Medicaid expansion enrollment begins Aug. 1

Rural Health

Nearly two years after voters approved a measure to expand Medicaid, Nebraskans will finally start to see the benefits take shape.

Enrollment will begin on Aug. 1. Eligible applicants must have an annual income at or below 138 percent of the federal poverty level, which is roughly $17,000 for an individual or $35,000 for a family of four. Additional circumstances, such as a health condition, dependents, or valuable assets, could alter eligibility.

Coverage for new enrollees will begin Oct. 1. Medicaid will provide insurance coverage for most healthcare services, however, dental, vision, and over-the-counter medication will only be covered for enrollees who are ages 18 to 19, pregnant, or medically frail. Access to those additional benefits for other enrollees will begin when the state’s Section 1115 waiver is approved by the Centers for Medicare and Medicaid Services (CMS).

That delay in full coverage is the result of the state seeking approval to set up a tiered-system of benefits for enrollees. Under the system, Medicaid recipients can receive dental, vision, and over-the-counter benefits by completing various wellness activities, such as an annual check up and listing a primary care physician. The Nebraska Department of Health and Human Services (DHHS) is proposing that eligible activities be monitored and verified by state employees.

It was anticipated that the tiered system would be in place starting in October when coverage began. However, the COVID-19 pandemic caused the approval of the waiver to be delayed while CMS dealt with new issues caused by the virus. The waiver is now expected to be returned in April 2021.

Applications can be submitted online at accessnebraska.ne.gov or at a local DHHS office. Various household, income, and background information will be needed. Local DHHS offices are located throughout the state. For assistance, you can contact the Nebraska Medicaid customer service line at 855.632.7633.