to schedule an appointment with a SHIIP volunteer.