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Wellness Visits

The right health screenings can help you live longer and healthier. Wellness visits can find problems before they get worse. This allows you to get the help and treatment you need. Plus, your doctor can address any health concerns or questions and recommend specialists if needed.

Well Visits Help Keep You Healthy.

Scheduling an appointment with your Primary Care Provider (PCP) is a good place to start. You can find a new PCP through your health plan if you don’t have one. Some screenings are recommended based on:

  • Age
  • Gender
  • Personal health history
  • Family health history

Lifestyle choicesYour PCP can help you find out if you are due for any tests or vaccinations.

Know Your Family History.

Do you have close family members with certain health conditions? It is important to let your doctor know. Your family history might impact your health. Your doctor can check your risk for conditions like:

  • Heart disease
  • Diabetes
  • High blood pressure
  • Stroke
  • Cancer
  • And more

Make Healthy Choices.

Your doctor might ask you about your health history and lifestyle. Making healthy choices can help reduce your risk of illness. Some choices can improve your health like:

  • Eating healthy foods like fruits and veggies
  • Being active
  • Choosing not to smoke
  • Managing any current health conditionsAsk your doctor about other steps you can take to improve your health.

You can choose any PCP in our network. You can change your PCP any time. Your PCP can be a:

  • Pediatrician
  • Family General Practitioner
  • Internist
  • Obstetrician/Gynecologist
  • Specialist who performs PCP functions
  • Nurse Practitioner

If you would like to know more about a PCP, you can call Member Services. They can tell you what language the provider speaks, if they are in the network, or where they are located. 

Learn how to find the perfect primary care provider (PDF).
You can use our Provider Search tool to find a PCP.  

Children and Teens
Getting care that is right for your age and your health needs is important. When children are young, they see a doctor who knows all about kids’ health. That doctor is called a pediatrician. But when they grow up, their health needs change. That is when it is time to move to a doctor who knows about adult health. Your doctor can help you and your child make this change. We can help you with this change.

Start your search for a doctor, dentist, specialist, hospital, clinic, or pharmacy in our Medicaid network. Click the search button below.

See your Primary Care Provider every year for an annual wellness checkup. This helps prevent health problems. The wellness checkup gives your PCP a chance to find health problems early, when they are easier to treat. These appointments can help you and your PCP to get to know each other.

Call your PCP's office to schedule appointments. You have unlimited visits to your PCP. There is no cost to you. Make appointments with them when you need them.

If you need to change or cancel your appointment let your doctor know as soon as you can. It is best to call at least 24 hours before the appointment. Do not just skip an appointment. If you need to change an appointment, call the doctor’s office as soon as you can. They can make a new appointment for you.

Getting Care

MEDICALLY NECESSARY SERVICES
Covered services you receive must be medically necessary. This means we want you to get the care that is most likely to work for you. It should be:
• The right care
• The right place
• The right time

We have guidelines to help make sure you get medically necessary care. These are the criteria that we follow for all providers and members. The guidelines are on our website. Decisions we make about your health care will follow those guidelines.

Nebraska Total Care does not reward providers or our staff for denying coverage or services.

PROVIDER NETWORK
Nebraska Total Care works with a large group of providers. This is called our Provider Network. We do our best to make sure the providers that members need are in our network.

We want providers in our network who give good services. Providers go through a screening process to be in the network. When they are approved, they sign a contract with Nebraska Total Care. They agree to meet certain requirements.

There is a list of providers who are in our network. This list is called the Provider Directory. You can search for providers on our website. Use the Find A Provider tool.

The directory can tell you about the provider. It tells you the provider’s:
• Name, address, and phone number
• Business hours
• Accessibility to people with disabilities
• Specialties
• Languages spoken
• Gender
• Board certification
• Accepting new patients
• Ages served
• Cultural training
• Medical group affiliations
• Hospital affiliations

You can call Member Services for help finding a provider. The phone number is 1-844-385-2192 (TTY 711). They can give you information over the phone. They can mail you a list of providers. Member Services can tell you about a provider’s medical school and residency.

Most of the time providers have to be in our network for us to pay them. If you need to see an out-of-network provider, please call Member Services. We will check to see if there is an in-network provider who can treat your medical condition. If not, we will help you find an out-of-network provider. Services from out-of-network providers need prior authorization. This includes Federally Qualified Health Centers and Rural Health Centers.

