Nebraska Total Care covers all of the medical services that are included in the Heritage Health plan. In addition to those, we offer some additional services to help members be well. These are called Value-Added Services.
Some of these services are available to all Nebraska Total Care members. Others are offered to members that meet certain health criteria. Listed below are some of the additional services that we offer.
These adult immunizations are covered every year:
Please note: Beginning January 1, 2019 Tdap will also be covered for adults.
An annual membership for the Boys & Girls Club can be covered for all age-appropriate members.
Breastfeeding has many healthy benefits for babies. Nebraska Total Care wants to help members who are breastfeeding. We will give a free electronic breast pump to any new mother in our plan. We will give:
- One electronic breast pump. Per member, per delivery. For multiples (twins, triplets, etc.) only one pump will be provided.
- Breast pump kit You can ask for your breast pump at the beginning of your 37th week of pregnancy, until 45 days after your baby is born.
Your doctor will need to write a prescription for a breast pump. There are two ways to get a breast pump:
From a Durable Medical Equipment (DME) provider: You can take your prescription to a DME provider in our network. Call Member Services. We can help you find a provider. Not every DME provider has breast pumps. Check before you go to a provider. The DME provider may ask you to complete a form with your member number.
By mail: Your doctor can fax a prescription to provider. They will need to include:
- Your name
- Your Medicaid number
- Your mailing address
- The breast pump billing code- E0603
- Include “lifetime” as the length of time
- Delivery preference- standard or next day
Hospital grade pump rental
In some cases providers may want you to use a hospital grade pump. These pumps can be rented. Your doctor will need to get prior authorization.
Call Member Services for help with this process. Our number is 1-844-385-2192 (TTY: 1-844-307-0342, Relay 711).
The Client Assistance Program (CAP sessions) covers up to five outpatient therapy sessions annually without an Initial Diagnostic Interview. Members can contact providers directly to receive services.
CentAccount Healthy Rewards gives Nebraska Total Care members rewards for completing healthy behaviors.
Earning and using rewards is easy
Step 1: Complete a healthy activity.
Step 2: Reward dollars will be put on your CentAccount rewards card after we receive the claim for your health activity.
Step 3: If it's your first reward, a card will be mailed to you.
Step 4: Spend your reward dollars at one of the following participating stores:
- CVS Pharmacy
- Dollar General
- Family Dollar
You can buy hundreds of items with your card. Here are some of the items you can buy: baby care, healthy groceries, over-the-counter medicines, personal care. For a complete list of items you can buy, log in to your member account. Remember, this card is not a credit card. It already has funds on it. Keep the card after you use it. As you earn more rewards, they will be added to this card.
|$15||For completing a Health Risk Screening within 30 days of enrollment|
|$10||For completing the Health Risk Screening within 90 days of enrollment|
|$10||For signing up on the portal and selecting a primary care doctor within 30 days of enrollment|
|$10||For completing the first primary care doctor’s appointment within 30 days of enrollment|
|$10||For a breast cancer screening (one every two years)|
|$10||For an annual chlamydia screening|
|$10||For an annual cervical cancer screening|
|$10||For the 3rd prenatal doctor visit*|
|$10||For the 6rd prenatal doctor visit*|
|$10||For the 9rd prenatal doctor visit*|
|$10||For a postpartum doctor visit.* (Must be completed within four to six weeks of delivery)|
|$5 per month||For responding to all monthly text questions if you participate in our breastfeeding text program after delivery|
*To be eligible for these rewards, you must notify us you are pregnant prior to having your baby by submitting a completed Notification of Pregnancy (NOP) form. This form is available online. Or you can call Member Services. The phone number is 1-844-385-2192, TTY: 1-844-307-0342, Relay 711. Prenatal visit count begins after we are notified you are pregnant.
After you send us the Notice of Pregnancy you will get information from us in the mail. That information will have postcards for you to fill out. After you go to three prenatal appointments fill out that postcard. Have your doctor sign it.
The postcard is already addressed to us. Put it in the mail. That will tell us you earned your $10 prenatal reward.
|$10||For an annual child well care visit with a primary care doctor (ages 2-21)|
For annual comprehensive diabetes care – must complete all of the following once in the calendar year:
Already earned a reward and received a card?
