Basic and Prime Benefits

 
2
Medicaid Related Assistance
Medicaid & Long-Term Care
 
No
No

What would you like to do?

What you need to know

Update to Medicaid Expansion Program

On June 1, 2021, DHHS announced it is no longer planning to implement the Heriage Health Adult Demonstration program. As a result, everyone who is eligible for Medicaid through expansion will receive equal benefits coverage, including dental, vision, and over-the-counter medication coverage, effective October 1, 2021. There will be no change to who can become Medicaid eligibile with this change.

For more details, see DHHS's press release


If you have Medicaid coverage through the adult expansion group (Heritage Health Adult), there are two benefit packages available: Basic and Prime benefits. Both benefit packages include comprehensive physical health, behavioral health, and prescription drug services.  For more information, see our list of covered services:

Medicaid Services

What's included with Basic benefits?

Basic benefits include physical health, behavioral health, and prescription drug coverage.

What's included with Prime benefits?

Prime benefits include all Basic benefits, plus dental, vision, and over-the-counter medication coverage.

Who gets Basic benefits?

Everyone eligible for Medicaid in the adult expansion group will receive at least Basic benefits.

Who gets Prime benefits?

Adults eligible for Medicaid in the expansion group who are pregnant, ages 19 & 20, or medically frail will receive Prime benefits.

If I have Basic benefits, can I qualify for Prime benefits?

Everyone in Heritage Health Adult will be able to qualify for Prime benefits at a later date.

How will I receive my benefits?

Nearly all of your benefits will be provided through Nebraska's Medicaid managed care program, Heritage Health, and your Heritage Health managed care plan. If you receive Prime benefits, your dental benefits will be provided by Nebraska's Medicaid Dental Benefits Manager, MCNA.