2023 Plan Documents

Options at a glance

Schedule of Benefits Summaries

• $1,250 Deductible
• $1,500 Deductible
• $2,000 Deductible
• $2,000 HSA Deductible
• $3,250 Deductible
• $3,250 HSA Deductible
• $5,250 HSA Deductible
• Dental

Summaries of Benefits & Coverage

• $1,250 Deductible
• $1,500 Deductible
• $2,000 Deductible
• $2,000 HSA Deductible
• $3,250 Deductible
• $3,250 HSA Deductible
• $5,250 HSA Deductible

Certificates of Coverage

• $1,250 Deductible
• $1,500 Deductible
• $2,000 Deductible
• $2,000 HSA Deductible
• $3,250 Deductible
• $3,250 HSA Deductible
• $5,250 HSA Deductible

At Blue Cross and Blue Shield of Nebraska, we think everyone should be able to understand their health insurance so they can make better decisions about their health. So we created myNebraskaBlue—an online member resource center that makes sense of members’ medical bills and health care spending—all in one place at myNebraskaBlue.com.

Visit myNebraskaBlue.com today, and see how it can help members manage their health care dollars.

With myNebraskaBlue, your employees can:

• understand their benefits, see their deductible and out-of-pocket costs
• find in-network doctors and hospitals
• estimate costs before seeing a doctor
• see claims sent from their doctor and what they owe
• access pharmacy information
• select how they would like to receive their Explanation of Benefits–paper or electronic

Sign up for free:

• Go to myNebraskablue.com. Select "Activate Now" and complete the easy steps.
  • Members will need their member ID number found on the front of their BCBSNE ID card.
• Or view the tool as a guest by selecting "Guest" on the myNebraskaBlue.com home page.

Blue Cross and Blue Shield of Nebraska contracts with Prime Therapeutics® to provide your group's pharmacy benefits. Employees may view information about their pharmacy benefits by going to myPrime. This website is loaded with interactive tools to help your employees manage their prescription drugs.

With MyPrime, your employees can find:

• their prescription benefits
• their prescription history
• coverage information for their medicine
• a pharmacy locator
• prescription cost information
• a comparison of brand name and generic drug costs
• information about the AllianceRx Walgreens Prime Home Delivery and Specialty pharmacies

Prime Therapeutics LLC is an independent company providing pharmacy benefit management services for Blue Cross and Blue Shield of Nebraska.