Out-of-network emergency services do not need approval from Nebraska Total Care. Call us as soon as you can if you have an emergency and go to an out-of-network provider. We will need to help them so they can get paid.

IMPORTANT: You may have to pay for out-of-network services if you do not get prior authorization. If you have questions, call Member Services at 1-844-385-2192 (TTY 711).

Provider Incentives
A provider incentive plan rewards doctors for giving good care. Plans are based on national standards of care. They are intended to help providers give the right care at the right time. Nebraska Total Care cannot reward providers for refusing, limiting, or reducing medically necessary care.
You have the right to know if we have a plan with your provider that might affect you. To get this information call Member Services. The number is 1-844-385-2192 (TTY 711).

FINDING NEW TREATMENTS TO BETTER CARE FOR YOU
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.

PRIOR AUTHORIZATION FOR SERVICES
Some covered services need prior authorization by Nebraska Total Care. This means that the provider has to get the service approved before they treat you. The right treatment is different for every person. Our goal is to make sure you get care to help you be well.
Call your doctor’s office first when you need care. They will help get the authorization. They will tell us why you need that treatment. They will explain how they think it will help you.

A prior authorization decides if a service should be covered. Nebraska Total Care will consider:
• Medical Necessity- whether the service is needed
• Clinical appropriateness- whether the service is likely to be helpful
Sometimes providers talk to us on the phone. Sometimes they send written information. We will check to see if the service is covered. Then we will make sure it is medically necessary.

Sometimes members get these services but need to keep getting treatment. Your provider will ask for another authorization to continue the care.

We will make the decision as quickly as we can based on your medical condition. Usually we decide within 14 days. If the service is urgent, we will make the decision within three days. We will let your provider know if the service is approved or denied. You can check if services were approved in the Member Portal. There is information in the Secure Member Portal section of this handbook.

If you or your provider believe we made the wrong decision you can request a second review. This is called an appeal. There is more detailed information about appeals in the Member Satisfaction section of this handbook.

Emergency room (ER) and post stabilization services NEVER need prior authorization. If you have a medical emergency get help right away.

Your provider can tell you if a service needs a prior authorization. You can also call Member Services and ask us. The phone number is 1-844-385-2192 (TTY 711). If there are big changes to the prior authorization process, we will tell you. We will inform our members and providers right away.

PRIOR AUTHORIZATION FOR DRUGS
Some medication needs prior authorization from Nebraska Total Care. If you need these drugs, your doctor will ask us for authorization. They will give us information about your health. Then Nebraska Total Care will decide if we can pay for the drug.

Your doctor must ask for prior authorization if:
• A drug is listed as non-preferred on the Preferred Drug List
• Certain conditions need to be met prior to you receiving the drug
• The medication is injected in a doctor’s office
• The medication is considered a “specialty drug.” The list of specialty drugs is on our website.
• You are getting more of the drug than is usually prescribed
• There are other drugs that should be tried first
You might get up to a three day supply of a drug while you are waiting for a decision. The decision will be made within one business day. Your doctor will be notified of the decision.

If you would like more information, you can call Member Services. The phone number is 1-844-385-2192 (TTY 711).

SECOND MEDICAL OPINION
You have the right to a second opinion by another doctor. You can get this at no cost to you. If you would like a second opinion, tell your provider. You must use a doctor who is in the network. Or you can get prior approval from Nebraska Total Care to see a provider out-of-network. Nebraska Total Care will pay for a doctor outside of the network if one is not available in-network. Your provider will review the second opinion. They can use that to help decide the best treatment plan.

GETTING CARE OUT OF STATE
Regular medical care is only covered when you see a Nebraska Total Care provider. But you could be outside of Nebraska and need unplanned medical care. In those situations we still want you to get the help you need. We will pay for services when:
• You are out of state and have a health emergency. Go to a hospital or emergency room where you are. Your follow-up care must be with a Nebraska Total Care network provider. Contact your Nebraska doctor for a referral if you need to see a specialist.
• You are outside of Nebraska and have an urgent health problem. If you need care quickly but it is not an emergency, go to an urgent care clinic. Or you could go to a doctor’s office where you are.
Show the provider your Nebraska Total Care member ID card and your Nebraska Medicaid card. Call us to report your emergency within 48 hours. Providers outside of our network will need help right away so that they can be paid. If they do not complete tasks within 30 days, you may be responsible for paying for service.

Only medically necessary emergency and urgent care services will be covered outside of Nebraska.

