The SHIP – State Health Insurance Assistance Program provides information and counseling to older Nebraskans and persons with disabilities regarding Medicare, Medicaid and health insurance.
The Mission – Because Medicare, Medicaid, and other types of health insurance can be confusing to most people, the federal government, through the Centers for Medicare & Medicaid Services, funds a state health insurance assistance program in every state. The Nebraska State Health Insurance Assistance Program is located within the Nebraska Department of Insurance. SHIP has a statewide network of volunteer counselors trained to help people with Medicare across Nebraska. Anyone interested in becoming a trained volunteer should contact the Aging Office.
Part A
Medicare Part A insurance covers inpatient hospitalization, some followup skilled nursing or home health care, and in-home hospice care.
- Offered by federal government – administered by CMS (Centers for Medicare and Medicaid services).
- No monthly premiums for most.
- Deductibles and copays when using most services, no out-of-pocket maximum..
- Accepted by a national network of Medicare providers.
You can enroll in Medicare Part A at your local Social Security office, or online at Social Security.
Enrollment Caution: If you are receiving Social Security benefits at or after turning 65, you must take Medicare Part A (even if you have other insurance through an employer) or you will not be able to continue receiving your Social Security benefits.
If you or your employer are contributing to an HSA (Health Savings Account), neither of you will be able to continue contributing to the HSA once you start Medicare Part A and/or Part B. However, your HSA funds can still be used to pay for qualified medical expenses.
If you start Medicare after turning 65, your Medicare Part A start date will be back dated up to six months (no further than your 65th birthday month). That means, you should stop contributing to your HSA at your expected backdated Part A start date.
Part B
Medicare Part B insurance covers medical costs including outpatient hospitalization, emergency room visits, physicians, laboratory testing, diagnostic testing, therapy and durable medical equipment.
- Offered by federal government – administered by CMS (Centers for Medicare and Medicaid services)
- Monthly premiums for all, with higher premiums for those with higher income.
- Annual deductible, copays when using most services, no out-of-pocket maximum.
- Accepted by a national network of Medicare providers.
You can enroll in Medicare Part B at your local Social Security office, or online at Social Security if you are enrolling in both Medicare Part A and Part B.
Enrollment Caution: Enrolling in Medicare Part B for the first time after turning 65 triggers your only ‘guarantee issue’ enrollment period for a Medigap Supplement policy. Most delay enrolling in Medicare Part B if they have active employer insurance through work or their spouse’s work. WCNAAA can help you determine your Medicare enrollment timing.
If you delay enrolling in Medicare Part B when you are 65 and older and are not covered by active work insurance, you may have a delayed enrollment window and a permanent monthly penalty when you do enroll.
Medigap Supplement
Medigap Supplement insurance pays for some or all of the Medicare deductibles and copays for Medicare approved services, depending on which Medigap Supplement plan you choose.
- Offered by private insurance companies within your state
- All have monthly premiums that vary based on Medigap plan type and insurance company.
- Accepted wherever Medicare is accepted.
Our SHIP counselor can meet with you and provide detailed information on Medigap policies that are available.
Enrollment Caution: You have only one ‘guarantee issue’ enrollment period for a Medigap Supplement that begins when you first start Medicare Part B after turning 65 and ends six months later.
Medigap Supplement policies are generally not available to those under 65 in Nebraska. Your options would be to enroll in Original Medicare (Part A, Part B, Part D) without the Medigap Supplement, or enroll in a Medicare Advantage plan (Part C).
Part D
Medicare Part D Prescription Drug Insurance covers many brand name and generic prescriptions.
- Offered by private insurance companies within your state
- All have monthly premiums, with higher premiums for those with higher income
- May have annual deductibles with copays for most prescriptions that may vary by pharmacy.
- May not be accepted by all pharmacies.
You may schedule an appointment with our SHIP counselor to review the prescription drug plans costs and coverage available in Nebraska.
Enrollment Caution: Even if you take few or no drugs, it is important to have a Part D prescription drug plan when you turn 65, or have “creditable coverage” through other insurance such as employer or VA, to avoid a permanent late enrollment penalty in the future.
Medicare Advantage Part C
The Medicare Part C Advantage plan is all-in-one insurance covering hospital, medical and prescription drugs.
- Offered by private insurance companies in county of residence
- Have low or no monthly premiums
- Have copay for most health services with an annual out-of-pocket maximum for health coverage.
- May have annual deductibles with copays for most prescriptions that may vary by pharmacy.
- Accepted only by health providers in the local network (HMO) or possibly out-of-network with higher copays and out-of-pocket maximums (PPO). Accepted everywhere Medicare is accepted in an emergency.
Enrollment Caution: You must be enrolled in Medicare Part A and Part B to enroll in Medicare Part C.
Be sure to check with all of your providers to see if they will accept the Medicare Advantage plan before you enroll. Once you enroll, most likely you will have to wait until the next open enrollment period to change plans (up to a year).
You may schedule an appointment to meet with our SHIP counselor to show you the Medicare Advantage plans available in your county.
-
Part A
Medicare Part A insurance covers inpatient hospitalization, some followup skilled nursing or home health care, and in-home hospice care.
- Offered by federal government – administered by CMS (Centers for Medicare and Medicaid services).
