Nebraska Health Insurance Marketplace Guide

To qualify for health coverage through the Nebraska Marketplace, you must: ⁶

• Live in Nebraska
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare⁷

Eligibility for financial assistance in the form of premium subsidies and cost-sharing reductions depends on your household income.

In addition, to qualify for financial assistance with your Marketplace plan you must: ⁸

• Not have access to an employer’s health coverage that’s deemed affordable. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁹
• If married, file a joint tax return with your spouse.¹⁰
• Not be able to be claimed by someone else as a tax dependent.¹⁰
• Starting in 2027, if you’re not a U.S. citizen, you’ll need to be a lawful permanent resident (LPR), Cuban-Haitian entrant (CHE), or COFA migrant to qualify for Marketplace subsidies. All other immigration statuses will no longer be eligible for subsidies. ¹¹

Nebraska’s open enrollment period for 2027 coverage begins November 1, 2026 and ends January 15, 2027. Plans must be selected by December 15 to have a January 1 effective date.¹²

(A federal rule change that would have shortened the open enrollment period was vacated by a court, and is not taking effect in the fall of 2026.)¹²

Outside of the annual open enrollment period, you may still be able to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage.

Here’s a guide to the special enrollment periods that will let you enroll or make a plan change outside of the annual open enrollment period.

To enroll in an ACA Marketplace plan in Nebraska, you can:

• Visit HealthCare.gov to compare the health plans that are available in your area, determine whether you’re eligible for financial assistance, and enroll in coverage during open enrollment or during a special enrollment period.
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator, or certified application counselor.
• Enroll in a Marketplace plan via an approved enhanced direct enrollment entity (EDE).¹³ Note that EDEs can also help you enroll in off-exchange coverage and even non-ACA-compliant coverage, so be clear about wanting a Marketplace plan, as that’s the only way you can qualify for financial assistance.

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

87% of Nebraska Marketplace enrollees saved money on 2026 premium payments, amounting to an average savings of $674/month. Subsidy-eligible enrollees paid an average of $120 per month for health coverage (including those who didn’t qualify for subsidies, the overall average net premium was $217/month).³

The Affordable Care Act also provides income-based assistance with out-of-pocket costs, if the enrollee’s household income isn’t more than 250% of the poverty level and they select a Silver-level plan through the Marketplace. This benefit is called cost-sharing reductions (CSR).¹⁴ During the open enrollment period for 2026 coverage, about a quarter of Nebraska Marketplace enrollees selected plans with CSR benefits.³

Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you. This is still true even though federal subsidy enhancements expired at the end of 2025. Most Marketplace enrollees still qualify for subsidies that offset a large portion of their monthly premiums. But the subsidies do not cover as much of the premiums as they did in 2025, and households with income above 400% of the federal poverty level lost their subsidies altogether as of 2026.

Learn more about how income is calculated under the ACA, and how certain tax deductions can lower your income and potentially change your subsidy eligibility.

Source: CMS.gov³

Nebraska expanded Medicaid under the ACA starting in late 2020. This means adults under age 65 with household income up to 138% of the poverty level can qualify for Medicaid in Nebraska. Medicaid enrollment is available year-round for eligible applicants.

Five insurers will offer coverage for 2027 in the Nebraska Marketplace,¹⁵ all of which also offered plans for 2026:¹⁶

• Blue Cross Blue Shield of Nebraska
• Medica
• Ambetter Health/Celtic
• Oscar Health
• UnitedHealthcare

Nebraska Total Care enrollees were transferred to similar plans offered by Ambetter Health (Celtic) for 2026.¹⁷ But those who would prefer a different plan could select one during open enrollment.

The following average premium changes have been proposed for 2027 by the health insurance companies that offer coverage in Nebraska’s individual market (calculated before any subsidies are applied):¹⁵

Source: RateReview.HealthCare.gov¹⁵

The weighted average proposed rate increase amounts to about 13.3%, before any subsidies are applied.¹⁸

For perspective, here’s a summary of how average full-price (pre-subsidy) premiums have changed over time in Nebraska’s individual/family health insurance market:

• 2015: Average increase of 10%¹⁹
• 2016: Average increase of 16.2%²⁰
• 2017: Average increase of 34.8%²¹
• 2018: Average increase of 31%²² (only one insurer remained at this point)
• 2019: Average increase of 2.2%²³
• 2020: Average decrease of 6.9%²⁴ (a second insurer joined)
• 2021: Average decrease of 2.6%²⁵
• 2022: Average increase of 8.6%²⁶ (two more insurers joined)
• 2023: Average increase of 0.4%²⁷ (still four insurers, but with one exit and one new entrant)
• 2024: Average increase of 4.7%²⁸
• 2025: Average increase of 4%²⁹
• 2026: Average increase of 29.1%³⁰

128,492 people enrolled in health plans through Nebraska’s ACA Marketplace during the open enrollment period for 2026 coverage.³¹

This was a decline from the record-high enrollment the year before (see chart below). Enrollment had grown each year from 2022 through 2025, driven in part by the American Rescue Plan (ARP) making the ACA’s premium subsidies more substantial. Under the ARP – extended through 2025 by the Inflation Reduction Act – subsidies were larger and more widely available than had been before 2021.³² But those subsidy enhancements expired at the end of 2025, causing Nebraska Marketplace enrollment to decline for 2026 (as was the case in most states).

The record-high enrollment in 2024 and 2025 was also partially due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in 2023 after a three-year pause. CMS reported that nearly 24,000 people transitioned from Nebraska Medicaid to a Marketplace plan during the unwinding period.³³

Source: 2014,³⁴ 2015,³⁵ 2016,³⁶ 2017,³⁷ 2018,³⁸ 2019,³⁹ 2020,⁴⁰ 2021,⁴¹ 2022,⁴² 2023,³² 2024,⁴³ 2025⁴⁴ 2026³¹

HealthCare.gov
The federal government operates the exchange in Nebraska.

State Exchange Profile: Nebraska
The Henry J. Kaiser Family Foundation overview of Nebraska’s progress toward creating a state health insurance exchange.

Nebraska Department of Insurance
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in Nebraska.
(877) 564-7323 / Toll Free: (800) 833-7352