Frequently Asked Questions

Heritage Health Frequently Asked Questions

1. Can I change my health plan?

After your health plan begins you will have 90 days to change it. After that 90 day timeframe, you may only change your health plan during the Open Enrollment period.

2. Can I change my PCP?

You may change your primary care provider at any time. You will need to contact your health plan to do so.

3. What is open enrollment?

Open Enrollment is the period when members can change plans without State approval. Open Enrollment occurs annually towards the end of each calendar year. You will receive reminder letters alerting you of these time periods.

4. What if I need to change my health plan outside the Open Enrollment period?

Plan transfers made outside of the Open Enrollment period will only be granted if the State approves a “for-cause” reason.

5. What is "for-cause"?

This is a State-approved reason to change plans outside your Open Enrollment period. Some examples of “for-cause” reasons are poor quality of care given by your medical provider (e.g., not enough treatment for a medical condition, refusal to give referrals for a second opinion), lack of access to covered medical services and lack of access to medical providers.

6. I am on Nebraska Medicaid (fee-for-service). I received a letter that stated I must choose a health plan. Can I choose to stay on fee-for-service Medicaid?

No. You will need to select a new health plan.

7. I have a special health care need. Are there special plans that will cover my needs?

All health plans cover people with special health care needs. You get to choose the health plan that best meets your individual and your family’s needs.

8. I am pregnant and on Medicaid. How do I enroll my baby in my health plan?

Your baby is pre-enrolled in your health plan during prenatal care. After the birth of your baby, if you would like to select a different health plan for the baby, call the Heritage Health Enrollment Center within 90 days of birth to speak with a Choice Counselor.

9. If I move, do I have to switch to a new health plan?

Your health plan is state-wide and will not change if you move within Nebraska. As a reminder, if you move you need to contact ACCESSNebraska to report your change of address.

10. Can I still see the same medical professional?

Each plan has its own network of providers, which may include your current providers. If you need assistance searching through their networks, contact a Choice Counselor.

11. How do I get materials if I don’t have access to the Website?

All materials are mailed out but if you have misplaced your Enrollment materials, reach out to a Choice Counselor at 1-888-255-2605. We will be happy to assist you.

12. When is an authorized representative form needed for Heritage Health?

An authorized representative form is needed for an individual not listed as the head of household who wants to speak on behalf of or make a health plan change for a Heritage Health member.

13. How do I change a health plan or speak on behalf of a Heritage Health member if I am an authorized representative?

Download the Designation of Authorized Representative Form from the website, complete, sign and date the form and return it to the Heritage Health Enrollment Center via mail or fax. The form will be kept on file so that you can speak or take action on behalf of a Heritage Health member at any time.