Ranked 15 of 15 states · median $875/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old bookkeeper in Nebraska pays a median $875/month for a Silver plan before subsidies — the most expensive of the states covered here. The cheapest plan in the state is $640 from Blue Cross and Blue Shield of Nebraska in Burt. On cheapest Silver at age 27, Nebraska ranks 13 of 15 for this occupation.
Screen-based work skews younger and healthier, which is exactly the profile a high-deductible plan is built for. The risk is real — you carry the first several thousand dollars yourself — so the tables below show what a healthy buyer pays across the age curve, not just at 40.
Occupational context: Repetitive stress and eye strain from screen work.
None of that changes your price. ACA plans in Nebraska are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a bookkeeper in one Nebraska county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Hooker | $826 | Ambetter Health | $6,000 | 5 |
| Perkins | $826 | Ambetter Health | $6,000 | 5 |
| Dodge | $640 | Blue Cross and Blue Shield of Nebraska | $6,000 | 5 |
| Cass | $694 | Ambetter Health | $6,000 | 5 |
| Pawnee | $694 | Ambetter Health | $6,000 | 5 |
| Buffalo | $755 | Blue Cross and Blue Shield of Nebraska | $6,000 | 5 |
The spread across just these six is $186/month — $2,232 a year for the same metal tier. Statewide the range runs $640 to $1,460. Coverage by County publishes all 93 Nebraska counties individually.
| Nebraska — the age curve | 2026 |
|---|---|
| Cheapest Silver @27 | $525 |
| Cheapest Silver @40 | $640 |
| Cheapest Silver @60 | $1,359 |
| Cheapest Bronze @40 | $573 — UnitedHealthcare |
| Bronze deductible | $10,600 |
| Lowest deductible in state | $500 |
A 27-year-old bookkeeper in Nebraska starts at $525; the same plan class at 60 starts at $1,359 — roughly 2.6× as much. If a Bronze plan here is HSA-qualified, the deduction plus low claim volume usually beats Silver on total annual cost. Confirm HSA eligibility on the plan document, not the metal tier.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 5,902 plan records across 93 Nebraska counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Texas ($807), North Carolina ($828), Arkansas ($828).
Side-by-side: Nebraska vs North Carolina · Nebraska vs Arkansas
This only matters if you can actually choose — you buy in the state where you live, not where you work. If you are a bookkeeper who moved this year, that move is a qualifying life event and opens a special enrollment period.
Self-employed Bookkeepers in Nebraska typically deduct: Software subscriptions, home office, continuing education. Health premiums sit separately, above the line under IRC §162(l), and only when neither you nor a spouse could have joined an employer plan — eligibility disqualifies you even if you declined the coverage.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in Nebraska is $640 per month from Blue Cross and Blue Shield of Nebraska, with a state median of $875. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
Yes. Plan types filed for 2026: EPO, PPO.
Nebraska ranks 15 of 15 states covered here, at a median $875 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
This page compares states. For Nebraska specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Bookkeepers in Nebraska and a blog covering deductibles, subsidies and special enrollment.