To activate your card, go to myotccard.com or call 1-888-682-2400. To check your balance, log into your member account.
The card cannot be used to buy alcohol, cigarettes, tobacco, firearms or ammunition. All rewards expire one year (365 days) from the date the reward is added to your card. If you do not use or earn more rewards for 12 months, your card will close. When your card closes, you will lose any remaining balance. Your card expires 60 days after your coverage terminates.
Please note: Beginning January 1, 2019 there will be some changes to the reward program.
|$20||Adult annual exam with a PCP|
|$20||Child Lead Screening blood test before their 2nd birthday|
|$10||Adult Tdap immunization|
|No reward||Prenatal doctor visits|
Nebraska Total Care offers GED testing materials. Contact Member Services for additional information.
New parents whose infant has been admitted to the NICU receive additional supplies and supports from Nebraska Total Care. Services are delivered by Community Health Workers.
Many over the counter drugs are covered if you have a prescription from your doctor. Show your Nebraska Total Care Member ID card at your pharmacy when purchasing OTC medication.
There are other medications and personal care items you can receive by mail. These items are listed on the Over-the-Counter Mail-Order Program Description (PDF).
- Members can receive $30 worth of these items per household each quarter.
- Members are only allowed one order per household per quarter. The quarters are:
- January, February, and March
- April, May, and June
- July, August, and September
- October, November and December
- Remaining balances are not carried over.
- Medication and products cannot be returned.
- Items may only be ordered for the member.
To order these items, call 1-866-768-8490.
Please note: Beginning January 1, 2019 this will no longer be a benefit.
Nebraska Total Care can arrange for an electronic monitoring system for adults who meet certain criteria. Adults must have a serious impairment. And, they must live alone or be alone much of the day.
In an emergency, the person can press a call button to ask for help. The system will ensure that the appropriate person or service agency responds to the call.
Call Member Services if you would like information about this program.
Members who have had an inpatient psychiatric admission should see a behavioral health provider within seven days following their discharge. Adults can receive a gift card and children can receive a teddy bear for attending this follow up appointment.
Nebraska Total Care covers required sports physicals for members ages 4-18. Contact the youth’s PCP to receive services.
Nebraska Total Care provides eligible members vouchers for Weight Watchers participation. You can go to your local meeting or use their online support.
To be eligible, members need to be:
- At least twelve years old
- For children ages 12-16 have a BMI of 25 or higher
- For members age 17 and older have a BMI of 30 or higher
To get the Weight Watchers vouchers your doctor needs to confirm your BMI. They need to have checked you within the last month. The doctors office can call or fax us with your information.
Extensions can be approved if you decrease your BMI by 1 point. Go to your doctor and get a note showing the decrease in your BMI. You will also have to be involved with our Care Management team. To talk to Care Management staff call Member Services. The number is 1-844-385-2192, TTY: 1-844-307-0342, Relay 711. Choose the option to talk to Care Management.
Doctor’s notes can be mailed or faxed to us. Mail to:
Nebraska Total Care
ATTENTION: Care Management
2525 N. 117th Avenue, Suite 100
Omaha, NE 68164
The fax number is: 1-844-340-4888.
When you meet these requirements we will send you another set of vouchers. We will stop giving extensions when your BMI makes you not eligible for the program. If you stop participating in Care Management we won’t give more extensions.
PLEASE NOTE: Beginning on January 1, 2019 the Weight Watchers benefit will will be for online supports only. In person meetings will not be covered. Individuals who qualify will be given a voucher for 3 months of online support. Extension can still be approved for people who qualify.
Nebraska Total Care will pay for one 3 month membership for all of our members.
To get an extension of the YMCA membership you must be involved in Care Management. If you want an extension please call us. The number is 1-844-385-2192, TTY: 1-844-307-0342, Relay 711. Choose the option to talk to Care Management.
If you stop participating in Care Management we won’t give more extensions.
Please note: Beginning January 1, 2019, a doctors note may be accepted for a YMCA extension instead of involvement in Case Management in some cases.