Governor Pete Ricketts held a briefing to announce that the State’s expanded Medicaid program, Heritage Health Adult, has been approved to offer enhanced benefits to qualifying beneficiaries. Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS), joined the Governor to ceremonially sign a letter of approval for the State of Nebraska’s Section 1115 demonstration waiver.
CMS Administrator Verma described the Trump Administration’s philosophy of empowering states to innovate, as opposed to expecting them to follow a single model. She congratulated the State of Nebraska on the waiver approval and on the design of the Heritage Health Adult program.
Department of Health and Human Services CEO Dannette R. Smith noted that the coronavirus pandemic delayed approval of the wavier, which was originally anticipated to be in place by the October 1, 2020 launch of Medicaid expansion. The waiver will now take effect April 1, 2021. CEO Smith reported that over 14,000 Nebraskans have been determined eligible for benefits under the new Heritage Health Adult plan.
With the approval of the waiver, able-bodied adults within the plan will be able to qualify for Prime benefits to cover dental services, vision services, and over-the-counter medications. Eligibility for these benefits is earned by meeting wellness, personal responsibility, and community engagement qualifications. Wellness qualifications include completing a health risk screening and making annual health visits. The personal responsibility qualification involves attending appointments with a health care provider, keeping any employer-sponsored health insurance, and reporting important life changes in a timely manner. Community engagement activities include working, volunteering, or studying for a degree or certificate. The community engagement component will be added to the Heritage Health Adult program in 2022.
DHHS Deputy Director of Policy and Regulations Nate Watson overviewed the timeline for rolling out Prime benefits to qualifying beneficiaries, which will occur in stages. Answers to frequently asked questions on the Prime benefits package, including information on eligibility and timing, are available by clicking here.