Nebraska Medicare Supplement Rules: Open Enrollment, Under 65 (2026)

A Nebraska Medicare supplement policy cannot be denied or priced on your health if you apply before or during the six months that start the first month you are 65 or older and in Part B.1 That protection comes from the Nebraska Department of Insurance (NDOI) regulation 210 NAC 36, which implements the state's minimum standards for Medigap, the insurance that pays your share of costs after Medicare Part A or Part B pays first.1,2 Since January 1, 2025, Nebraska law has also required insurers that sell Medigap to 65-year-olds to offer at least one Medicare supplement policy to people under 65 who have Medicare because of a disability.3

In This Guide

• Can You Buy a Medicare Supplement Under 65 in Nebraska?
• When Is the Nebraska Medigap Open Enrollment Window?
• Will a Pre-Existing Condition Be Covered Right Away?
• When Must an Insurer Sell You a Policy Later?
• Which Medicare Supplement Plans Can You Buy in Nebraska, and How Are They Priced?
• Should You Pick Medigap or Medicare Advantage?
• What Protections Come After You Buy?
• Which Nebraska Medicare Supplement Right Fits Your Situation?
• Who Helps Nebraskans Compare Medicare Supplement Quotes for Free?
• Frequently Asked Questions
• Learn More

Can You Buy a Medicare Supplement Under 65 in Nebraska?

Yes: since January 1, 2025, Nebraska law has required any insurer that makes a Medicare supplement policy available to 65-year-olds to make at least one Medicare supplement policy available to a Nebraskan under 65 who is eligible for and enrolled in Medicare because of a disability.3 Medicare.gov says federal law generally doesn't require insurance companies to sell Medigap to people under 65, although insurers in some states do offer it.4 Nebraska closed that gap with LB 852, which NDOI's January 17, 2025 news release says took effect January 1, 2025.3

Nebraska Revised Statute 44-3614, the section LB 852 enacted, sets three rules for Medicare supplement insurers:3

1. At least one policy: An insurer that makes a Medicare supplement policy available to a 65-year-old who is eligible for Medicare must make at least one qualifying Medicare supplement policy available to a person under 65 who is eligible for and enrolled in Medicare by reason of disability.
2. A 150% premium cap: Nebraska Medigap premiums for disabled enrollees under 65 may differ from premiums for people 65 or older, but they must rest on sound actuarial principles and may not exceed 150% of the premium for a similarly situated 65-year-old.3
3. A new window at 65: A disabled enrollee under 65 becomes subject to the same open enrollment rules as a 65-year-old beginning on the first day of the first month the enrollee turns 65. NDOI's 2025 release says a Nebraskan receiving Medicare because of a disability becomes eligible, on turning 65, for a six-month Medigap Open Enrollment period with guaranteed issue for a new Medicare Supplement plan, beginning on the first day of their 65th birthday month.3

When does the under-65 window open?

NDOI, not the statute, ties the under-65 window to Part B. NDOI's 2026 fact sheet says Nebraskans who qualify for Medicare because of a disability have the same Medigap Open Enrollment available when their Medicare Part B begins.3 NDOI's 2025 release describes the under-65 disability window as the same six-month Medigap Open Enrollment that Nebraskans who qualify at 65 or older receive, with no underwriting for the Plan A supplement during it.3

Which plans can a Nebraskan under 65 buy?

The statute guarantees at least one policy, not every plan letter. NDOI's January 17, 2025 release said that, at that time, only Medicare Supplement Plan A was available to people under 65 in Nebraska.3 NDOI's 2026 fact sheet says insurance companies may not offer every plan option to Nebraskans who qualify for Medicare because of a disability, so ask each insurer which plans it sells to buyers under 65.3

Who is left out before 65?

NDOI's 2025 release states that people with End-Stage Renal Disease (ESRD) are not eligible for a Nebraska Medicare supplement before age 65.3

When Is the Nebraska Medigap Open Enrollment Window?

NDOI's 2026 Medicare Supplement Fact Sheet states that the six-month Medigap Open Enrollment Period starts the first month you have Part B at age 65 or older, and that you cannot be denied a policy because of your health during it.1

The Open Enrollment section of 210 NAC 36 (Section 13) spells out what a Nebraska insurer may not do with an application submitted before or during that six-month period:1

• Deny or condition the issuance or effectiveness of any Medicare supplement policy available for sale in Nebraska because of the applicant's health status, claims experience, receipt of health care or medical condition.
• Charge a different price for any of those health reasons.
• Hold back any Medicare supplement policy it currently offers: each one must be made available to every applicant who qualifies for the window.

Federal law sets the same six-month floor. Section 1882 of the Social Security Act, at subsection (s)(2)(A), bars an issuer from denying, conditioning or pricing a Medigap policy on health for an application submitted before or during the six-month period that begins the first month a person is 65 or older and enrolled in Part B.4 Medicare.gov describes the Medigap Open Enrollment Period as a one-time window that doesn't repeat every year, unlike the annual Medicare Open Enrollment Period.4

The window closing changes the rules. NDOI's 2026 fact sheet warns that if you apply for a Nebraska Medicare supplement after the six-month period, companies may refuse coverage because of health reasons.1 Medicare.gov adds that outside the window you may pay more, have fewer policy options and be denied a policy for not meeting an insurer's medical underwriting requirements.4 Brevy's national guide to the Medigap open enrollment period covers the federal timing in more detail.

