State Detail

Nebraska

4 plans reporting · CY 2025

Across 4 plans reporting in Nebraska, standard prior authorization denial rates range from 13.7% to 24.2%, averaging 18.6%. Among plans reporting appeal outcomes, 71.4% of appealed denials are overturned. All data is from mandatory CMS-0057-F disclosures for calendar year 2025.

Plan Comparison

		Standard												Expedited
Plan	Org	Requests	Approved	Denied	Appr %	Denial % ▼	Appeals	Overturn %	Denied Appeal %	Appr Ext %	Denied Ext %	Mean Days	Med Days	Requests	Approved	Denied	Appr %	Denial %	Appeals	Overturn %	Denied Appeal %	Appr Ext %	Denied Ext %	Mean Days	Med Days	Source
Centene Corporation
Nebraska Total Care MedicaidMedicaid MCO	Centene Corporation	53,396	40,497	12,899	75.8%	24.2%	1,429	55.7%	44.3%	0.1%	99.9%	4.0	3.0	1,253	907	346	72.4%	27.6%	48	56.3%	43.8%	0.0%	100.0%	1.0	1.0	View source ↗
Ambetter Health (Nebraska Total Care)Exchange Plans	Centene Corporation	36,793	28,533	8,260	77.5%	22.4%	996	36.0%	64.0%	0.0%	100.0%	4.0	2.0	1,605	1,365	240	85.0%	14.9%	68	44.1%	55.9%	2.2%	97.8%	1.0	1.0	View source ↗
Wellcare Medicare Advantage (H1215)Medicare Advantage	Centene Corporation	2,770	2,376	394	85.8%	14.2%	48	95.8%	4.2%	0.0%	0.0%	4.0	2.0	166	148	18	89.2%	10.8%	4	100.0%	0.0%	0.0%	0.0%	0.0	1.0	View source ↗
Wellcare Medicare Advantage (H1395)Medicare Advantage	Centene Corporation	5,566	4,801	765	86.3%	13.7%	95	97.9%	2.1%	0.0%	0.0%	4.0	2.0	260	228	32	87.7%	12.3%	10	100.0%	0.0%	0.0%	0.0%	0.0	0.0	View source ↗