Blue Cross Blue Shield Nebraska — Special Enrollment

Your Guide to Health Insurance

The process to get health insurance might seem complex, but Blue Cross and Blue Shield of Nebraska has the information you need to easily understand your options and get coverage.

6 facts You Need to Know About Health Insurance

These guidelines will help you better understand when and how to buy coverage.


Most people are only able to enroll or switch their health insurance during the Open Enrollment Period, which was from November 1, 2015 through January 31, 2016. The next Open Enrollment Period does not begin until November 1, 2016.

2. Everyone Qualifies

The Affordable Care Act (ACA) guarantees coverage, which prevents insurance companies from denying coverage because of pre-existing conditions, age, or gender.

3. Young adults are covered

Children can now stay insured under a parent’s health insurance plan until age 26.

4. A tax credit can save you money

Depending on your income and family size, you may qualify to receive help paying for health insurance through a tax credit (also known as a subsidy). A tax credit can lower what you pay in monthly premiums.

5. Not having health insurance will cost you

If you didn't get health insurance by January 31, 2016, you could be charged a penalty fee by the government.


The time outside of the annual Open Enrollment Period when you can purchase health insurance only if you have a qualifying life event. Learn more.

10 Benefits You’ll Receive

Any Affordable Care Act health insurance plan you buy will always include these 10 essential benefits:

Outpatient care


Emergency room trips


Inpatient care in the hospital


Maternity and newborn care


Mental health and substance
abuse services


Your prescription drugs


Rehab services if you’re
injured or have a disability


Your lab tests


Preventive services like
vaccines and screenings


Pediatric services for kids

You Could Get Help Paying for Health Insurance

There are a few different factors that may have impacted your income this year, such as having a baby or switching jobs. The great news is you may be able to get help paying for your health insurance.

A tax credit (also known as a subsidy) can be applied to your premium payments if you qualify, helping make health insurance easier for you to afford.

  • Tax credits can lower your monthly premium costs.
  • You can’t receive a tax credit if you can get insurance from your employer.
  • You can’t receive a tax credit if you’re eligible for Medicare.
  • You can use your tax credit to shop through your insurance company and the Health Insurance Marketplace (healthcare.gov).

Questions? Call us today at 1-844-335-8814.


How do I know if I qualify?

In just a few simple steps, our Subsidy Calculator can quickly let you know if you qualify for a tax credit (or subsidy) and how much you could save on your monthly insurance payment.

Click Here

Then click Shop Medical, then click Shop Now to see if you qualify.

How to Shop for Health Insurance

You can shop for your health insurance directly with Blue Cross and Blue Shield of Nebraska or through the Health Insurance Marketplace.

Blue Cross and Blue Shield of Nebraska

Shopping with Blue Cross and Blue Shield of Nebraska for your individual or family health insurance plan means you’ll have our trusted team on your side. Talk to one of our advisors to receive personal guidance while finding the best plan for you.

Health Insurance Marketplace

The Health Insurance Marketplace (healthcare.gov) gives you access to the same plans and pricing available through Blue Cross and Blue Shield of Nebraska. Visit our website to access the Marketplace and see if you’re eligible to receive a tax credit. If you do qualify for a tax credit, you can purchase your plan through your insurance company or the Marketplace.

What plan options are available?

The ACA requires each health insurance plan to cover a certain percentage of health care costs.


  • Health plan pays 60%
  • You pay 40%
  • Lower monthly payments
  • Higher out-of-pocket costs


  • Health plan pays 70%
  • You pay 30%
  • Mid-level monthly payments
  • Mid-level out-of-pocket costs


  • Health plan pays 80%
  • You pay 20%
  • Higher monthly payments
  • Lower out-of-pocket costs

What this information means for you

If you’re shopping for individual or family health insurance and want to know how to pick the right plan, it’s important to think about how much you use your insurance. If you go to the doctor frequently, you may want a plan with higher monthly payments but lower out-of-pocket costs so your medical expenses are more predictable. If you rarely go to the doctor, you may want a plan with lower monthly payments. However, such plans have higher out-of-pocket costs, so you’ll pay more up front when you do need medical care.

Call us today at 1-844-335-8814 or


What Happens If You Don’t Get Health Insurance?

If you decide not to get health insurance, you won’t just risk the cost of an unexpected illness, you’ll also have to pay a penalty fee for the year when it’s time to file your 2016 federal income tax return.

The penalty fee for 2016 is:

  • $695 per adult + $347.50 per child under 18
  • or 2.5% of your household income, whichever is higher.
The maximum penalty fee is $2,085 per family.

Why Blue?

Blue Cross and Blue Shield of Nebraska delivers valued health and wellness solutions, providing Nebraskans with the peace of mind and security needed to feel protected. With our headquarters and customer service located in Omaha, we continue to be the trusted, experienced health insurance partner Nebraskans have turned to for 76 years and counting.
years of service
to Nebraskans
employees, all based
in Nebraska

Still have questions?
Call us today at 1-844-335-8814 or

Click Here

Health Insurance Terms

Affordable Care Act:

The Affordable Care Act (ACA) is a United States federal statute signed into law on March 23, 2010, and is designed to make healthcare more affordable, accessible and of a higher quality.


The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.


The amount you pay for health services each calendar year before your insurance begins to pay.

Health Insurance Marketplace:

Also known as the Exchange (healthcare.gov), it is the place set up by the government where you can find information about private health insurance options, purchase health insurance and obtain help with premiums and out-of-pocket costs if you are eligible.

Inpatient care:

Care you receive that requires admission to a hospital.

Open Enrollment Period:

The window of time from November 1, 2015 – January 31, 2016 when you can purchase health insurance.


A term for providers that aren’t contracting with your insurance company. (Tend to be more expensive than in-network providers.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance, and copayments for covered services, plus all costs for services that aren’t covered.

Outpatient care:

Care you receive at a hospital without being admitted.

Pediatric services:

Health care for kids, including dental care and vision care.


If you can afford health insurance but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month.

Preventive Services:

Routine health care that includes screenings, check-ups and patient counseling to prevent illness, disease, or other health problems.

Rehab services:

Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.

Substance Abuse Disorder Services:

Includes behavioral health treatment, counseling, and psychotherapy.

Special Enrollment Period:

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

Tax Credit:

Financial assistance from the government that helps those who are eligible pay for health insurance. Eligibility is generally determined by household income and family size.