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Blue Cross Blue Shield Nebraska MA Connect (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Blue Shield Nebraska MA Connect (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Blue Shield Nebraska MA Connect (PPO) in 2025, please refer to our full plan details page.
Blue Cross Blue Shield Nebraska MA Connect (PPO) is a PPO plan offered by Blue Cross Blue Shield of Nebraska available for enrollment in 2025 to people living in Omaha/ Lincoln Metro Area and Central Nebraska. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Blue Cross Blue Shield Nebraska MA Connect (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue Cross Blue Shield Nebraska MA Connect (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Blue Cross Blue Shield Nebraska MA Connect (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $12.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Blue Cross Blue Shield Nebraska MA Connect (PPO)
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Drug Coverage
The Blue Cross Blue Shield Nebraska MA Connect (PPO) plan has an enhanced alternative drug benefit. The plan has no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, you'll pay a $14 copay for preferred generic drugs at standard, preferred mail, and standard mail pharmacies. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Blue Cross Blue Shield Nebraska MA Connect (PPO) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient and outpatient services, with copays varying by service type, and also covers emergency and urgent care with copays. Preventive services, hearing, vision, and dental services are also included, with specific limits on the number of services covered. The plan also offers coverage for home health, skilled nursing facilities, and other services like home infusion and dialysis.
Inpatient Hospital See details
The Blue Cross Blue Shield Nebraska MA Connect (PPO) plan covers Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute, you'll pay a $400 copay for days 1-4, and no copay for days 5-90, while Inpatient Hospital Psychiatric has a $420 copay for days 1-4, and no copay for days 5-90.
Outpatient Services See details
Outpatient services are covered, with varying copays depending on the service: outpatient hospital services and observation services have a $350 copay, ambulatory surgical center (ASC) services have a $300 copay, and outpatient substance abuse services have a $35 copay for individual and group sessions. Outpatient blood services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization benefits are covered with a $60 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan, with a $350 copay for both Ground and Air Ambulance Services, and no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered under the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan with a $125 copay and no coinsurance, while urgently needed services have a $55 copay and no coinsurance. Worldwide emergency services are also covered, with a $125 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation, and the maximum plan benefit coverage is $50,000.
Primary Care See details
The Blue Cross Blue Shield Nebraska MA Connect (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $35 copay, physician specialist services with a $35 copay, and mental health specialty services with a $35 copay for individual and group sessions. The plan also covers other health care professionals with a copay between $0 and $35, psychiatric services with a $35 copay for individual and group sessions, physical therapy and speech-language pathology services with a $35 copay, additional telehealth benefits with a copay between $0 and $55, and opioid treatment program services with a $35 copay.
Preventive Services See details
Preventive services are covered, including annual physical exams and other services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered. Fitness benefits, specifically memory fitness, and remote access technologies (including web/phone-based technologies and nursing hotlines) are covered.
Hearing Services See details
Hearing Services include Routine Hearing Exams, Fitting/Evaluation for Hearing Aid, and Prescription Hearing Aids. Routine Hearing Exams have no copay, and are limited to one exam per year. Fitting/Evaluation for Hearing Aid is covered once per year. Prescription Hearing Aids (all types) are covered with a copay between $495.00 and $1695.00, limited to two hearing aids per year; Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams with a $35 copay, and coverage for eyewear including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 per year. Routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are each limited to one per year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $35 copay, as well as Oral Exams (2 visits per year) and Dental X-Rays (1 per year), Other Diagnostic Dental Services, Prophylaxis (Cleaning) (2 visits per year), Fluoride Treatment (1 per year), Other Preventive Dental Services, Restorative Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), and Oral and Maxillofacial Surgery. This plan also covers Orthodontic Services, with a maximum benefit of $1500 per year for both in-network and out-of-network services. Adjunctive General Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and no copay, Prosthetics/Medical Supplies - Non-Medicare benefit with no copay and coinsurance for Medicare-covered devices and supplies, and Diabetic Equipment with 0-20% coinsurance depending on the specific service. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for diagnostic procedures/tests with a copay between $30 and $350, and diagnostic radiological services with a copay of at least $195. Outpatient X-ray services have a $25 copay, and therapeutic radiological services have a 20% coinsurance. Lab services are not covered.
Home Health Services See details
Home Health Services are covered by the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan with no copay or coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation, Medicare-covered Pulmonary Rehabilitation, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD), and additional Cardiac Rehabilitation Services are not covered. The plan has a copay for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue Cross Blue Shield Nebraska MA Connect (PPO) plan, but require prior authorization. For days 1-20, there is no copay, days 21-50 have a $196 copay, and days 51-100 have no copay. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for over-the-counter (OTC) items, and a meal benefit, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and other services are not covered. The plan provides up to $50 every three months for OTC items, which includes nicotine replacement therapy and Naloxone. The meal benefit is offered for a chronic illness.
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