It could be decided that you need special care that is not available in Nebraska. If Nebraska Total Care approves your special care, the care you get in the other state will be covered.
Members are not covered for services they get outside of the United States.

URGENT CARE AFTER HOURS
Urgent care is NOT emergency care. You should use urgent care when you have an injury or illness that is not life threatening but needs to be treated within 48 hours. Use urgent care when you cannot wait for an appointment with your doctor. Only go to the ER if your provider tells you to or if you have a life-threatening emergency.
When you need urgent care, follow these steps:
• Call your Primary Care Provider (PCP). The name and phone number are on your Nebraska Total Care member ID card. An after-hours number is listed. Your doctor may help you and give you directions over the phone.
• If you cannot reach your PCP, call our 24/7 Nurse Advice Line. The number is
1-844-385-2192 (TTY 711). You will talk to a nurse. Have your Nebraska Total Care member ID card with you. They will ask you for your number. The nurse will help you over the phone. If you need to see a doctor they will help you find care.
• If you have a mental illness or addiction crisis, do not wait to get help. Call us any time at 1-844-385-2192 (TTY 711). Press * to talk to a licensed professional. They can help with depression, substance use and other behavioral health needs.
• If your provider tells you to go to the nearest emergency room go right away. Take your Nebraska Total Care member ID card and your Nebraska Medicaid ID card.

EMERGENCY CARE
Emergency care is always covered by Nebraska Total Care in the United States. An emergency is when not getting medical attention could risk your health. Or the health of your unborn child. An emergency can include an accident, injury or sudden illness.

Go to the emergency room for:
• Broken bone(s)
• Gun or knife wound(s)
• Bleeding that will not stop
• You are pregnant and in labor and/or bleeding
• Severe chest pain or heart attack
• Drug overdose
• Poisoning
• Bad burn(s)
• Shock (you may sweat, feel thirsty or dizzy or have pale skin)
• Convulsions or seizures
• Trouble breathing
• Suddenly unable to see, move or speak

Do NOT go to the emergency room for:
• Flu, cold, sore throat or earache
• A sprain or strain
• A cut or scrape that does not need stitches
• To get more medicine or have a prescription refilled
• Diaper rash

Emergency rooms are for emergencies. If you can, call your Primary Care Provider (PCP) first. If your condition is severe, call 911 or go to the nearest hospital. You do not need approval.

If you are not sure if it is an emergency, call your doctor’s office. Your doctor will tell you what to do. If your doctor’s office is closed there should be a message telling you how to get help.

You can also call our 24/7 Nurse Advice Line. The number is 1-844-385-2192 (TTY 711). Press *

You can go to any hospital emergency room. It can be a hospital that is not in the Nebraska Total Care network. Show the provider your Nebraska Total Care member ID card and your Nebraska Medicaid ID card. Providers outside of our network will need help from us right away so that they can be paid. If they do not complete tasks within 30 days, you may be responsible for paying for service.

Call your PCP and Nebraska Total Care after you go to the emergency room. Call within 48 hours of your emergency. This helps us make sure you get the follow-up care you need. The phone number is 1-844-385-2192 (TTY 711).

Out-of-Network Services
Out-of-network emergency services do not need approval from Nebraska Total Care. All other services from an out-of-network provider need prior authorization. We will check to see if there is an in-network provider who can help you. If not, we will help you find an out-of-network provider.

IMPORTANT: You may have to pay for out-of-network services if you do not get prior authorization. If you have questions, call Member Services. The phone number is
1-844-385-2192 (TTY 711).

Post Stabilization Services
Post stabilization services are care you need after an emergency. These help get your health back to normal. These services are important and help make sure you do not have another emergency.
Post stabilization services do not require prior authorization. It does not matter if you get emergency care from an out-of-network provider. Post stabilization services will still be covered.

Emergency Transportation
Nebraska Total Care covers emergency ambulance transportation. They will take you to the nearest hospital.
Ambulance transportation from one healthcare facility to another is only covered when it is:
• Medically necessary
• Arranged for and approved by an in-network provider
If you have an emergency and you need help getting to the emergency room, call 911.
 

