Getting Started
Finding a health insurance plan doesn’t have to be complicated. Let us show you how. Follow these simple steps to find the best plan for you and your family.
Review Networks
Nebraska HeartlandBlue plans are considered Exclusive Provider Organization (EPO) plans. This means that services are covered only if you use doctors, hospitals and other health care providers in your network (except in an emergency). The chart below outlines which networks are available in each county, depending on the plan option chosen. Only emergency services and urgent care services are covered outside the state of Nebraska.
NETWORK BLUE HB
Made up of 98% of Nebraska’s non-governmental acute care hospitals1, this network includes Nebraska Methodist Health System, Nebraska Medicine, CHI Health, and more.
See if your doctors are in network with NEtwork BLUE HB:
NebraskaBlue.com/NEtworkBLUEHB.
PREMIER SELECT BLUECHOICE HB
This network features Nebraska Methodist Hospital System, Nebraska Medicine, Children’s Nebraska and Bryan Health.
See if your doctors are in network with Premier Select BlueChoice HB:
NebraskaBlue.com/
PremierSelectBlueChoiceHB.
BLUEPRINT HEALTH HB
This network features CHI Health, Creighton University System, Nebraska Spine Hospital LLC, Boys Town National Research Hospital, Children’s Nebraska and more.
See if your doctors are in network with Blueprint Health HB:
NebraskaBlue.com/BlueprintHealthHB.
| NETWORK BLUE HB | PREMIER SELECT BLUECHOICE HB | BLUEPRINT HEALTH HB | ||||
| County | Standard Plans | Non-Standard Plans2 | Standard Plans | Non-Standard Plans2 | Standard Plans | Non-Standard Plans2 |
| Adams | ||||||
| Antelope | ||||||
| Arthur | ||||||
| Banner | ||||||
| Blaine | ||||||
| Boone | ||||||
| Box Butte | ||||||
| Boyd | ||||||
| Brown | ||||||
| Buffalo | ||||||
| Burt | ||||||
| Butler | ||||||
| Cass | ||||||
| Cedar | ||||||
| Chase | ||||||
| Cherry | ||||||
| Cheyenne | ||||||
| Clay | ||||||
| Colfax | ||||||
| Cuming | ||||||
| Custer | ||||||
| Dakota | ||||||
| Dawes | ||||||
| Dawson | ||||||
| Deuel | ||||||
| Dixon | ||||||
| Dodge | ||||||
| Douglas | ||||||
| Dundy | ||||||
| Fillmore | ||||||
| Franklin | ||||||
| Frontier | ||||||
| Furnas | ||||||
| Gage | ||||||
| Garden | ||||||
| Garfield | ||||||
| Gosper | ||||||
| Grant | ||||||
| Greeley | ||||||
| Hall | ||||||
| Hamilton | ||||||
| Harlan | ||||||
| Hayes | ||||||
| Hitchcock | ||||||
| Holt | ||||||
| Hooker | ||||||
| Howard | ||||||
| Jefferson | ||||||
| Johnson | ||||||
| Kearney | ||||||
| Keith | ||||||
| Keya Paha | ||||||
| Kimball | ||||||
| Knox | ||||||
| Lancaster | ||||||
| Lincoln | ||||||
| Logan | ||||||
| Loup | ||||||
| Madison | ||||||
| McPherson | ||||||
| Merrick | ||||||
| Morrill | ||||||
| Nance | ||||||
| Nemaha | ||||||
| Nuckolls | ||||||
| Otoe | ||||||
| Pawnee | ||||||
| Perkins | ||||||
| Phelps | ||||||
| Pierce | ||||||
| Platte | ||||||
| Polk | ||||||
| Red Willow | ||||||
| Richardson | ||||||
| Rock | ||||||
| Saline | ||||||
| Sarpy | ||||||
| Saunders | ||||||
| Scotts Bluff | ||||||
| Seward | ||||||
| Sheridan | ||||||
| Sherman | ||||||
| Sioux | ||||||
| Stanton | ||||||
| Thayer | ||||||
| Thomas | ||||||
| Thurston | ||||||
| Valley | ||||||
| Washington | ||||||
| Wayne | ||||||
| Webster | ||||||
| Wheeler | ||||||
| York | ||||||
Traveling outside of Nebraska?
Services received from health care providers outside the state of Nebraska are not covered except for emergency and urgent care services. If you’re traveling outside of Nebraska, you still have access to your plan’s telehealth benefits.
BCBSNE offers telehealth services through Amwell, so you can access a nationwide network of U.S. board-certified physicians, available for live visits over the computer, tablet or phone, whenever you need them. Telehealth visits cost less than an emergency room, urgent care or even in-office doctor visits. Visit NebraskaBlue.com/Telehealthfor more information.
Compare Plan Options
All our plans meet the requirements mandated by the Affordable Care Act (ACA), which means they meet cost-sharing limits and cover all Essential Health Benefits, including pediatric dental and vision.All Nebraska HeartlandBlue plans are available on and off the Individual Market Exchange and are available in every county in Nebraska. All plans are also offered as child-only policies.
