Most Medicare Advantage (MA) plans offer more well-rounded coverage than Original Medicare, which is why the program grows more popular every year. In 2022, nearly half of Medicare beneficiaries were enrolled in an Advantage plan. This page describes Medicare Advantage plans in Nebraska and how to compare your options.
What Is Medicare Advantage in Nebraska?
Also known as Medicare Part C, Medicare Advantage plans must provide same benefits as Original Medicare. This includes Medicare Part A, hospital insurance, and Medicare Part B, medical insurance. Original Medicare does not include prescription drug coverage, however. For that, you need Medicare Part D.
While Medicare Advantage must provide the same coverage as Parts A and B, they are not limited to offering those benefits. In fact, around 90 percent provide prescription drug coverage, routine vision care, fitness benefits, and more.
Nebraska Medicare Advantage Plans with Prescription Drug Coverage
Medicare Advantage Prescription Drug plans (MA-PD) combine your Parts A, B, and D benefits. These all-in-one plans often save beneficiaries money, since there's no need to buy a standalone Medicare Part D plan when you join an MA-PD.
Who Is Eligible for Medicare Advantage in Nebraska?
Once you sign up for Medicare Parts A and B, you are eligible for Medicare Advantage in Nebraska.
You qualify for Medicare if you are an American citizen or permanent legal resident age 65 or older. People who collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months also qualify for Medicare.
Those who "age" into the program are only automatically enrolled if they begin collecting Social Security at least 4 months before their 65th birthday. If you qualify for Medicare due to a disability, enrollment occurs automatically during month 25.
When Can You Sign Up for a Medicare Advantage Plan in Nebraska?
The five Medicare Advantage enrollment periods are:
- Initial Enrollment Period: Your IEP begins 3 months before your Medicare eligibility month and lasts for 7 months. So, if your 65th birthday or 25th month of disability is in July, your IEP runs from April 1 through October 31.
- General Enrollment Period: If you did not sign up for Medicare Part A and/or Part B during your Initial Enrollment Period, you may do so during General Enrollment from January 1 through March 31. You can sign up for a Medicare Advantage plan from April 1 through June 30.
- Annual Enrollment Period: You can sign up for an MA plan any time during AEP, which runs from October 7 through December 15.
- Medicare Advantage Open Enrollment Period: If you already belong to an Advantage plan, you may either change to a new plan or move back to Original Medicare during Open Enrollment. It runs from January 1 through March 31.
Medicare also offers Special Enrollment Periods for people who experience certain life changes, like moving or losing your current coverage. The full list of qualifying special circumstances is available on Medicare.gov.
Types of Medicare Advantage Plans in Nebraska
The four most common types of Medicare Advantage plans in Nebraska are:
- Health maintenance organizations: HMO plan requirements include a provider network, choosing a primary care doctor, and obtaining referrals before seeing a specialist. Out-of-network services are rarely covered by an HMO plan.
- Preferred provider organizations: PPO plans have provider networks but they do not require members to choose a primary doctor or get a referral to see a specialist. They also allow you to visit an out-of-network provider, you just have a higher copayment for those services.
- Private fee-for-service: PFFS plans set cost guidelines for all covered services. Most have a provider network but allow plan members to go out-of-network for a higher cost. There is no need for a primary doctor and you do not need a referral to see a specialist with a PFFS plan.
- Special needs plans: SNPs are limited to people who meet one of the following guidelines: have a chronic condition, qualify for both Medicare and Medicaid (dual eligible), or live in a nursing home/require home healthcare. All services covered by an SNP are geared toward whichever population that plan serves.
How to Choose a Medicare Advantage Plan in Nebraska
Before you join a Medicare Advantage plan in Nebraska, you should compare your options carefully. Consider the following metrics:
- Costs (may include yearly deductible, monthly premium, and copays or coinsurance)
- Coverage (includes the drug formulary for an MA-PD plan)
Our Find a Plan tool makes it easy to compare Medicare Advantage plans in Nebraska. Just enter your location information and estimated coverage start date to review Medicare plans in your area.
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