Nebraska health plan · 2026

HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision · 29678NE1590015

Blue Cross and Blue Shield of Nebraska offers this marketplace health insurance plan (Plan ID 29678NE1590015) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Silver Plan type: EPO CSR: Limited Cost Sharing Plan Variation Issuer: Blue Cross and Blue Shield of Nebraska
Telehealth Data pending HSA eligible No Dental Child Vision Adult/Child

CMS AV Calculator output: 70.08% (29.92% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$689 – $2701

Before subsidies

Estimate after subsidies

Deductible

$5,500

$11000 per group

See deductible details

Max out-of-pocket

$6,000

$12000 per group

Review MOOP rules

Office visits

Primary care 50.00% Coinsurance after deductible
Specialist 50.00% Coinsurance after deductible
HSA Not eligible

Drug tiers

Generic 20.00% Coinsurance after deductible
Preferred brand 50.00% Coinsurance after deductible

View formulary tiers

$943 / mo before subsidies

≈ $11321 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$2990 / mo before subsidies

≈ $35875 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$3621 / mo before subsidies

≈ $43448 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$2301 / mo before subsidies

≈ $27611 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

50.00% Coinsurance after deductible

Advertisement

Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Nebraska). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

50.00% Coinsurance after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Nebraska 18093
PCPs in Nebraska 1913
Telehealth support Data pending
Nationwide providers 70206
18,093 doctors statewide 1,913 PCPs 56 OB/GYN
Providers Nebraska All US states
All 18093 70206
PCP 1913 2330
Allergy 5 6
OB/GYN 56 82
Dentists 745 801

Drug coverage overview

3,870 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
HIGH-COST-GENERIC 2,354
NON-PREFERRED-BRAND 830
NON-PREFERRED-SPECIALTY 686
Prior authorization Drugs
Required 617
Not Required 3,253
Step therapy Drugs
Required 15
Not Required 3,855
Quantity limits Drugs
Has Limit 549
No Limit 3,321

Customer highlights

What stands out for members

  • Issuer: Blue Cross and Blue Shield of Nebraska · Plan ID 29678NE1590015 · 2026 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 29678NE1590015-03 (Open to Indians above 300% FPL) currently displayed.
Advertisement

Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

50.00% Coinsurance after deductible

Diabetes Care Management

50.00% Coinsurance after deductible

Diabetes Education

50.00% Coinsurance after deductible

Home Health Care Services

50.00% Coinsurance after deductible

Laboratory Outpatient and Professional Services

50.00% Coinsurance after deductible

Other Practitioner Office Visit (Nurse, Physician Assistant)

50.00% Coinsurance after deductible

Preventive Care/Screening/Immunization

No Charge

Primary Care Visit to Treat an Injury or Illness

50.00% Coinsurance after deductible

Rehabilitative Occupational and Rehabilitative Physical Therapy

50.00% Coinsurance after deductible

Rehabilitative Speech Therapy

50.00% Coinsurance after deductible

Specialist Visit

50.00% Coinsurance after deductible

Urgent Care Centers or Facilities

50.00% Coinsurance after deductible

X-rays and Diagnostic Imaging

50.00% Coinsurance after deductible

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

50.00% Coinsurance after deductible

Delivery and All Inpatient Services for Maternity Care

50.00% Coinsurance after deductible

Dialysis

50.00% Coinsurance after deductible

Durable Medical Equipment

50.00% Coinsurance after deductible

Emergency Room Services

50.00% Coinsurance after deductible

Emergency Transportation/Ambulance

50.00% Coinsurance after deductible

Hospice Services

50.00% Coinsurance after deductible

Inpatient Hospital Services (e.g., Hospital Stay)

