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Thank you for choosing Nebraska Total Care as your health plan.

Nebraska Total Care works with Nebraska Medicaid. We provide health services for the Heritage Health program. With your doctor, we help you manage your care and health. Our job is to make sure you get the services you need to be healthy.

There is important information that you need to know. We can send you hard copies of everything you need. We can send information in any language, including Braille.

  • Use the Health Insurance Portal mobile app to get connected with Nebraska Total Care. Stay informed on the go. Our mobile app is a convenient and secure tool, to help you take control of your health.
  • My Health Pays® is our healthy rewards program. Starting January 1, 2027, you must sign up for the program to keep earning rewards. If you don’t sign-up for the program, you won’t be able to earn new rewards – even if you complete rewardable healthy activities.

If you need help with any of these changes you can call us. The phone number is 1-844-385-2192 TTY: 711.

You can request a Handbook at no cost at least one time each year. There is a lot of information in the Handbook. It includes:

  • What is the Case Management Program
  • How the Utilization Management Team makes decisions about your health
  • Immunization schedule for children, teenagers and adults
  • Appointment access standards

If you log into the Member Portal you can get health information that is just about you and/or your dependent.

  • There is a Health Risk Screening that you can fill out. This will help us make sure your health needs are met.
  • There is a Notice of Pregnancy. We have tools to help you if you are pregnant.
  • There is a Wellness Assessment Roadmap. You can complete this to guide you to better health and wellness.
  • There are wellness tools to help you with your goals.

As a member you have Rights and Responsibilities. Nebraska Total Care wants to always respect your rights. We expect our providers to respect your rights.

These are some of the things that you can find on our website:

  • How to contact us with questions about your benefits
  • Your rights as a member. This includes all of your rights given by the federal government.
  • Your responsibilities as a member
  • How to file a grievance and ask for an appeal.
  • How to ask for a State Fair Hearing if you disagree with our decisions
  • Pharmacy benefits, policies and approved medications
  • Member newsletters
  • Information about providers. You can request a Provider Directory at no cost at least one time each year.
  • Safety resources to help you work with your doctor
  • Resources to help answer your health questions
  • A summary of our Quality Program. This includes information about our goals, processes, and outcomes.
  • Our policies about clinical and pharmacy decisions

Nebraska Total Care is a covered entity as defined and regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This means that we have to follow the law about your privacy.

Through our Member Advisory Committee, we give members like you the chance to share your thoughts and ideas with us. The Member Advisory Committee meets four times a year.

At these meetings, you can talk about the services you get. You can tell us how we are doing. You may ask questions or share any concerns. Would you like to join? Just call Member Services.

The Whole You podcast is an educational resource to help our members engage the healthcare system, access their benefits, advocate for their needs, and get the support they need for their best health. Subscribe on Amazon, Apple, Spotify, iHeart Radio, or wherever you listen to podcasts.

Use the Health Insurance Portal mobile app to get connected with Nebraska Total Care. Stay informed on the go. Our mobile app is a convenient and secure tool, to help you take control of your health.

Schedule an appointment with your Primary Care Provider (PCP) for a physical exam at least once every year. This is important even if you feel healthy. If you need help making an appointment with your doctor, call Members Services. Take your Member ID card to all of your medical appointments. We will tell you any time your provider leaves our network.

We will tell you any time your provider leaves our network.

Wellness visits are an important part of staying healthy. These visits allow you and your doctor to check for early signs of health problems before they become serious. These visits are covered by Nebraska Total Care and should happen at least once a year. They can include:

  • Screenings: Routine checks like blood pressure, cholesterol, and diabetes tests.
  • Immunizations: Vaccines to protect against diseases like the flu or measles.
  • Lab Work: Blood tests to help detect conditions like high cholesterol or diabetes.
  • Lifestyle Advice: Guidance on healthy habits such as diet, exercise, and stress management.

Wellness visits help you stay on top of your health, making it easier to prevent or catch problems early. These visits are a great opportunity to talk to your doctor about your health goals.

There are a few times when disenrollment from Nebraska Total Care is possible. This means you can change health plans. Those are:

  • During the first 90 days that you have the plan
  • During the enrollment period at the end of every year
  • If losing your Medicaid makes you miss open enrollment
  • You move out of Nebraska

You can disenroll at other times for other reasons, including but not limited to:

  • Poor quality of care
  • Lack of access to services that are covered by the plan
  • Lack of access to providers who have experience with your healthcare needs

You may ask to disenroll (with or without cause) in writing or by calling the Enrollment Broker.  The phone number is 1-844-385-2192 TTY: 711. Learn more about your disenrollment rights and how you can disenroll from Nebraska Total Care.

Nebraska Medicaid reviews all Medicaid eligibility once per year or any time you report a change to see if you still qualify for Medicaid coverage. Nebraska Medicaid will be reviewing eligibility again to make sure you still qualify for coverage.

Has your contact information changed? 

To see if your contact information is up to date or to report a change to Nebraska Medicaid you can: 

Reviewing your Medicaid eligibility:

If you have an online account with iServe Nebraska, you can use the 'Medicaid Renewal' to see when your next renewal is due. Or you can contact Nebraska Medicaid as listed above.

Reporting important changes:

You must report any changes that might affect your coverage to Nebraska Medicaid. Please report changes for both you and other people with Medicaid coverage in your household, like:

  • If you or someone with Medicaid in your house moved in the last 3 years.
  • If you or someone with Medicaid in your house had an income or resource change.
  • If your household changes. For example, someone with Medicaid in your household marries or divorces, becomes pregnant, or has or adopts a child.

Questions?

We are happy to help meet your health care needs. If you want help or want to tell us ways we can improve, please call Member Services. The phone number is 1-844-385-2192 TTY: 711. 

We are required to follow all federal rules. We will always follow rights given to you by federal guidelines. Nebraska Total Care does not limit coverage of services based on moral or religious objections.