Medicaid Cost Estimates and Medicaid Coverage in Nebraska

If you are wondering, “How much is Medicaid in Nebraska?” it is important to consider the many factors that will determine your individual Medicaid costs. In Nebraska, when considering Medicaid cost estimates, you should also consider what services you and your family will require. Many residents may have low or free health care coverage options depending on your income, family status or other factors. You may have to pay either a copayment, coinsurance payment, or both in a single visit depending on the services you require at the time of your visit. It is also possible that different visits will require you to make different types of payments. Download our helpful guide to affordable coverage so that you can learn more about eligibility requirements for Medicaid.

How much does Medicaid cost in Nebraska?

The cost of Medicaid coverage in Nebraska is dependent on multiple factors, including copayments, coinsurance payments, deductibles and other similar charges. The first factor of your Medicaid cost estimates is your copayment, which is a set amount of money you have to pay each time you visit your doctor. The insurance company that provides your benefits determines this amount. When considering plans, “What services are covered by Medicaid?” is an important question to answer. The copayment that your Nebraska Medicaid plan has you pay is also based off of your allowable cost, which is the maximum amount your insurance plan will pay for certain medical services. A payment type similar to a copayment is a coinsurance payment. The coinsurance payment that your Medicaid benefits ask you to pay is a percentage of your allowable cost. The amount of your copayment or coinsurance payment is determined by the service you need and who you receive it from. For example, the Medicare coverage benefits copayment and coinsurance amounts that you pay for your doctor’s visits may differ from those you pay for a visit to your dentist.

The second factor used to determine your Medicaid coverage costs is your deductible, which is a fixed amount that you have to pay for your health care before your Medicaid coverage insurance plan takes over the costs of your medical care. Once you have paid the full amount of your deductible, you will only have to pay either your copay or your coinsurance amount.

Download our comprehensive guide to Medicaid to understand the documents necessary to complete your application and eligibility for coverage.

What Services are Covered by Medicaid in Nebraska?

Understanding what services are covered by Medicaid in Nebraska and what does Medicaid not cover will help you determine if you are eligible and if the program will work for you. There are two types of Medicaid coverage that the program covers are mandatory and optional. Federal law requires states to provide certain benefits to anyone enrolled in Medicaid who is receiving Medicaid benefits.

Mandatory

Mandatory Medicaid services are the Medicaid benefits that every state must offer its residents, these types of Medicaid insurance services include laboratory tests and X-ray, family planning services and home health services.

For the most part, your Medicaid coverage services include all age groups, from children to adults. However, some may have age limits applied to them. For example, some states may offer transportation service for all participants, while others may only provide them for seniors.

Optional

Optional services are the Medicaid services that Nebraska does not have to cover under their Medicaid coverage plans but chooses to anyway. Nebraska Medicaid’s optional benefits outnumber their mandatory benefits. Some of the optional services you can choose from are:

  • Vision related services
  • Dental services
  • Hospice services
  • Prescription drugs
  • Mental health services

As with mandatory Medicaid benefits most of the optional services do not have an age limit. However, some do. Meanwhile, medical supplies and prescription drugs are available to Medicaid beneficiaries of all ages.

What does Medicaid not Cover in Nebraska?

While Nebraska Medicaid coverage provides for many services and programs, they do not cover everything. Medicaid does not cover treatments that are untested or that are still in the testing phase. Medicaid also will not cover anything that your Medicaid coverage plan does not consider medically effective, as well as any treatment that is not considered normal for your illness or injury and any services that do not have guidelines to regulate them. Your Medicaid coverage also does not cover any kind of cosmetic surgeries that you would use to improve your appearance, private nursing services, massage therapy, chiropractic care or medical services given by a family or friend.

While Medicaid coverage includes prescription drugs, it might not include all of them. For instance, fertility drugs, cosmetic drugs and weight loss drugs are not covered under your Nebraska Medicaid plan for any reason.

Types of Medicaid Insurance in Nebraska

The Nebraska Medicaid Workers with Disabilities program provides NE Medicaid coverage for individuals who are disabled but are still working, either part time or full time. If they qualify, they will qualify for full Medicaid coverage. However, their income will determine how much their copayments will be. Individuals with a lower income will pay the normal Medicaid coverage copay, while individuals with a higher income will pay higher copays.

Long-term care is reserved for individuals with Medicaid coverage who currently live in nursing homes. They may qualify for Medicaid’s long-term care program if they are deemed medically needy and meet the income and resource requirements, among other criteria.

Nebraska Medicaid offers a wide variety of different services and programs. Some other types of Medicaid insurance are as follows:

  • The Program of All-Inclusive Care for the Elderly (PACE)
  • Long term care
  • Workers with Disabilities program
  • ARChoices

The Program of All-Inclusive Care for the Elderly (PACE) is a Medicaid program under Nebraska Medicaid that provides individuals with comprehensive health and social services benefits that include coordinating primary, preventative, acute and LTSS care for individuals who require the assistance of nursing homes.