50.00% Coinsurance after deductible

Inpatient Physician and Surgical Services

50.00% Coinsurance after deductible

Mental/Behavioral Health Inpatient Services

50.00% Coinsurance after deductible

Mental/Behavioral Health Outpatient Services

50.00% Coinsurance after deductible

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

50.00% Coinsurance after deductible

Outpatient Rehabilitation Services

50.00% Coinsurance after deductible

Outpatient Surgery Physician/Surgical Services

50.00% Coinsurance after deductible

Radiation

50.00% Coinsurance after deductible

Skilled Nursing Facility

50.00% Coinsurance after deductible

Substance Abuse Disorder Inpatient Services

50.00% Coinsurance after deductible

Substance Abuse Disorder Outpatient Services

50.00% Coinsurance after deductible

Transplant

50.00% Coinsurance after deductible

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

50.00% Coinsurance after deductible

Hearing Aids

50.00% Coinsurance after deductible

Major Dental Care - Child

50.00% Coinsurance after deductible

Prenatal and Postnatal Care

50.00% Coinsurance after deductible

Routine Eye Exam for Children

No Charge

Well Baby Visits and Care

No Charge

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

20.00% Coinsurance after deductible

Non-Preferred Brand Drugs

55.00% Coinsurance after deductible

Off Label Prescription Drugs

50.00% Coinsurance after deductible

Preferred Brand Drugs

50.00% Coinsurance after deductible

Specialty Drugs

60.00% Coinsurance after deductible

Tier 2 Generic Drugs

30.00% Coinsurance after deductible

Tier 2 Specialty Drugs

70.00% Coinsurance after deductible

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

50.00% Coinsurance after deductible

Basic Dental Care - Adult

Coverage details pending

Dental Anesthesia

50.00% Coinsurance after deductible

Dental Check-Up for Children

No Charge

Infusion Therapy

50.00% Coinsurance after deductible

Major Dental Care - Adult

Coverage details pending

Nutritional Counseling

50.00% Coinsurance after deductible

Orthodontia - Adult

Coverage details pending

Orthodontia - Child

70.00% Coinsurance after deductible

Prosthetic Devices

50.00% Coinsurance after deductible

Routine Dental Services (Adult)

Coverage details pending

Weight Loss Programs

Coverage details pending

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Acupuncture

Coverage details pending

Allergy Testing

50.00% Coinsurance after deductible

Bariatric Surgery

Coverage details pending

Cosmetic Surgery

Coverage details pending

Eye Glasses for Children

50.00% Coinsurance after deductible

Gender Affirming Care

50.00% Coinsurance after deductible

Habilitation Services

50.00% Coinsurance after deductible

Imaging (CT/PET Scans, MRIs)

50.00% Coinsurance after deductible

Infertility Treatment

Coverage details pending

Long-Term/Custodial Nursing Home Care

Coverage details pending

Private-Duty Nursing

Coverage details pending

Reconstructive Surgery

50.00% Coinsurance after deductible

Routine Eye Exam (Adult)

No Charge

Routine Foot Care

Coverage details pending

Treatment for Temporomandibular Joint Disorders

50.00% Coinsurance after deductible

Variant attributes

HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision · Variant 29678NE1590015-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

29678NE159

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

29678NE1590015-03

Plan Marketing Name

HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision

Plan Variant Marketing Name

HeartlandBlue Silver Limited 5500 NEtwork Blue w/ Adult Vision

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

29678

Issuer Marketplace Marketing Name

Blue Cross and Blue Shield of Nebraska

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

NEN001

Out of Country Coverage

Yes

Out of Country Coverage Description

Emergency Services

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Coverage for emergency health services and urgent care center visits at in-network benefit level.

Service Area ID

NES003

State Code

NE

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.700812556

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$500

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$5,500

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$5,300

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,800

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$12000 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$6000 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$6,000

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

NEF007

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$70

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs

EHB Percent of Total Premium

0.9939

First Tier Utilization

100%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

New

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

EPO

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

29678NE1590015

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$11000 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$5500 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$5,500

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

No

Wellness Program Offered

Yes

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Nebraska?

HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision (29678NE1590015) is a Silver EPO from Blue Cross and Blue Shield of Nebraska in Nebraska for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental add-ons: Child.

Vision add-ons: Adult, Child.

Does HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs.

Is there out-of-country coverage for HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency Services

Does HeartlandBlue Silver HSA 5500 NEtwork Blue w/ Adult Vision cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Coverage for emergency health services and urgent care center visits at in-network benefit level.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
Open comparison tray

Add at least two plans to launch side-by-side comparisons.