Your Primary Care Provider

MAKING APPOINTMENTS AND GETTING CARE
To get many kinds of care, you can just choose an in-network provider and make an appointment. You do not need approval from Nebraska Total Care or a referral from your provider for these services:
• Visits to a Primary Care Provider (PCP), pediatrician or family doctor
• Visits to specialist doctors (some specialists need a referral from your PCP)
• Urgent care
• OB/GYN care. Make an appointment as soon as you think you are pregnant.
• Behavioral health services (mental health and substance use services)
• Routine dental care
• Routine vision services

We can help you find or choose a provider. Call Member Services at 1-844-385-2192 (TTY 711). We are available Monday to Friday, 8 a.m. to 5 p.m., Central. Or you can find a provider online at ProviderSearch.NebraskaTotalCare.com.
These services are always covered even if the provider is not in our network:
• Emergency services
• Family planning services and supplies
• Women’s preventive health services

You can see a women’s health specialist in addition to your PCP. You never need a referral or prior authorization for these services.
If transportation to an appointment is difficult for you, please call us. We can help. Call Member Services at 1-844-385-2192 (TTY 711). There is more information in the Transportation section of this handbook.

YOUR PROVIDER DIRECTORY
Your Provider Directory lists all the in-network providers. Nebraska Total Care covers all of these providers. Your Provider Directory includes information on how to contact providers. It includes:
• Doctors
• Hospitals
• Specialists
• Urgent care clinics
• Behavioral health providers
• Dentists
• Any other provider we cover

You can use the online provider search to look for providers at ProviderSearch.NebraskaTotalCare.com. The search tells you about the type of provider they are. It also tells you where they are located. It tells you what languages they speak and their gender.

If you need printed provider information, we can send it to you. Call Member Services at 1-844-385-2192 (TTY 711). We are here Monday to Friday, 8 a.m. to 5 p.m., Central.

You can get the full Provider Directory at least once a year. We can either mail it to you or email it to you. The Provider Directory and Provider Search are always on our website. We will help you find providers any time that you need them.
If you have Medicare, see your Medicare providers.

CHOOSING A PRIMARY CARE PROVIDER (PCP)
When you become a Nebraska Total Care member, you must choose a Primary Care Provider (PCP). If you do not choose one, we will assign you one. Your PCP will be your main doctor. They can help coordinate all of your health needs.

You can choose any PCP in our network if they are taking new patients. You can change your PCP any time. Your PCP can be a:
• Pediatrician
• Family General Practitioner
• Internist
• Obstetrician/Gynecologist
• Nurse Practitioner
• Specialist who performs PCP functions

Getting care that is right for your age and your health needs is important. When children are young, they see a doctor who knows all about kids’ health. That doctor is called a pediatrician. But when they grow up, their health needs change. That is when it is time to move to a doctor who knows about adult health. Your doctor can help you and your child make this change. We can help you with this change.

If you would like to know more about a PCP, you can call Member Services. They can tell you what language the provider speaks, if they are in the network, or where they are located. The phone number is 1-844-385-2192 (TTY 711). 

If you would like to change your PCP, we will help you. There are three ways to change your PCP.
1. Look in the Forms section of this handbook. Find the form called “Request to Change My Primary Care Provider Form.” Fill this out and mail it.
2. Use the secure member portal. This is on our website, NebraskaTotalCare.com.
3. Call Member Services to help you. The phone number is 1-844-385-2192 (TTY 711).

After you tell us who your new PCP is, we will send you a new Nebraska Total Care member ID card. This will have your new PCP’s name and telephone number on it.

VISIT YOUR PCP
After you choose your Primary Care Provider (PCP), make an appointment with them. This will give you both a chance to get to know each other. Your PCP can give you medical care, advice and information about your health.

Call your PCP’s office to make an appointment. Remember to bring your Nebraska Total Care member ID card and your Nebraska Medicaid ID card. If you need help getting an appointment with your PCP, please call Member Services. The phone number is 1-844-385-2192 (TTY 711).
Important: You have unlimited visits to your PCP. There is no cost to you.

Make appointments with them when you feel sick. You should also have a wellness checkup every year.
PCP Responsibilities

Your PCP will:
• Make sure you get all medically necessary services when you need them
• Follow-up on the care you get from other medical providers
• Make referrals for specialty care when needed
• Give ongoing care you need
• Keep your medical record up to date
• Keep track of all the care you receive
• Give services in the same manner to all of their patients
• Give you regular physical exams as needed
• Give preventive care visits
• Give you immunizations
• Offer 24/7 contact information
• Discuss what advance directives are and keep them in your medical record
• Treat you with respect
• Advocate for your health
• Offer the same appointment availability to all patients
• Review all of your medications and dosages at every visit

It is helpful to schedule an annual wellness checkup with your PCP. Do this in the first 60 days of choosing them. Schedule a checkup every year. This helps you stay healthy. It helps your PCP find health problems early, when they are easier to treat.

