Medicare in Nebraska: Plans and Coverage (2026)

Medicare in Nebraska runs on federal rules, but the state adds free Nebraska SHIP counseling and Medicare Savings Programs that can cut your premiums to zero.1,2

Unusually, both the free counseling and those cost-saving programs run through the Nebraska Department of Insurance and Nebraska DHHS. This guide covers Medicare in Nebraska for 2026: what Parts A, B, C, and D cost, which plan types are available across the state, and how to get help paying. Plan selection varies widely between the Omaha and Lincoln metros and rural counties.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Nebraska (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Nebraska
• Help Paying for Medicare in Nebraska
• Medicare Enrollment Periods
• Free Medicare Help: Nebraska SHIP and SMP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1; CMS announced them on November 14, 2025.3 Medicare costs change every year, and each year's amounts are posted at medicare.gov. To talk through your own coverage with a person, call 1-800-MEDICARE (1-800-633-4227), staffed 24 hours a day, 7 days a week; TTY users call 1-877-486-2048.5 For free one-on-one help in Nebraska, call Nebraska SHIP at 1-800-234-7119.1

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government. The mechanics and costs are the same in Nebraska as in every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.3

The hospital deductible rose $60 from 2025, to $1,736 per benefit period.3 A benefit period starts the day you're admitted and ends once you have gone 60 days in a row without inpatient hospital care or skilled care in a SNF; get readmitted after that and the deductible resets.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Part B doesn't cover routine dental, vision, or hearing.6 Most Medicare Advantage plans offer routine dental, vision, and hearing benefits instead, so check what a specific plan actually covers before you count on it.7

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)3
• Annual deductible: $2833
• After the deductible: you pay 20% of the Medicare-approved amount for most services3

Delay past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program and you'll owe a late penalty of 10% for every 12 months you could have had Part B, and that surcharge lasts as long as you have it.8

Medicare Advantage in Nebraska (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering. Most bundle in Part D drug coverage along with extras like dental, vision, and hearing.7

In Nebraska, plan availability tilts heavily toward the population centers. Omaha and Lincoln tend to have the widest plan selection; rural counties typically see fewer choices and narrower networks. Plan options and prices change every year and differ by county, so compare what's actually available at your ZIP code before deciding.

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium. CMS estimates the average Medicare Advantage plan premium at about $14 a month in 2026, and many plans charge $0 extra. CMS notes that some plans may have a $0 premium and may help pay all or part of your Part B premium, so check that on the plan's benefit summary.3,7
• Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you enroll. Emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered whether you get them in or out of the plan's network.7
• Plans typically require prior authorization for certain services; Original Medicare generally does not.7
• Every plan caps your annual in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap of its own, and CMS's full sentence is that there is no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap, Medicaid, employer, retiree, or union coverage.7

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Nebraska SHIP counselors can help you read the results for free.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the coverage gap (the donut hole), so that higher-cost middle stage is gone.4 Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).9
2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.4

The $2,100 cap is the number that matters most in 2026 Part D. The average standalone Part D premium is about $34.50 a month, though actual plan premiums vary widely.3 Every plan also has to offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into monthly payments across the year.4 People who qualify for Extra Help often pay much less.

Medigap in Nebraska

Medigap is extra insurance you buy from a private insurer to help pay your share of costs in Original Medicare. You can't use a Medigap policy to pay a Medicare Advantage plan's copayments, coinsurance, deductibles, or premiums.10

Nebraska has 10 standardized Medigap plans, and a plan with a given letter offers the same benefits no matter which company sells it.11 The plans are lettered A-D, F, G, and K-N, and Plans C and F are closed to people new to Medicare, meaning you turned 65 on or after January 1, 2020 and get Part A on or after that date.11 Our Nebraska Medigap guide covers the state's rules in detail. Plan G is the most common choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.11,3

Your strongest opening is the federal Medigap Open Enrollment Period: the six months that begin when you're 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate regardless of your health.11

After that window, your main protection is a guaranteed issue right. Under Nebraska's Medigap regulation, if certain coverage ends, such as when your Medicare Advantage plan stops serving your area or your employer plan that supplements Medicare ends, you generally have until 63 days after that coverage ends to apply. During that period an insurer can't deny you a policy the regulation covers, price it higher because of your health, or impose a pre-existing condition exclusion.11

Since January 1, 2025, Nebraska law (LB 852) has required insurers that sell Medigap to people 65 and older to offer at least one Medigap policy to people under 65 who have Medicare because of a disability. NDOI says those enrollees get the same six-month open enrollment when their Part B begins, though insurers may not offer every plan.12 The under-65 premium can't be more than 150% of the premium for a similarly situated 65-year-old, and when you turn 65 you get a new six-month open enrollment period starting the first day of your birthday month.12

Medigap or Medicare Advantage?

