Nebraska's plan for two-tier Medicaid expansion program suffers second blow

[Omaha Steve]

Source: AP

By Martha Stoddard

LINCOLN — Nebraska’s top Medicaid official announced Thursday that a second major part of the two-tier Medicaid expansion program has been put on hold.

The decision means that low-income, working-age adults — the bulk of those covered under the expansion — will have no way to receive dental, vision and over-the-counter medication benefits for the foreseeable future.

Those benefits are automatically part of traditional Medicaid. But state officials had planned to require that expansion patients meet six wellness and personal responsibility goals to qualify for the benefits. The qualification period was to start April 1.

Now, State Medicaid Director Kevin Bagley said federal officials have indicated that they have concerns about the plan and are unlikely to approve it in time for an April launch. That leaves the future of the two-tier plan, called Heritage Health Adult, up in the air.


Read more: https://omaha.com/news/state-and-regional/govt-and-politics/nebraskas-plan-for-two-tier-medicaid-expansion-program-suffers-second-blow/article_4d82e09c-76fe-11eb-9306-67b3eba4a03a.html

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Nebraskan's had to petition to get expanded Medicaid on the ballot and passed. The state keeps dragging it's feet.

[PoindexterOglethorpe]

1. I'd be interested to know what the six wellness and personal

responsibility goals are.

[jxla]

2. Wellness and Personal Responsibility Goals

https://enroll-ne.org/medicaidexpansion
Prime coverage includes vision and dental services and over-the-counter medicine, while Basic does not. People who are pregnant, those who are 19-20 years old, and those who are considered “medically frail” (having certain chronic health conditions) will receive Prime coverage. Everyone else will receive Basic coverage.

More information is available in our factsheet.
https://enroll-ne.org/download/3326/

To get Prime coverage, a person who starts in Basic coverage would need to meet these wellness requirements:
1. Participate in health and social determinants screenings upon
enrollment and every year after enrollment;
2. Attend a qualifying health visit every year;
3. Select a primary care doctor;
4. Do not miss more than 3 appointments in a 6-month period;
5. Maintain commercial medical coverage, if possible; and
6. Tell DHHS of any changes in status within 10 days of the change.

[PoindexterOglethorpe]

3. Thank you.