Communication with your PCP
Health care works best when patients and doctors work together to make decisions. You know how you feel better than anyone else. You should help decide what might make you feel better.
Be honest with your doctor. Your PCP need to know about your health and symptoms. If you have questions, ask! Your doctor wants to help you.

Unfortunately, most people have a hard time understanding words used in health care. You may have never heard the words before. Or words you know are being used in a new way. This can make it hard to make decisions about your health.

Ask Me 3® is a way to ask questions to help you understand what you provider is telling you. This will help you make decisions about care.

Ask your provider these questions at every appointment.
1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
Don't be nervous to ask your provider questions. Your provider wants you to understand your healthcare. They want to answer these questions.

If you still need help understanding your health, please call Member Services. We have people who can help you. The phone number is 1-844-385-2192 (TTY 711). If you need to change or cancel your appointment, let your doctor know as soon as you can. Do not just skip an appointment. A doctor can decide to stop seeing you if you are a “no show” or are late.

If you cannot be at an appointment, please call at least 24 hours before the appointment. If you need to change an appointment, call the doctor’s office as soon as you can. They can make a new appointment for you. If you need help getting to your appointment call Member Services. The phone number is 1-844-385-2192 (TTY 711).

Be honest with your doctor so they can help you. If you have questions about your health, your treatment, or your medicines, ASK! Your doctor is here to help you.

After Hours Appointments with Your PCP
You may need to see another doctor when your PCP’s office is closed. Your PCP’s office will have suggestions about after-hours care. Call them to get directions. Or you can call our 24/7 Nurse Advice Line. We can help you any time. The phone number is 1-844-385-2192 (TTY 711).

Some injuries or illnesses are not life threatening but cannot wait for an office visit. When this happens, you can use an urgent care clinic. If you need help finding an urgent care clinic you can call Member Services or the 24/7 Nurse Advice Line. The phone number is 1-844-385-2192 (TTY 711).

Have your Nebraska Total Care member ID card with you when you call. They will ask for your number.
If you have an emergency, call 911 or go to the nearest emergency room (ER).

IMPORTANT: Get urgent care from a network provider. Only emergencies, family planning and newborn care for their first 30 days can be covered if you see an out-of-network provider.

What to Do if Your PCP Leaves Our Network
If your PCP decides to leave our provider network, we will tell you. We will send you a notice at least 15 days before they leave. You can choose a new PCP. Call Member Services at 1-844-385-2192 (TTY 711). If you do not change your PCP, we will choose a new one for you. After you have a new PCP, we will send you a new member ID card.

If you are in the middle of getting treatment from your provider, we do not want that treatment interrupted. You can ask to stay with your PCP for at least 30 days after they have left our network. This will give you time to finish that treatment process. Or it will let you find a new provider who can continue the treatment.

We can only continue coverage if the provider agrees. They have to agree to:
• Accept payment at the rates they received as an in-network provider
• Follow the quality standards
• Provide the information we need about your care
• Follow the policies and procedures of Nebraska Total Care
If you are seeing a specialist and they leave our network we will help you find a new one. Call Member Services. We will work with you to make sure your care continues.

Referrals
You may need to see a specialist. Your PCP can coordinate your care. Nebraska Total Care does not need a referral from your PCP to cover the service. The specialist may still need a referral from your PCP. This helps them give you the right treatment. They will tell you if they need a referral.

If you would like help finding an in-network provider, please call Member Services. We will be happy to help.
Some of the services that need a referral from your PCP are:
• Diagnostic tests (X-ray & lab)
• Scheduled outpatient hospital services
• Planned inpatient admission
• Renal dialysis (kidney disease)
• Out-of-network providers need Nebraska Total Care approval
• Durable Medical Equipment (DME)
• Home health care

WELL-CHILD CHECKUPS
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) are preventive care for children under the age of 21. These are also called well-child checkups. Doctor visits when your child is well helps make sure they are growing, healthy, and safe.
This schedule shows when to have well child visits. You can ask your child’s doctor when they should have their next checkup.
Set up well-child visits when your child is:
• 3 5 days old
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 24 months old
• 30 months old
• Annually through age 20

Well-child checkups are important for your child’s health. Your child can look and feel well but still have a health problem. During your child’s appointment, their PCP will check:
• Growth and development
• Ears and eyes
• Diet
• Shot records
• Test records

Many schools, activities, and other organizations require a “sports physical.” This is a limited exam. It should not replace a yearly well-child checkup. Tell your provider if you need this exam. They can complete the forms you need during your child’s well child checkup.

