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2026 HMO and PPO Plan Options

With Medicare Advantage plans from Blue Cross and Blue Shield of Nebraska you'll have predictable, easy-to-budget costs for doctor office visits, prescription drugs and more. Each plan offers a different level of benefits and out-of-pocket cost, so you can choose the one that is best suited to your needs.

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Hospital and Medical Benefits

Click for more details Medicare Advantage Core HMO Medicare Advantage Connect PPO Medicare Advantage Access PPO Medicare Advantage Secure PPO
  When in- and out-of-network costs are applicable, costs are listed as follows:
(In-Network/Out-of-Network)
Monthly Premium
n/a
$0 $0 $30 $91
Medical Deductible
n/a
$0 $0 $0 $0
Travel Coverage  
Travel coverage means if you travel outside of the state you will be covered similar to in-state in-network benefits.
Yes Yes Yes Yes
Maximum Out-of-pocket Limit (In-network/Combined in- and out-of-network)  
Maximum out of pocket means the total amount you are responsible to pay for Medicare-covered services.
$4,100 $4,900 In-Network
$8,000 Out-of-Network 		$3,900 In-Network
$6,200 Out-of-Network 		$2,500 In-Network
$4,500 Out-of-Network
Primary Care Doctor Visits*  
This is your personally selected Physician to help guide your care.
$0 $0 In-Network
$15 Out-of-Network 		$0 In-Network
$15 Out-of-Network 		$0 In-Network
$15 Out-of-Network
Acute Inpatient Hospital $400 per day for days 1-4
$0 per day for days 5+		 $400 per day for days 1-4
$0 per day for days 5+ 		$390 per day for days 1-4
$0 per day for days 5+ 		$250 per day for days 1-4
$0 per day for days 5+
Outpatient Hospital Services $350 per day $350 per day $350 per day $175 per day
Urgent Care $55 $50 $55 $50
Emergency Care $135 $125 $125 $115
Inpatient Skilled Nursing Facility  
These facilites have the staff and equipment to give skilled nursing care or rehab services, they could be part of a hospital or nursing home.
Days 1-20: $0
Days 21-60: $214
Days 61-100: $0		 In-Network
Days 1-20: $0
Days 21-70: $214
Days 71-100: $0
Out-of-Network
Days 1-20: $0
Days 21-90: $214
Days 91-100: $0 		In-Network
Days 1-20: $0
Days 21-60: $214
Days 61-100: $0
Out-of-Network
Days 1-20: $0
Days 21-80: $214
Days 81-100: $0 		In-Network
Days 1-20: $0
Days 21-60: $204
Days 61-100: $0
Out-of-Network
Days 1-20: $0
Days 21-80: $204
Days 81-100: $0
Routine Eye Exam (one per year)  
Exam to diagnose diseases and conditions of the eye.
$0 $0 In-Network
$70 reimbursement Out-of-Network		 $0 In-Network
70% reimbursement Out-of-Network ($70 max)		 $0 In-Network
$70 reimbursement Out-of-Network
Routine Hearing Exam (one per year) from TruHearing provider  
Exam to diagnose hearing and balance problems.
$0 $0 $0 $0
Over-the-Counter Allowance $50 per quarter $50 per quarter $70 per quarter $115 per quarter
Dental Maximum Reimbursement* $1,200 $1,200 $1,500 $1,700
Fitness Allowance $300 annual allowance $300 annual allowance $300 annual allowance $300 annual allowance
Meal Benefit  
Specialized meal program designed for seniors.
2 meals/day for 14 days post hospital discharge 2 meals/day for 14 days post hospital discharge 2 meals/day for 14 days post hospital discharge 2 meals/day for 14 days post hospital discharge
Service Area

*Blue Cross and Blue Shield of Nebraska Medicare Advantage Core HMO plans have been divided into Metro/Central regional areas.

Metro region  includes Cass, Dodge, Douglas, Lancaster, Otoe, Sarpy, Saunders and Washington counties.

Central region  includes Adams, Antelope, Arthur, Blaine, Boone, Buffalo, Burt, Butler, Cedar, Chase, Clay, Colfax, Cuming, Custer, Dawson, Deuel, Dundy, Fillmore, Franklin, Frontier, Furnas, Gage, Garden, Garfield, Gosper, Grant, Greeley, Hall, Hamilton, Harlan, Hayes, Hitchcock, Holt, Hooker, Howard, Jefferson, Johnson, Kearney, Keith, Knox, Lincoln, Logan, Loup, Madison, McPherson, Merrick, Nance, Nemaha, Nuckolls, Pawnee, Perkins, Phelps, Pierce, Platte, Polk, Red Willow, Saline, Seward, Sherman, Stanton, Thayer, Thomas, Thurston, Valley, Wayne, Webster, Wheeler and York counties.

The Medicare Advantage Access, Connect and Secure PPO plans are available in all 76 counties listed above.

 

Prescription Drug Benefits

Medicare Advantage Core (HMO), Connect (PPO), Access (PPO), Secure (PPO)
Drug Tiers Rx Deductible Copayment/Coinsurance
30-day supply: In-network pharmacy 100-day supply: Mail order (Preferred Pharmacy/Standard Pharmacy)
Tier 1 (Preferred Generic) $0 $0 $0/$6
Tier 2 (Generic) $14 $0/$42
Tier 3 (Preferred Brand) $47 $131/$141
Tier 4 (Non-preferred Drug) $400 $100 $290/$300
Tier 5 (Specialty tier) 28% N/A

 

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Individual Plan Information

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Understanding all the coverage options available may feel confusing. Get important details from Blue Cross and Blue Shield of Nebraska about Medicare options and important dates to remember.

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