No
Retroactive coverage is a rule that lets Medicaid pay for medical bills that Medicaid members had before they applied for Medicaid.
To get retroactive coverage, someone must have been eligible for Medicaid during the period Medicaid is paying for. This means they met all requirements to qualify for Medicaid but hadn't applied yet. These requirements can include things like age and income.
2027 Retroactive Medicaid Changes
Before January 1, 2027, Nebraska Medicaid currently pays for medical bills for up to three months before a Medicaid member's application date, as long as they would have qualified for Medicaid during that three-month period.
Upcoming Retroactive Coverage Rules:
Starting January 1, 2027, federal rules for retroactive coverage will change, and the time period for retroactive coverage will shorten.
People who qualify in the Medicaid expansion group may be able to get retroactive coverage for up to one month before the month they apply.
People who qualify in any other Medicaid category may be able to get retroactive coverage for up to two months before the month they apply.
What is the Medicaid expansion group?
People enrolled through Medicaid expansion are Medicaid members who:
- Are between age 19 and 64
- Are not pregnant
- Do not have a disability
- Are not enrolled in Medicare
- Meet income limits (earn up to 138% of the federal poverty level or about $22,025 per year for one person or $45,540 for a family of four)
How to Apply for Retroactive Coverage
Current Medicaid Members Who Recently Applied:
People who are already on Medicaid have up to six months after submitting their application to request retroactive coverage.
Members can request retroactive coverage by visiting https://iserve.nebraska.gov/ and submitting a change report. Members can also contact DHHS:
- Online: at https://iserve.nebraska.gov/
- By mail: P.O. Box 2992 Omaha, NE 68103-2992
- By phone:
- Phone Number: (855) 632-7633 (press option 3)
- Lincoln Phone Number: (402) 473-7000 (press option 3)
- Omaha Phone Number: (402) 595-1178 (press option 3)
- TTY Number: (402) 471-7256
- Fax: (402) 742-2351
- In person: at a local DHHS office
New Applicants:
There is not a separate application for retroactive coverage. The general Medicaid application includes a question that asks if you need assistance paying past medical bills. Applicants can mark 'yes' if they need help with medical bills.
Frequently Asked Questions
For more information on the upcoming changes to retroactive Medicaid coverage, please read this frequently asked questions document.