ACA plans are grouped into different categories, often called “metallic levels.” These categories indicate how costs (coinsurance) are split between you and your insurance plan. BCBSNE offers plans in the Bronze, Silver and Gold categories.
Bronze
Offers the lowest premium costs - but has higher out-of-pocket costs.
Silver
Higher premium costs than Bronze plans - but lower out-of-pocket costs.
Gold
Offers the lowest out-of-pocket costs - but has the highest premium costs.
Standard Plans
Standard plans offer a uniform cost-sharing structure across all metallic levels. This allows you to easily compare plans across carriers and shop for coverage. CMS guidelines require all participating carriers to offer standard plans among their plan offerings.
See full plan details in the product brochure.
Download 2024 Brochure
Download 2025 Brochure
Prescription Drug Coverage
We offer prescription drug coverage through our Rx Nebraska Prescription Drug Program with our pharmacy benefit manager, Prime Therapeutics, Inc.
Cost Savings
You pay less when you choose generic medications from our drug list. You should talk to your doctor about what is right for you.
Convenience
With many in-network pharmacies to choose from, you can fill prescriptionsclose to home or work.
Time Savings
You may have up to a 90-day supply of maintenance medications delivered directly to you.
Online Resources
You may search the drug list, find a pharmacy, view your claims and estimate the cost of medications24/7 by logging in to myNebraskaBlue.com.
Pharmacy Networks
You will pay less out of pocket on prescriptions filled with in-network pharmacies. You may also use our home delivery services. Nebraska HeartlandBlue plans use Network J.
Pharmacy Network J
In-Network ($)
- Walgreens
- Walmart/Sam's Club
- Hy-Vee
- Baker's
- U-Save
- Super Saver
- Costco
Out-of-Network* ($$)
- Target/CVS
*Not covered
This a partial list and is subject to change at any time without notice. For a complete list visit NebraskaBlue.com/Pharmacy.
Prescription Drug List
Each Nebraska HeartlandBlue plan includes a list of covered medications, also called a prescription drug list (PDL). The PDL for our Standard plans is PDL69. All other plans offer PDL68.
View PDL68 View PDL69
Prescription Drug Tiers (Formulary)
Prescription drugs are divided into tiers. The cost for each 30-day supply of a covered prescription drug depends on the tier in which the medication is listed. Nebraska HeartlandBlue Standard plans offer four prescription drug tiers.
TIER 1
GENERIC
Commonly prescribed generic drugs.
TIER 2
PREFERRED BRAND
Brand-name drugs that do not have a generic equivalent.
TIER 3
NON-PREFERRED BRAND
Higher-priced brand-name drugs that often have a generic equivalent.
TIER 4
SPECIALTY
Drugs used to treat complex conditions such as cancer. These drugs can be generic or brand name.
All other plans offer 6 prescription drug tiers.
TIER 1
PREFERRED GENERIC
Commonly prescribed generic drugs.
TIER 2
NON-PREFERRED GENERIC
Higher-priced generic drugs that cost a little more than Tier 1.
TIER 3
PREFERRED BRAND
Brand-name drugsthat do not have ageneric equivalent.
TIER 4
NON-PREFERRED BRAND
Higher-priced brand-name drugs that often have a generic equivalent.
TIER 5
PREFERRED SPECIALTY
Lower-cost specialtydrugs. Used to treatcomplex conditions such as cancer.
TIER 6
NON-PREFERRED SPECIALTY
The most expensivedrugs on the drug listwhich can be genericor brand name.
Retail Pharmacies
You should take your prescriptions to a participating pharmacy and show the pharmacist your BCBSNE member ID card. You will pay the applicable copay/deductible/coinsurance amount.
Please note: Whenever appropriate, generic drugs will be used to fill prescriptions.
Home Delivery Service
MedsYourWayTM – Retail
MedsYourWay - Retail simplifies the brick-and-mortar shopping experience by automatically comparing plan-covered benefit prices to discount card prices at the pharmacy, without needing to present a separate discount card. Take your prescriptions to an in-network pharmacy and show the pharmacist your BCBSNE member ID card. You will pay the applicable copay, deductible or coinsurance amount or the discount card price, whichever is lower.
Amazon Pharmacy for Home Delivery with MedsYourWayTM Drug Discount Card Pricing
Pharmacy home-delivery services are offered exclusively through Amazon Pharmacy which delivers a breakthrough, integrated home-delivery shopping experience for you.
You will be shown the lowest cost options, whether that is your copay/coinsurance or the MedsYourWay discount card price. You may use home delivery services for your 90-day supply of maintenance medications. You will be responsible for paying the applicable cost-share amount for each 30-day supply.
Amazon Pharmacy does not dispense controlled substances. Amazon Pharmacy is an independent company that provides pharmacy home delivery services for Blue Cross and Blue Shield of Nebraska.
Prime Therapeutics LLC is an independent company providing pharmacy benefit management services for Blue Cross and Blue Shield of Nebraska.