While you're in an Advantage plan, it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare.10 That isn't permanent: if this is your first Advantage plan, a federal trial right lets you return to Original Medicare within 12 months and buy a Medigap policy.10 For a side-by-side look, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in Nebraska

If you're on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

Nebraska administers the Medicare Savings Programs through Nebraska Department of Health and Human Services (DHHS), the state's Medicaid agency, and its published income standards match the federal tiers rather than exceeding them.2

QMB is the most generous: it pays your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing.2 For all three programs the 2026 resource limit is $9,950 for one person and $14,910 for a couple.2 Those are the federal standards rather than absolute cutoffs: states can effectively raise both the income and the resource limits by disregarding certain income and resources, so apply rather than rule yourself out. The income figures above are the limits Nebraska applies once the $20 monthly income disregard comes off; DHHS's own eligibility appendix prints the poverty-level figures from before it, $1,330 for QMB and $1,596 for SLMB, so a state chart reading $1,330 and the $1,350 above are one limit counted two ways. Income figures tie to the Federal Poverty Level and update annually. QI has to be reapplied for every year; being selected one year does not entitle you to it the next. Apply through Nebraska DHHS, and enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help with Part D.2 QDWI, the fourth Medicare Savings Program, is the exception: it pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not confer Extra Help, so a QDWI enrollee who wants Extra Help has to apply through Social Security.2,13

Extra Help for Part D

Extra Help (also called the Low-Income Subsidy) pays Part D premiums, deductibles, and copays for people with limited income and resources.13 Since 2024 the partial-subsidy tier is gone, so everyone who qualifies gets the full subsidy.

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, the figures for the 48 contiguous states and DC (Alaska and Hawaii are higher)13
• Resource limits: $16,590 for an individual, $33,100 for a couple; those limits rise to $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses13
• QMB, SLMB, or QI enrollment qualifies you for Extra Help automatically2

Apply through Social Security at ssa.gov.13 You can also reach SSA by phone at 1-800-772-1213 (TTY 1-800-325-0778).14

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and the same in Nebraska as everywhere else.15

Changes made during Annual Open Enrollment take effect the following January 1. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically; if not, sign up yourself through the Social Security Administration.15 If you're still working past 65 with group health coverage based on that current employment, you can delay Part B without penalty and use an eight-month Special Enrollment Period to sign up, counted from the month that job or coverage ends, whichever comes first; miss it and you wait for the General Enrollment Period (January 1 to March 31) and may owe a late penalty. COBRA and retiree coverage do not count as coverage based on current employment, and if you're self-employed or your plan isn't available to everyone at the company, ask your insurer whether it qualifies before you delay; if it doesn't, sign up at 65. This Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD).16

For a full breakdown of how each period works and the late-enrollment penalties to avoid, see our Medicare enrollment periods guide.

Free Medicare Help: Nebraska SHIP and SMP

You don't have to sort this out alone. Nebraska runs its State Health Insurance Assistance Program (SHIP) and the Senior Medicare Patrol (SMP) through the Nebraska Department of Insurance (DOI).1 Housing it at the insurance regulator means the same agency that oversees Medigap insurers also provides the free counseling that helps you evaluate them.

Counselors are trained volunteers and staff who give free, unbiased Medicare guidance. They don't sell insurance.

A Nebraska SHIP counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for the Medicare Savings Programs and Extra Help
• Identify and report Medicare fraud through the SMP program
• Sort out claims, denials, and appeals

Call the statewide toll-free line at 1-800-234-7119 or visit doi.nebraska.gov/nebraska-ship-smp for local office information.1

Key Nebraska Medicare Contacts

Learn More

Find personalized help with Medicare in Nebraska 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.