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Frequently Asked Questions

If you have questions that aren’t answered here, call the number on the back of your ID card.

Benefits are provided for breastfeeding support, supplies and counseling at little or no cost to you when you use an in-network doctor/hospital/pharmacy. Out-of-network doctors/hospitals/pharmacies will be reimbursed only up to the maximum allowable amount. Benefits include one pump per pregnancy. To verify that breast pumps are covered under your specific plan, call the number on the back of your member ID card.

Find out how to get a breast pump.

Coordination of benefits is the process used when a member has two health insurance plans. This process allows the two plans to work together getting you the most out of your coverage. One plan becomes your primary plan, paying your claims first. The second plan becomes your secondary plan, which may pay toward the remaining cost, depending on the plan. Understanding which plan is your primary and which plan is your secondary is important to help prevent delays in claims processing.

Members may complete this form online on myNebraskaBlue.com or by downloading the Coordination of Benefits Form.

The cost estimator tool allows you to estimate how much you will spend for medical procedures and services. It helps you determine the best value for your money. To get started, go to the Find a Doctor tool and in the drop-down box on the far left-hand side, choose "Cost." Then enter the procedure or service.

Members can login to myNebraskaBlue to access cost estimates and cost comparisons for a variety of treatments and services. By logging in, your benefits will be applied to the estimate so you can see costs based on your benefit plan (copay, deductible, coinsurance, etc.).

Group coverage is provided to employees by an employer or to members by an association. Individual coverage is health insurance you purchase on your own.

Each time a claim is processed, we send an Explanation of Benefits (EOB) form. This EOB shows how we processed available benefits according to the terms of your coverage. If the claims filed were for a spouse or other adult member, the EOB is sent to that person. The EOBs for minor dependents (under 18) are generally sent to the subscriber/policy holder. 

Members may view EOB's online using their myNebraskaBlue.com account.

Members may find a pharmacy by logging into their myNebraskaBlue account or by visiting Find a Pharmacy.

A High Deductible Health Plan (HDHP) works in combination with a Health Savings Account (HSA) to offer sound, affordable coverage that features low out-of-pocket costs. These plans are designed to help you maximize your dollars and minimize your health care expenses.

A health savings account (HSA) is a tax-advantaged savings account that can be funded by individuals whose only health care coverage is a qualified high deductible health plan (QHDHP). An HSA is an alternative way for you to pay for your qualified health care expenses and save for future qualified health care expenses on a tax-free basis. Expenses such as out-of-pocket costs for office visits, prescription drugs, dental expenses and laboratory tests may be paid for from your HSA. 

In-network benefits are benefits provided by a licensed practitioner of the healing arts, a licensed facility or other qualified provider of health care services who has contracted with us to provide services as a part of a preferred network in Nebraska. These benefits mean less out-of-pocket for members.

Out-of-network benefits are benefits provided by a provider who has not contracted with us to provide services as a part of the preferred provider organization in Nebraska. These benefits mean more out-of-pocket for members when services are incurred.

This means a doctor's visit at an in-network provider would cost a member less than the same appointment with an out-of-network doctor.

The out-of-pocket maximum is the amount each covered person must pay in a calendar year before your insurance covers at 100%. The out-of-pocket limit includes deductible, coinsurance and copayment amounts for medical and pharmacy services. The out-of-pocket limit does not include premium amounts over the allowable charge, charges for non-covered services, or penalties for failure to comply with certification requirements or as imposed under the Rx Nebraska Prescription Drug Program.

For example, if your out-of-pocket maximum is $10,000 you must meet this amount before your insurance covers services at 100%. Please note there are in-network and out-of-network out-of-pocket maximums. This means you may not pay for in-network services, but for out-of-network services still receive a bill.

A Preferred Provider Organization (PPO) is a panel of Hospital, Physicians and other health care Providers who belong to a network of Preferred Providers, which agrees to more effectively manage healthcare costs.

You can do this during open enrollment or if you experience a qualifying event. The time outside of the open enrollment period when you can enroll or make changes to your health insurance if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

Telehealth is a fast, easy way to video chat with a doctor using your computer, tablet or phone. It is private and secure and often costs less than an emergency room, urgent care or even in-office doctor visit.

Learn more about Telehealth and Register for an account.

BlueCard is a national program that enables Blue Cross and Blue Shield of Nebraska members to obtain in-network services while traveling or living in another state. The program links participating health care providers with Blue Plans across the country and internationally through a single electronic network for claims processing and reimbursement.

Outside of the United States, you have access to doctors and hospitals in nearly 200 countries and territories around the world through the BlueCard Worldwide Program.

To locate providers network, visit our Find a Doctor tool or call 800-810-2583.

Deductibles are the amount you pay for health care services before your plan starts to pay. There are two deductibles: individual and family.

For example. if your individual deductible is $1,000 you must pay $1,000 before your insurance starts to pay. If you have a family plan, the deductible would be two times the individual deductible. For example, if the individual deductible is $1,000, the family deductible would be $2,000.

Coinsurance is the share of the costs you pay, calculated as a percentage (for example, you pay 20%, insurance pays 80%).

Copayments (copay) is a fixed amount you pay, usually at the time of healthcare service. Copayments are separate from and do not accumulate to the deductible. This amount can vary by the type of service. You may also have a copay when you get a prescription filled.