Benefits and Services
Nebraska Total Care provides the same benefits as Medicaid, plus more. In this section, you can learn about the Nebraska Medicaid health benefits, pharmacy services and value added services Nebraska Total Care offers.
If you need help understanding these benefits and services call Member Services. The phone number is 1-844-385-2192 (TTY 711).
You can also view more information about Nebraska Total Care and Nebraska Medicaid in our Member Handbook.
Nebraska Total Care has many doctors who are working to make sure you get the best care. They review new treatments for illnesses. They read studies from other doctors and scientific groups. They want to make sure we cover the treatments that are helping people. When new treatments are covered by Nebraska Medicaid we tell the Nebraska Total Care providers. This lets them give the best and most current treatment to you.
All services must be medically necessary. Your Provider will work with you to make sure you get the services you need.
Some services may:
- Have coverage limits.
- Need a doctor’s referral.
- Need prior authorization.
You can see authorization approvals on our secure Member Portal.
Guidelines for Care
We have guidelines to help make sure you get medically necessary care. These are the criteria that we follow for all providers and members. Decisions we make about your health care will follow these guidelines.
Co-Pays
We fully cover all of your medically necessary services. Medications for family planning never have a copay. There is never a copay for brand preferred medications. This means the drug is listed on our Preferred Drug List (PDL).
Some members will have copays for some drugs. There are some Medicaid members who have a copay for brand name prescriptions. For these members the copay is $3.
Update 5/11/2020: Due to COVID-19 we have made a change. At this time, there are no copays for any covered meds.
You can see more information about copays on the Pharmacy page.
*Some Medicaid members may not have all of the benefits listed.