- No monthly premiums for most.
- Deductibles and copays when using most services, no out-of-pocket maximum..
- Accepted by a national network of Medicare providers.
You can enroll in Medicare Part A at your local Social Security office, or online at Social Security.
Enrollment Caution: If you are receiving Social Security benefits at or after turning 65, you must take Medicare Part A (even if you have other insurance through an employer) or you will not be able to continue receiving your Social Security benefits.
If you or your employer are contributing to an HSA (Health Savings Account), neither of you will be able to continue contributing to the HSA once you start Medicare Part A and/or Part B. However, your HSA funds can still be used to pay for qualified medical expenses.
If you start Medicare after turning 65, your Medicare Part A start date will be back dated up to six months (no further than your 65th birthday month). That means, you should stop contributing to your HSA at your expected backdated Part A start date.
-
Part B
Medicare Part B insurance covers medical costs including outpatient hospitalization, emergency room visits, physicians, laboratory testing, diagnostic testing, therapy and durable medical equipment.
- Offered by federal government – administered by CMS (Centers for Medicare and Medicaid services)
- Monthly premiums for all, with higher premiums for those with higher income.
- Annual deductible, copays when using most services, no out-of-pocket maximum.
- Accepted by a national network of Medicare providers.
You can enroll in Medicare Part B at your local Social Security office, or online at Social Security if you are enrolling in both Medicare Part A and Part B.
Enrollment Caution: Enrolling in Medicare Part B for the first time after turning 65 triggers your only ‘guarantee issue’ enrollment period for a Medigap Supplement policy. Most delay enrolling in Medicare Part B if they have active employer insurance through work or their spouse’s work. WCNAAA can help you determine your Medicare enrollment timing.
If you delay enrolling in Medicare Part B when you are 65 and older and are not covered by active work insurance, you may have a delayed enrollment window and a permanent monthly penalty when you do enroll.
-
Medigap Supplement
Medigap Supplement insurance pays for some or all of the Medicare deductibles and copays for Medicare approved services, depending on which Medigap Supplement plan you choose.
- Offered by private insurance companies within your state
- All have monthly premiums that vary based on Medigap plan type and insurance company.
- Accepted wherever Medicare is accepted.
Our SHIP counselor can meet with you and provide detailed information on Medigap policies that are available.
Enrollment Caution: You have only one ‘guarantee issue’ enrollment period for a Medigap Supplement that begins when you first start Medicare Part B after turning 65 and ends six months later.
Medigap Supplement policies are generally not available to those under 65 in Nebraska. Your options would be to enroll in Original Medicare (Part A, Part B, Part D) without the Medigap Supplement, or enroll in a Medicare Advantage plan (Part C).
-
Part D
Medicare Part D Prescription Drug Insurance covers many brand name and generic prescriptions.
- Offered by private insurance companies within your state
- All have monthly premiums, with higher premiums for those with higher income
- May have annual deductibles with copays for most prescriptions that may vary by pharmacy.
- May not be accepted by all pharmacies.
You may schedule an appointment with our SHIP counselor to review the prescription drug plans costs and coverage available in Nebraska.
Enrollment Caution: Even if you take few or no drugs, it is important to have a Part D prescription drug plan when you turn 65, or have “creditable coverage” through other insurance such as employer or VA, to avoid a permanent late enrollment penalty in the future.
-
Medicare Advantage Part C
The Medicare Part C Advantage plan is all-in-one insurance covering hospital, medical and prescription drugs.
- Offered by private insurance companies in county of residence
- Have low or no monthly premiums
- Have copay for most health services with an annual out-of-pocket maximum for health coverage.
- May have annual deductibles with copays for most prescriptions that may vary by pharmacy.
- Accepted only by health providers in the local network (HMO) or possibly out-of-network with higher copays and out-of-pocket maximums (PPO). Accepted everywhere Medicare is accepted in an emergency.
Enrollment Caution: You must be enrolled in Medicare Part A and Part B to enroll in Medicare Part C.
Be sure to check with all of your providers to see if they will accept the Medicare Advantage plan before you enroll. Once you enroll, most likely you will have to wait until the next open enrollment period to change plans (up to a year).
You may schedule an appointment to meet with our SHIP counselor to show you the Medicare Advantage plans available in your county.
Part A
Medicare Part A insurance covers inpatient hospitalization, some followup skilled nursing or home health care, and in-home hospice care.
- Offered by federal government – administered by CMS (Centers for Medicare and Medicaid services).
- No monthly premiums for most.
- Deductibles and copays when using most services, no out-of-pocket maximum..
- Accepted by a national network of Medicare providers.
You can enroll in Medicare Part A at your local Social Security office, or online at Social Security.
Enrollment Caution: If you are receiving Social Security benefits at or after turning 65, you must take Medicare Part A (even if you have other insurance through an employer) or you will not be able to continue receiving your Social Security benefits.
If you or your employer are contributing to an HSA (Health Savings Account), neither of you will be able to continue contributing to the HSA once you start Medicare Part A and/or Part B. However, your HSA funds can still be used to pay for qualified medical expenses.
If you start Medicare after turning 65, your Medicare Part A start date will be back dated up to six months (no further than your 65th birthday month). That means, you should stop contributing to your HSA at your expected backdated Part A start date.