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
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.
- 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:
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 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 benefits letters are sent to the power of attorney or whoever is legally entitled to act on behalf of the Medicaid-eligible client. The signed assignment of benefits 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.
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)