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BCBSNE Nebraska Centers of Excellence
Nebraska Centers of Excellence
Beginning January 1, 2019, Blue Cross Blue Shield Nebraska (BCBSNE) will waive deductible and coinsurance for the surgical facility charges for total knee or hip replacement surgeries performed at one of the Nebraska Centers of Excellence below.
We believe in helping you receive affordable, high-quality care. As part of our commitment to you, we have established Nebraska Centers of Excellence across the state for total knee or hip replacement surgeries resulting in significant cost savings to you.
These facilities have met or exceeded our high quality of care and costs standards.
Kearney Regional Medical Center – Kearney Regional Medical Center offers diagnostic and therapeutic services covering the spectrum of medical and surgical specialties.
Lincoln Surgical Hospital – Founded in 1994, 11,000 surgeries a year are performed at this physician-owned facility. Lincoln Surgical Hospital ranks among 250 surgical specialty hospitals in the United States and is the only multi-specialty hospital in Nebraska.
1710 S. 70th Street, Lincoln, NE
OrthoNebraska Hospital – Formerly known as Nebraska Orthopaedic Hospital upon its opening in April 2004, OrthoNebraska is the region’s first hospital dedicated to the complete care and treatment of the orthopedic patient. The hospital has recently been named by U.S. News and World Report as the top hospital for orthopedics in Nebraska and was also recognized by the publication as high performing in both the total hip and total knee replacement categories.
2808 S 143rd Plaza, Omaha, NE
Midwest Surgical Hospital – Opened in 2008, Midwest Surgical Hospital has been rated as “One of the 82 physician-owned hospitals to know in America,” by Becker’s Hospital Review. The hospital has also received the Edge Survey Apex Quality Award for recognition of excellence in overall patient satisfaction, 2012-2014.
7915 Farnam Drive, Omaha, NE
To have the deductible and coinsurance waived, your surgery and health plan must meet the following requirements:
- Nebraska Center of Excellence must be in-network for your plan
- Only inpatient total knee or hip replacement surgeries qualify for this benefit
- Facility approves your surgery (higher risk patients maybe referred to another facility)
Please note, if you have a qualified high-deductible health plan, only coinsurance will be waived if all other requirements are met.
This program does not apply to BlueCard members.
Frequently Asked Questions
What is a Center of Excellence?
A Nebraska Center of Excellence is a surgical facility that has demonstrated high-quality through low readmission and infection rates, high patient satisfaction and lower costs for total knee and hip replacements.
What surgical facilities are included in the program?
- Kearney Regional Medical Center
- Lincoln Surgical Hospital
- Midwest Surgical Hospital
- OrthoNebraska Hospital
What requirements need to be met in order to have the deductible and coinsurance waived for the surgical facility?
This program covers inpatient total knee and hip replacement surgeries only at an in-network Nebraska Center of Excellence. Deductibles and coinsurance will be waived for PPO plans and coinsurance will be waived on qualified high deductible health plans for the surgical facility charges only. You will be responsible for deductible, coinsurance and copays (if applicable) for all other costs related to your surgery.
How are Centers of Excellence different from Blue Distinction providers?
Nebraska Centers of Excellence surgical facilities do not have an ICU and emergency room, both of which are required to qualify as a Blue Distinction Center. The exception is Kearney Regional Medical Center, as it meets requirements for both.
What surgeries are covered?
Total knee and hip replacement surgeries are the only procedures covered under the Nebraska Center of Excellence program. All other surgeries will be subject to the terms your health plan.
Do the waived deductible and coinsurance amounts apply to other fees like lab work, anesthesiologist, surgeon fees, etc.?
No. We will waive deductible and coinsurance amounts for the approved Nebraska Center of Excellence inpatient surgical facility charges only. You will be responsible for any deductible, coinsurance and copay amounts for the other services related to your surgery.
What provider networks does this program apply to?
At this time, this program is available for the plans using NEtwork Blue and Premier Select BlueChoice networks. Members covered under BluePrint health are not eligible for this benefit, as the Nebraska Centers of Excellence are out of network.
What if I have met my deductible for the year?
If your deductible has been met for the year, the program will cover any applicable coinsurance amounts for surgical facility charges only.
Could the Nebraska Center of Excellence surgical facility refer me to another location for my surgery?
Yes. The surgical facility could determine that your health conditions warrant additional safety measures and you would be better managed at another location with an emergency department and/or intensive care unit. If this occurs, standard plan benefits would apply.
What if my doctor cannot perform surgery at a Nebraska Center of Excellence facility?
Nebraska Centers of Excellence on this program are open to all doctors. Your doctor would need to contact the facilities to complete the necessary requirements.
Will there be a penalty if I do not use a Center of Excellence?
No. You will not be penalized for using another facility. However, you will be responsible for all deductible, coinsurance and copay amounts.
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