MedsYourWay is a trademark of Prime Therapeutics. Savings may differ depending on current benefit design. Prime Therapeutics is contracted to provide pharmacy benefits to Blue Cross and Blue Shield of Nebraska.
Paying for Your Coverage
Don’t let premium costs keep you from giving your family the health coverage they deserve. Many individuals can qualify for an advanced premium tax credit to lower monthly premiums and even extra savings with cost-sharing reduction.
Advance Premium Tax Credits
The Advanced Premium Tax Credit (APTC) is a credit that can be used to lower your monthly premium on plans purchased through the Marketplace. This tax credit is based on your estimated household income and will be calculated when you fill out your application for coverage.
Cost-Sharing Reduction
In addition to APTC, you can also see if you qualify for a cost-sharing reduction (CSR), also called “extra savings.” These extra savings allow you to save additional money on your out-of-pocket costs when receiving medical services.
Only plans in the Silver category are eligible for a CSR; the savings amount depends on your household income. These savings include:
Lower deductibles
Lower coinsurance and/or copays
Lower out-of-pocket maximums
Additional benefits and protections are available for American Indians and Alaska natives.
To learn more, visit Healthcare.gov.
Member Tools and Resources
We provide our members with access to resources to better manage their health care expenses.
Online Tools
Access your online member account to find in-network doctors, view claims and track your health care spending.
Log in to myNebraskaBlue
Cost Estimators
Estimate costs for a variety of services including hospital stays, surgeries, office visits and more.
Estimate costs
Discount Programs
With Blue365, you have access to exclusive discounts and savings so it’s easier and more affordable to make healthy choices.
Care Management
You have access to a team of health care professionals who can help maximize your benefits and get the right care, at the right time, in the right place.
Care Management Programs
Wellness Program
Get rewarded for making healthy choices. The Blue Cross and Blue Shield of Nebraska wellness program provides tools and motivation to help you make healthy choices and forge your path to well-being.
ACAWellness
Interoperability - Member Claims Access
Interoperability is a federal rule from the Centers for Medicare & Medicaid Services (CMS), designed to give greater access and transparency across healthcare systems. Blue Cross and Blue Shield of Nebraska (BCBSNE) HeartlandBlue members who would like electronic access to their medical records, such as claims information, can download one of two applications, One Record or Care Evolution.
Want more information?Download our FAQs.
Download One Record
Download Care Evolution
Are you a developer and want to learn more?
- If you’re a developer and want to learn more about HL7®Fast Healthcare Interoperability Resources (FHIR®) Release 4.0.1. OR The software components and configurations an application must use in order to successfully interact with the API, visitSupported FHIR Resources.
- If you want to learn more about OpenID Connect Core 1.0, incorporating errata set 1. OR All applicable technical requirements and attributes necessary for an application to be registered with any authorization server(s) deployed in conjunction with the API, visitDeveloper Overview.
- If you want to learn more about API syntax, function names, required and optional parameters supported and their data types, return variables and their types/structures, exceptions and exception handling methods and their returns, visithttps://api.bcbsnefhir.com/r4/metadata.
- For sample cURL requests and other example queries, visitAPI References.
Ready to Learn More?
Speak to one of our licensed sales agents. We look forward to serving you and your family as Blue Cross and Blue Shield of Nebraska members.
Work With an Agent
Or call844-665-1121
Frequently Asked Questions
What plans are available?
We offer a selection of plans both on- and off-exchange in the gold, silver, bronze and standard categories.
When can I purchase a plan?
Plans may be purchased during the Open Enrollment Period (OEP) that runs from Nov. 1 through Dec. 15. Or during a Special Enrollment Period (SEP) based on qualifying life events, for any plans that are effective Jan. 1, 2023, or later.
Are plans available in all counties?
Yes, all Nebraskans will have access to purchase an individual ACA plan from BCBSNE. The network options will vary depending on the county you live in based on the providers available in that area.
Will I be able to switch to an ACA plan from my Armor Health policy?
If you are currently on an Armor Health policy, you may apply for an ACA plan during the Open Enrollment Period (OEP). Or, if you are declined for coverage upon the annual review/re-enrollment, you can apply for an off-exchange ACA plan. Contact your agent or one of our consumer sales reps for more information.
What if I can't afford a health plan?
When applying for a plan, you can enter your financial information to see if you qualify for an Advanced Premium Tax Credit or a Cost Sharing Reduction plan. Learn moreabout cost-saving options.
How does the 2021 Consolidated Appropriations Act promote transparency between brokers and their customers?
Health insurance issuers offering individual health insurance coverage or short-term limited duration plans in the individual market must let individuals know about direct and indirect compensation provided to the agent or broker. The broker’s compensation is paid by the insurance carrier. Monthly premium is the same whether or not individuals use a broker. View 2024 information here.
What Cost Sharing Reduction (CSR) plans are available for those who qualify?
For a complete listing of all Nebraska HeartlandBlue plans, please refer to the Nebraska HeartlandBlue Options at a Glance. Please note that CSR plans are only available for those who qualify. Please call one of our licensed sales agents at 844-665-1121 for more information.
