Nebraska Health Insurance Marketplace
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Guide to Nebraska Health Insurance Marketplace
What Is the Nebraska Health Insurance Marketplace?
Nebraska uses a federally facilitated Health Insurance Marketplace, where residents can compare, shop for, and enroll in ACA-compliant health insurance plans.
This Marketplace is designed for individuals and families who do not have access to affordable employer coverage, are self-employed, early retirees under 65, or need to purchase their own insurance. The Nebraska Department of Insurance oversees plan approval and consumer assistance, while the federal government manages the enrollment process.
How It Works and Who It’s For
The Marketplace is for Nebraska residents who:
Live in Nebraska
Are lawfully present in the U.S.
Are not incarcerated
Are not enrolled in Medicare
It serves people who do not qualify for affordable employer coverage, Medicaid, or CHIP. The Marketplace also screens applicants for Medicaid and CHIP eligibility and refers them to Nebraska’s Medicaid program or CHIP if they qualify.
Open Enrollment Period in Nebraska
Open Enrollment for 2025: November 1, 2024 – January 15, 2025
Enroll by December 15 for coverage starting January 1, 2025
Enroll between December 16 and January 15 for coverage starting February 1, 2025
Outside of this period, you need a qualifying life event to enroll or change plans.
Special Enrollment Period (SEP) Rules
A SEP is available if you experience a qualifying life event, such as:
Loss of other health coverage
Marriage or divorce
Birth or adoption of a child
Change in residence
Change in household income
You typically have 60 days from the event to enroll in a new plan.
Types of Health Insurance Plans Available
Marketplace plans are divided into four “metal” tiers, plus catastrophic coverage for those under 30 or with a hardship exemption:
Tier | Plan Pays | You Pay | Premium Level |
---|---|---|---|
Bronze | 60% | 40% | Lowest |
Silver | 70% | 30% | Moderate |
Gold | 80% | 20% | Higher |
Platinum | 90% | 10% | Highest |
Catastrophic Plans: For those under 30 or with a hardship exemption; low premiums, high deductibles, and coverage for all essential benefits after the deductible is met.
Plan Types:
HMO: Lower premiums, limited network, referrals required for specialists.
PPO: Higher premiums, broader network, out-of-network coverage, no referrals.
EPO: Must use network providers, no out-of-network coverage except emergencies, no referrals needed.
Eligibility for Subsidies and Cost Assistance
Premium Tax Credits: Available for incomes between 100% and 400% of the federal poverty level, with expanded eligibility through 2025. Subsidies are only available for Marketplace plans.
Cost-Sharing Reductions (CSR): For incomes up to 250% FPL on Silver plans, reducing deductibles, copays, and coinsurance.
Medicaid/CHIP: Nebraska expanded Medicaid to adults up to 138% FPL. CHIP covers children in families with higher incomes, with eligibility ranging from 109% to 213% FPL depending on age.
How to Compare and Choose a Plan in Nebraska
When comparing plans, consider:
Premiums: Monthly cost
Deductibles/Out-of-Pocket Maximums: What you’ll pay before coverage kicks in
Provider Networks: Ensure your doctors and hospitals are in-network
Drug Formularies: Check if your medications are covered
Tips:
Self-employed: Consider high-deductible plans with HSAs for tax benefits.
Families: Look for pediatric dental/vision, family out-of-pocket limits.
Retirees: Marketplace coverage bridges the gap until Medicare at 65.
Top Insurance Providers on the Nebraska Exchange
For 2025, major insurers offering Marketplace coverage in Nebraska include:
Blue Cross and Blue Shield of Nebraska
Ambetter
Medica
Oscar
UnitedHealthcare
Other regional and Medicaid-focused providers include Nebraska Total Care and Healthy Blue Nebraska.
Navigating Nebraska’s Online Enrollment Portal
How to Apply:
Go to the federal enrollment website and create an account.
Enter household and income information to check eligibility for subsidies or programs.
Compare available plans by premiums, coverage, and network.
Select a plan and complete enrollment.
Pay your first premium to activate coverage.
Where to Get Help:
Certified Navigators and Enrollment Assisters are available statewide for free, in-person, phone, or virtual assistance. Local resources and nonprofit organizations can also help.
Alternatives to the Marketplace
Short-term health plans: Available for up to four months; not ACA-compliant, may exclude pre-existing conditions.
Off-exchange private plans: Purchased directly from insurers; no subsidies available.
Faith-based health-sharing ministries: Not insurance, lack ACA protections, but may be an option for some.
Common Mistakes to Avoid During Enrollment
Waiting until the last minute to enroll
Not comparing multiple plans or checking network/drug coverage
Overlooking financial assistance eligibility
Not updating income or household information if it changes during the year
Choosing the wrong metal tier for your needs
Not making the first premium payment to activate coverage
State-Specific Health Programs or Initiatives
Nebraska’s Medicaid and CHIP program, expanded to cover more adults and children.
Free enrollment help is available statewide from local organizations.
Premium tax credit enhancements continue through 2025 under federal law, making coverage more affordable for many.
Medicaid expansion increased eligibility for low-income adults.
Nebraska’s Marketplace offers a variety of plans, robust consumer protections, and strong assistance resources for residents seeking affordable health coverage.
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Get CoverageFrequently Asked Questions
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