Medicaid and Private Health Insurance

 
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Medicaid Related Assistance
Medicaid & Long-Term Care
 
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What you need to know

​​​The Coordination of Benefits (COB) program gathers, verifies, and maintains the health insurance information of Medicaid-eligible individuals. With this information, Medicaid determines what claims it pays. ​

Frequently Asked Questions


When should I report to COB?

If you are covered by Nebraska Medicaid and have other health insurance, please report any insurance policy information and any changes to your other insurance such as:

  • Termination of insurance
  • Changes to coverage type, insurance company, or policyholder
  • Lapses in coverage

COB information can be reported by clients, DHHS staff, providers, or the Managed Care Organizations.​

What kind of health insurance needs to be reported?

  • Employer-sponsored health insurance
  • Insurance purchased through an insurance company or agent, such as Medicare supplements and Medicare Advantage plans (HMO)
  • Student insurance
  • Insurance provided by someone who does not live in the same household as the Nebraska Medicaid client
  • Insurance that could pay a medical expense for any insured or provider (e.g. AFLAC, United Commercial Travelers, Washington National, etc.)


 

With questions, please contact:

 Coordination of Benefits

DHHS Division of Medicaid and Long-Term Care

Phone Number
(402) 471-3153​
Mailing Address

Attn: Coordination of Benefits

Nebraska DHHS

P.O. Box 95026

Lincoln, NE 68509-5026​



Long-Term Care Insurance 

Long-Term Care (LTC) insurance is private insurance coverage separate from Medicaid that pays a specific amount per day for an individual who is residing in a nursing home facility. Some LTC insurance policies will pay for assisted living as well, but rarely for home health care. If a client is eligible for Medicaid and enters into a nursing home, then Medicaid may pay up to the Medicaid allowable for their nursing home stay.

Reimbursements are funds sent to Medicaid from the LTC insurance company for benefits that Medicaid has paid for the client's nursing home stay. 


Frequently Asked Questions

When should LTC insurance be reported to Medicaid?

When a Social Services/Eligibility Worker receives information that a Medicaid-eligible client has entered a nursing home, an email should be sent to DHHS.MedicaidLTCInsurance@Nebraska.gov with the Medicaid client's information, complete power of attorney's contact information or the entity who is legally entitled to act on behalf of the client, and the LTC insurance declaration page.

Assignment of benefit letters are sent to the power of attorney or whomever is legally entitled to act on behalf of the Medicaid-eligible client. The signed assignment of benefit letter gives permission to the long-term care insurance company to begin sending reimbursements for benefits that Medicaid has paid on behalf of the client directly to DHHS.

What if the power of attorney does not want to sign the assignment of benefit letters?

The reimbursement from the long-term care insurance company will be included as income for the Medicaid eligible client, which in turn may increase their share of cost.


If you have any further questions, please feel free to contact Medicaid using any of the contact information listed below: 


Recovery and Cost Avoidance (RCA)
Medicaid & Long-Term Care
Phone Number
(531) 530-7494
Mailing Address

Nebraska Department of Health and Human Services

Attn: RCA Unit, Medicaid & Long-Term Care 

P.O. Box 95026
Lincoln, Nebraska 68509-5026