Will a Pre-Existing Condition Be Covered Right Away?

Getting a Nebraska Medigap policy during open enrollment does not always mean every condition is covered on day one. Under 210 NAC 36 Section 13, a Medicare supplement policy may, during its first six months, exclude benefits for a pre-existing condition that was treated or diagnosed during the six months before the policy took effect.1

Prior health coverage can erase or shorten that exclusion for an open enrollment applicant in Nebraska:1

• Six months or more of creditable coverage: 210 NAC 36 bars a Nebraska insurer from excluding benefits for a pre-existing condition when an open enrollment applicant has had at least six months of continuous creditable coverage.
• Less than six months: The regulation reduces any pre-existing condition exclusion period by the total months of creditable coverage the applicant had.
• The 63-day gap limit: Medicare's 2026 guide Choosing a Medigap Policy states that prior health coverage counts as creditable coverage for Medigap only if the break in coverage was no more than 63 days.

A Nebraskan moving from job-based or other health coverage to Medicare should keep the end date of that coverage, because a break longer than 63 days stops it from counting toward the pre-existing condition credit.1 Brevy's guide to Medigap and pre-existing conditions walks through the look-back.

When Must an Insurer Sell You a Policy Later?

After open enrollment ends, a Nebraska insurer must still sell certain Medigap policies to an "eligible person" who loses or leaves other coverage in a situation 210 NAC 36 Section 14 lists.2 For an eligible person who applies during the guaranteed issue period, the regulation bars the insurer from denying or conditioning a covered Medicare supplement policy it offers to new enrollees, from pricing it on health, and from imposing a pre-existing condition exclusion.2

The Nebraska guaranteed issue situations in 210 NAC 36, in plain words:2

• Employer coverage ends: An employer plan that supplements Medicare ends or stops providing all of its supplemental benefits, or you lose eligibility for an employer plan through current employment that pays after Medicare.
• Medicare Advantage ends or moves away: Your Medicare Advantage plan's certification is terminated, it stops serving your area, you lose eligibility because you moved or your circumstances changed, or you show the plan substantially broke its contract or materially misled you in marketing. The regulation applies similar rules to people 65 or older in the Program of All-Inclusive Care for the Elderly (PACE).
• Your Medigap policy ends: Your Medicare supplement ends because the insurer became insolvent or the coverage ended involuntarily, or because the insurer substantially violated the policy or misrepresented it.
• A first-time Medicare Advantage trial: You dropped a Medicare supplement to join a Medicare Advantage or similar plan for the first time and leave that plan within the first 12 months.
• Medicare Advantage or PACE at 65: You joined a Medicare Advantage plan or PACE when you first became eligible for Part A at 65 and leave within 12 months.
• Part D replaces drug coverage: You enroll in Medicare Part D during your initial enrollment period while holding a Medicare supplement with outpatient drug coverage, and you drop that supplement.

The Nebraska guaranteed issue right applies to certain Medigap policies an insurer offers to new enrollees, and Brevy's national guide to Medigap guaranteed issue rights explains which policies federal rules reach.2

How long do you have to apply?

Each Nebraska guaranteed issue period under 210 NAC 36 ends 63 days after a stated date, usually the date the old coverage ends or the date a disenrollment takes effect.2 When you leave a plan voluntarily, including a Medicare Advantage plan, the Nebraska window opens 60 days before the disenrollment takes effect and closes 63 days after it.2

What proof does the insurer need?

210 NAC 36 requires a Nebraska guaranteed issue applicant to submit evidence of the date of termination, disenrollment or Part D enrollment with the Medicare supplement application.2 Keep the letter or notice that shows when your old coverage ended before you apply.

Switching Medigap policies without one of these rights is harder. Medicare.gov says that, under federal rights, you usually can't switch Medigap policies outside your six-month open enrollment period unless you have a guaranteed issue right, and that switching outside it may mean paying more and answering medical questions.5

Which Medicare Supplement Plans Can You Buy in Nebraska, and How Are They Priced?

NDOI's 2026 fact sheet says there are 10 standardized Medigap policies in Nebraska, and that policies with the same letter offer the same benefits no matter which insurance company sells them.2 Medicare's Choosing a Medigap Policy guide charts those plans as A, B, C, D, F, G, K, L, M and N, and states that every insurance company selling Medigap must offer at least Plan A.2

A few Nebraska buying rules come before comparing letters:2

• Original Medicare first: NDOI says you can buy a Medicare supplement only if you have Original Medicare, meaning you must sign up for Part A and Part B first.
• No drug coverage: NDOI's fact sheet says Medicare supplements do not provide prescription drug coverage, so a separate Part D plan may be needed.
• Plans C and F: NDOI says Plan C and Plan F are available only to people eligible for Medicare before January 1, 2020.
• High-deductible versions: NDOI says Plan G and Plan F offer a high-deductible option.

