Looking for health care in the Cornhusker State? Good news: Nebraskans have plenty of health insurance options. According to US News, Nebraska has the 19th best health care in the nation. That study looks at access, quality, and good public health.
Health insurance options in Nebraska
There are several ways for NE residents to access health care in their state:
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Nebraska residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 55% | ||
| Individual or family | 7% | ||
| Medicaid | 13% | ||
| Medicare | 14% | ||
| Military | 2% | ||
| Uninsured | 8% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
Eight percent of Nebraskans are uninsured, lower than the national average. That’s great news for policyholders. A high percentage of uninsured people raises rates for insured people.
Nebraska health insurance companies
There are a couple options for providers in your state. These companies offer individual and family plans in NE:
- Bright Health
- Medica
Nebraska health insurance costs and rate factors
NE residents spend an average of $8,412 on health care per year, a few hundred dollars above the national average. How much should you expect to pay for health insurance in Nebraska? Monthly premiums vary person to person, but are based primarily on these factors:
Health insurance plan type
Marketplace plans come in metal tiers: bronze, silver, and gold. The more coverage you want, the more you’ll have to pay in monthly premiums.
So, how much should you expect to pay every month in NE? These are the average prices for a middle-aged resident in your state in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $468 | $667 | $613 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Premiums for a gold plan cost about 31 percent more than a bronze plan. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent.
You may also qualify for a catastrophic plan, the lowest level of coverage available in your state’s marketplace. Catastrophic plans have low monthly premiums, but a yearly deductible of $8,150. Because of this, you may save money by investing in a bronze or silver plan if you actually use your health insurance.
Body mass index
According to the CDC, a high body mass makes you more likely to suffer from numerous health conditions. That’s why health insurance companies analyze you BMI when determining your risk-level. A higher BMI often means higher insurance rates.
In 2019, NE had a 34 percent obesity rate, the 18th highest rate in the country. Out of the many state residents who used QuoteWizard to compare health insurance plans, 36 percent of shoppers have a BMI in the obese range.
Tobacco use
Smokers pay more for health insurance because of the health conditions caused by tobacco use. About 17 percent of Nebraskans are smokers, the 23rd lowest rate in the country.
Age
According to HealthCare.gov, health care costs up to three times more for older people than younger people. State residents who used QuoteWizard to shop for health insurance are, on average, 38 years old.
Location
Where you live plays a large role in the cost of your health insurance. That’s because every state has different health care rules, regulations, and companies.
Also, health insurance companies use community-rating to determine prices. So, rates are based in part on the combined claims that everyone files. If your community files an unusually high number of claims, your rates may increase.
That’s why the overall health of your state matters. According to America’s Health Rankings, NE is the 13th healthiest state in the country.
Nebraska health insurance laws
The Affordable Care Act limits health insurance providers from using certain factors to price your policy.
- Pre-existing conditions: Insurance companies used to charge people with pre-existing conditions more for health care. Now, providers can’t raise your prices because of a pre-existing condition.
- Gender: According to a study by Health Services Research, women historically pay more than men for health care. But the ACA mandates that companies can’t charge women and men different prices for the same policy.
- Insurance and medical history: Insurance companies also used to analyze medical history and past insurance coverage. People with previous medical problems or lapses in insurance used to pay a lot more for health care.
There's a limit to how much you’ll pay out-of-pocket for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
NE law requires health insurance companies to offer at least some coverage for the following services:
- Mental health conditions
- Off-label drugs for cancer and HIV/AIDS
- Diabetes coverage
- Childhood immunizations
- Cancer screenings
- Diabetes education
- Breast reconstruction
There are additional services that providers need to offer. Find the full list at cms.gov.
Medicare and Medicaid in Nebraska
Medicare and Medicaid are both government-funded health care programs. Medicare covers seniors, and Medicaid helps low-income families and children.
Medicare
Medicare offers affordable coverage to people 65 and older. There are several coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Program with these income restrictions:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The number of uninsured Americans has improved considerably since the Affordable Care Act (ACA) became law in 2010. Medicaid expansion was influential in reducing Nebraska's overall number of uninsured residents.
In 2008, 10.8% of Nebraska’s residents did not have medical insurance. After Nebraska expanded its Medicaid program, the state's uninsured rate dropped to 7.9% between 2014 and 2018. The primary cause of this was a 32% increase — or 235,600 Nebraska residents — in Medicaid enrollment from 2008 to 2019.
Medicaid is primarily meant for low-income families and children. These are the state’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Nebraska Department of Insurance
- Website:
- Homepage
- Insurance Commissioner:
- Bruce R. Ramge
- Insurance Hotline:
- (877) 564 – 7323
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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