Immunizations will be given at well-child checkups. Below is the schedule for immunizations:

Age Immunization
Birth Hep B
1 Month Hep B
2 months DTaP,Hib,IPV,PCV,Rota
4 months DTaP,Hib,IPV,PCV,Rota
6 months Hep B, DTaP, Hib, IPV,PCV, Influenza, Rota
12 months Hib, PCV, MMR, VAR, Hep A Series
15 months DTaP
4-6 years DTaP, IPV, MMR, VAR
9 years HPV (2 doses)
11-12 years Tdap or Td, MCV
13-18 years MCV, HPV series (catch-up)
Every year Influenza (after 6 months)

Before your child is two, they should have a lead screening. This is a blood test. Ask your doctor for the blood test at their 15- or 18-month appointment. 

Dental Services
Dental care is important to your health and well-being. Oral diseases can cause pain and infections that can lead to other problems.
If transportation to an appointment is difficult for you, please call us. We can help. Call Member Services at 1-844-385-2192 (TTY 711). There is more information in the Transportation section of this handbook.

DENTAL HOME
When you become a Nebraska Total Care member, you must choose a Primary Dentist. If you do not choose one, we will assign you one. Your Primary Dentist will help coordinate all of your oral health needs. Your Primary Dentist is on your ID Card.
You can see any dentist in our network. We can help you find or choose a dentist. Call Member Services at 1-844-385-2192 (TTY 711). We are available Monday to Friday, 8 a.m. to 5 p.m., Central. Or you can find a provider online at ProviderSearch.NebraskaTotalCare.com.

PREVENTIVE CARE
Preventive care begins at age one or when a child gets their first tooth. Everyone age one and older should see their dentist twice every year. They will clean your teeth to help prevent other problems. The dentist will do an exam to check for conditions that need treatment.
COVERED SERVICES
Preventive and diagnostic care is covered for members age two and older. These services do not need prior authorization. This includes:
• Cleaning and exams
• Fluoride treatment
• Sealants
• Space maintainers
• X-rays

Treatments for dental conditions are covered but may need prior authorization. Your dentist will help get the authorization. There is more information in the Prior Authorization section of this handbook. Treatment might include:
• Filling
• Crown
• Root canal
• Full or partial dentures
• Tooth removal
• Orthodontics
• Oral surgery

EXCLUDED SERVICES
Cosmetic services are not covered.
Members with coverage limited to care for an unborn child do not have dental coverage. If you are not sure if you have coverage, please call Member Services. The phone number is 1-844-385-2192 (TTY 711).

URGENT DENTAL CARE
If you have an urgent dental need, call your primary dentist. This could be pain, injury, or infection. You should receive urgent care within 24 hours. You can also call our 24/7 Nurse Advice Line. The number is 1-844-385-2192 (TTY 711). Press *

EMERGENCY DENTAL CARE
A dental emergency requires immediate treatment. Some examples are:
• Severe pain
• Severe bleeding
• Serious injury to the teeth or gums
• Unusual swelling of the face, gums, or tongue
• Difficulty or pain when opening or closing the jaw

If you have a dental emergency call your primary dentist for direction if you are able. You can also call our 24/7 Nurse Advice Line. The number is 1-844-385-2192 (TTY 711). Press *. If you cannot reach your primary dentist go to the nearest emergency room.

You can go to any hospital emergency room. It can be a hospital that is not in the Nebraska Total Care network. Show the provider your Nebraska Total Care member ID card and your Nebraska Medicaid ID card. Providers outside of our network will need help from us right away so that they can be paid. If they do not complete tasks within 30 days, you may be responsible for paying for service.

Call your primary dentist and Nebraska Total Care after you go to the emergency room. Call within 48 hours of your emergency. This helps us make sure you get the follow-up care you need. The phone number is 1-844-385-2192 (TTY 711).

CHILDREN WITH SPECIAL NEEDS
Dental care can be confusing for children with special needs. These children can have extra “practice” visits. It may help them feel more comfortable before the dentist does any work. If your child needs a practice visit talk to your dentist. Any dentist can give this service.