Healthy Blue Medicaid benefits
What you get with Healthy Blue
We help you and your family get the most from your Nebraska Medicaid benefits. Plus, Healthy Blue members get extra benefits at no cost!
As a Healthy Blue member, you get all of your Medicaid benefits and services, including:
- Primary care provider (PCP) visits.
- Immunizations and wellness visits.
- Health Check Services (EPSDT) (early and periodic screening, diagnosis and treatment) services for members age 21 and younger.
- Specialist visits.
- Maternity care.
- Hospital care.
- Lab and X-ray services.
- Family planning.
- Chiropractic services.
- Physical and occupational therapy.
- Speech and hearing services.
- Urgent and emergency care.
- Behavioral health care (mental and substance abuse services).
- Home Health Agency Services.
There are no copays, or fees, for these benefits. This does not include brand-name pharmacy drugs, durable medical equipment (DME) or vision services. See your member handbook for a full list of benefits.Find a Doctor
Your benefits include a wide range of prescription and over-the-counter (OTC) medicines. We can even deliver your medicines to your home. We work with IngenioRx to provide these benefits. Coverage is subject to benefits plan.
Visit the pharmacy page to find a pharmacy near you and check if your medicine is covered.Go to the Pharmacy page
Eligible members can receive an annual eye exam and glasses through Avesis Vision (every year for members age 20 and younger; every two years for members age 21 and older). There is a $2 copay for eye exams and a $2 copay for eyeglasses. Coverage is subject to benefits plan.Find an eye doctor
Part of staying healthy is getting the care you need, when you need it. And we make it easy. As a member of Healthy Blue, you may be eligible to get rides to and from your doctor’s office, pharmacy and other providers of covered services.
Call IntelliRide at 844-531-3783 (TTY 402-401-6998) or visit www.iridenow.com to set up your ride.
Whether you are thinking about having a baby, pregnant, already a new mom, or you are not planning to have a baby, we can help you take steps to stay healthy at every stage.Find pregnancy resources
You may have special care needs. To help with these, we have care and Disease Management programs. If you need extra support to get and stay healthy, we can help.
You may qualify for care management services if you have:
- Complex illnesses that require the coordination of many services.
- Children with special health care needs.
- Had or are going to have a transplant.
- A high-risk pregnancy.
- Multiple chronic illnesses.
- High-risk behavioral health care needs.
- Experienced domestic abuse.
- A responsibility for someone in foster care or adult guardianship.
- Special health care needs.
A care manager will work with you to help arrange your care needs. They will work with your doctors to make sure you get the right care when and where you need it.
Call Member Services at 833-388-1405 (TTY 711) to connect with a care manager.Go to My Care Plan
You may qualify for Disease Management services if you have or need help with:
- Bipolar Disorder.
- Coronary Artery Disease (CAD).
- Congestive Heart Failure (CHF).
- Chronic Obstructive Pulmonary Disease (COPD).
- Major Depressive Disorder – Adult.
- Major Depressive disorder – Child and Adolescent.
- Substance Use Disorder.
- Stopping smoking.
- Weight management.
Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages you to get the care you need to create a healthy lifestyle.
You can redeem these Healthy Rewards through the Benefit Reward Hub:
- $10 per visit for well-baby checkups (up to 8 visits), age 0-15 months
- $25 for childhood wellness visits, ages 3-13
- $25 for childhood and adolescent immunizations
- 25 for children’s lead screening
- $25 for initial prenatal visit
- $25 for postpartum visit 7-84 days after birth
- $50 for diabetic eye exam
- $25 for diabetic A1c screening
- $25 for A1c screening for diabetic members on antipsychotic medication
Log on to the Benefit Reward Hub to redeem your Healthy Rewards and view the rewards you are eligible for. You can also call the Healthy Rewards Customer Service Line at 888-990-8681 (TTY 711) Monday through Friday from 9 a.m. to 8 p.m. Eastern time.
We know that health care is more than just doctor visits. As a Healthy Blue member, you get no-cost extras to help you live your best.
Pregnant women and new moms
- Electric breast pump
- Rewards for going to doctor visits
- Diapers for completing postpartum and well-baby visits
- Stroller, portable playpen, car seat or six packs of diapers for completing initial prenatal visit
- Community baby showers
- Prenatal Care Management program
Active and healthy lifestyle
- WW® membership
- Online health and wellness resources through ChooseHealthy
- myStrength, online tools and support for mental health and well-being
- Boy and Girl Scout memberships
- 4-H annual membership for members ages 5 – 18
- Gift card for members ages 4 – 12 to help pay for summer camp
- Swim lessons for qualified members
- Three monthly shipments of fresh fruits and veggies for members diagnosed with obesity or diabetes
- Scale and blood pressure cuffs
- Hypoallergenic bedding
- $10 a month for personal care items like lotions, sunscreen, toothbrushes and baby items
Invest in your future
- GED Program: Free GED testing to help members 16 and older get their high school diploma
- Jump Start Training Program: Helps members assess their skills, train and search for jobs, and prepare for the GED. Access this program online whenever you need to.
- Dorm room items for foster care youth headed to college
- School supplies for members headed to college
- $25 Barnes and Noble gift card for members ages 4 – 12
- Bus passes
- $25 gas gift card
- $20 Lyft/Uber gift card
- Rides to the doctor and pharmacy
Limitations and restrictions apply. Benefits may change.
You can redeem some benefits online through your secure account. View the extra benefits you are eligible for on the Benefit Reward Hub, or call Member Services at 833-388-1405 (TTY 711).
Log in to get started today!Visit the Benefit Reward Hub
Some members will have a small copay, or fee, for brand-name prescriptions, durable medical equipment (DME) and vision services. All other benefits have a $0 copay.
There are no copays for:
- Members age 18 or younger.
- Pregnant women (including up to 60 days after pregnancy).
- Members in a hospital, long-term care facility or other medical institution who is required to spend all but a minimal amount of his/her income for medical care costs.
- Members who live in residential care facilities, centers for the developmentally disabled, or adult family homes.
- Native Americans who receive items or services through a Native American Health Care Provider or their referral.
- Members who are receiving waiver services.
- Members who receive assistance under the State Disability Program (SDP).
- Brand-name prescriptions — $3 per prescription
- Eye exams — $2 per office visit or eye exam
- Eyeglasses — $2, includes lenses and frames
- Durable Medical Equipment (DME) — $3 per item
Your primary care provider (PCP) may send you to a specialist to get care. This is called a referral. You can see any doctor in your plan without a referral.
For some services, your doctor will need to get approval, or an OK, from us before you get them. This is called prior authorization. Your PCP will contact us for this approval.
You do not need an approval for:
- Primary care services.
- In-network OB/GYN services.
- Family planning.
- Well-child visits for children age 20 or younger.
- Routine vision care.
- Post-stabilization (follow-up) services.
- Emergency and urgent care.
For more information about services that need approval, please see your member handbook.
Healthy Blue members pay $0 for primary care provider (PCP) visits, specialists, generic prescriptions, behavioral health care, urgent care services and labs.
Get the most from your benefits
New to Healthy Blue?
As a new member, we know you have questions, and we want you to get the most out of your benefits. Read our tips to help you get started with your new health plan.
Healthy Blue member handbook
Complete benefit information can be found in your member handbook.