The Plan C and Plan F cutoff follows federal law. Medicare's Choosing a Medigap Policy guide says Medigap plans sold to people new to Medicare on or after January 1, 2020 can't cover the Part B deductible, so those people have the right to buy Plans D and G instead.2 Medigap Plans E, H, I and J are no longer sold, though someone who already has one can generally keep it.2

How do Nebraska insurers set premiums?

NDOI's 2026 fact sheet says Nebraska Medicare supplement premiums vary by plan, insurance company and where you live, and that each company sets the premium for the policies it offers.2 NDOI describes three ways a Nebraska policy can be priced:2

• Attained age: The premium is based on your current age and generally increases as you get older.
• Issue age: The premium is based on your age when you buy the policy; it cannot rise because you age, but it can rise because of inflation or other factors.
• Community rated: The premium is generally the same for everyone regardless of age or gender.

NDOI's fact sheet states that the majority of Medicare supplement plans in Nebraska are rated by attained age.2 Ask which method a quote uses before comparing two companies, and see Brevy's guide to how Medigap premiums are priced for the rating methods side by side. NDOI says you can buy by contacting a company directly or through a local agent or broker.2

Should You Pick Medigap or Medicare Advantage?

A Medigap policy works only alongside Original Medicare. The Centers for Medicare & Medicaid Services (CMS) booklet Understanding Medicare Advantage Plans states that you can't use Medigap to pay Medicare Advantage plan copayments, coinsurance, deductibles or premiums.6

The same CMS booklet sets out three rules for anyone weighing the switch:6

• Illegal sales: If you are in a Medicare Advantage plan, it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare, and CMS says to report a seller who tries to your State Insurance Department.
• Hard to get back: In most cases, if you drop a Medigap policy to join a Medicare Advantage plan, you may not be able to get the same policy back.
• Trial right: A person who joins a Medicare Advantage plan for the first time and isn't happy with it has a federal "trial right" to buy a Medigap policy and a separate drug plan when returning to Original Medicare within 12 months of joining.

In Nebraska, 210 NAC 36 lists both first-year exits as guaranteed issue situations: dropping a Medicare supplement to try Medicare Advantage for the first time, and joining Medicare Advantage or PACE at first Part A eligibility at 65, each followed by leaving within 12 months.2 Brevy's guides to Medicare Advantage trial rights and to illegal Medigap sales cover the federal side.

What Protections Come After You Buy?

Two Nebraska rules protect a Medicare supplement policy once it is issued:1

• Guaranteed renewable: 210 NAC 36 requires each standardized Medicare supplement policy to be guaranteed renewable, bars the insurer from cancelling or nonrenewing it solely because of your health, and allows cancellation only for nonpayment of premium or material misrepresentation.
• 30-day free look: 210 NAC 36 requires Nebraska Medicare supplement policies to carry a notice that you may return the policy within 30 days of delivery and get the premium refunded if you are not satisfied for any reason.

Federal law backs both protections. Section 1882(c)(4) of the Social Security Act lets a Medigap policy be returned for a full premium refund during a period of at least 30 days after it is issued, and Medicare's 2026 Choosing a Medigap Policy guide states that any new Medigap policy issued since 1992 is guaranteed renewable even if you have health problems.1

Replacing a policy you have held for a while doesn't restart the clock on similar benefits. Under Social Security Act §1882(s)(2)(C), a Medigap policy that replaces one in effect for six months or longer may not impose a new pre-existing condition, waiting, elimination or probationary period for similar benefits.5 Medicare.gov still warns that if you drop a Medigap policy, you might not be able to get it or any policy back later, so keep the old policy until the new one is issued.5

Which Nebraska Medicare Supplement Right Fits Your Situation?

The table condenses 210 NAC 36, Nebraska Revised Statute 44-3614 and NDOI's 2026 fact sheet; the sections above give the exact wording and limits.1,3,2

Who Helps Nebraskans Compare Medicare Supplement Quotes for Free?

• Nebraska SHIP & SMP: NDOI says the Nebraska State Health Insurance Assistance Program (SHIP) can produce quotes and answer questions about Medicare and Medicare supplement coverage, and NDOI's fact sheet lists the Nebraska SHIP & Senior Medicare Patrol (SMP) at 1-800-234-7119.2
• No endorsements: NDOI's 2026 fact sheet states that neither the Nebraska SHIP nor NDOI endorses any specific agent, company, product or plan of insurance.2
• Complaints: CMS tells people to report an illegal Medigap sale to their State Insurance Department, and NDOI's online File a Complaint page is the Nebraska starting point.6
• 1-800-MEDICARE: For Original Medicare questions, 1-800-MEDICARE (1-800-633-4227) is the official line run by CMS, TTY users call 1-877-486-2048, and Medicare.gov says a real person answers 24 hours a day, 7 days a week, except some federal holidays.7

Brevy's Nebraska Medicare hub covers the rest of Medicare in the state, and the guide to Nebraska Medicare Savings Programs covers help with Medicare costs.

Learn More

Find personalized help timing your Nebraska Medicare supplement window and checking your under-65 options at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.