Ranked 15 of 15 states · median $875/mo · CMS PY2026
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A 40-year-old speech therapist 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 median Silver premium, Nebraska ranks 15 of 15 for this occupation.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Vocal strain; infectious exposure in clinical settings.
Worth being clear about what this does and does not affect: a carrier in Nebraska cannot ask what you do for a living, cannot charge a speech therapist more than a librarian of the same age in the same ZIP, and cannot exclude anything you were already treated for. Occupation only tells you which plan structure to shop for.
Premium is set by rating area, so a speech therapist 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 |
|---|---|---|---|---|
| Buffalo | $755 | Blue Cross and Blue Shield of Nebraska | $6,000 | 5 |
| Boyd | $778 | Ambetter Health | $6,000 | 5 |
| Dakota | $778 | Ambetter Health | $6,000 | 5 |
| Greeley | $778 | Ambetter Health | $6,000 | 5 |
| Loup | $778 | Ambetter Health | $6,000 | 5 |
| Polk | $778 | Ambetter Health | $6,000 | 5 |
The spread across just these six is $22/month — $268 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 — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $875 |
| Cheapest Silver @40 | $640 — Blue Cross and Blue Shield of Nebraska (Burt) |
| Most expensive Silver @40 | $1,460 |
| Carriers filing in the state | 5 — Ambetter Health, Blue Cross and Blue Shield of Nebraska, Medica, Oscar |
| Plan types available | EPO, PPO |
| Counties with only one carrier | 0 of 93 |
Nebraska has 5 carriers filing and 0 of 93 counties served by a single issuer. For a speech therapist with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
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 speech therapist who moved this year, that move is a qualifying life event and opens a special enrollment period.
Self-employed Speech Therapists in Nebraska typically deduct: Licensing, materials, malpractice insurance, CE. 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.
It cannot happen on an exchange plan. Rating in Nebraska uses four inputs only: age, ZIP code, tobacco use and how many people are on the policy. Trade, injury history and pre-existing conditions are all excluded from pricing by law.
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.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation is above the cliff in all 21 states reported.
What this figure is. It is the median annual wage BLS reports for Speech-Language Pathologists (SOC 29-1127) in Nebraska. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed speech therapist. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
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 Speech Therapists in Nebraska and a blog covering deductibles, subsidies and special enrollment.
Nebraska has 5 carriers filing across 93 counties right now. That list is rebuilt every year, so what you can choose from in November may not match what you see today — and for a speech therapist buying your own cover, who stays matters more than the headline rate.
Rate filings for 2027 point to roughly a 15% median increase nationally, from −1% at one end to 54% at the other. Nebraska has not finalised, so treat exact local 2027 pricing as unavailable rather than unknown.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in Nebraska and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
Check before renewing: PPOs are sold in 34 of Nebraska’s 93 counties, not all. Whether yours has one decides how much out-of-network care is covered — usually a bigger question for Speech Therapists than the monthly figure.
Nothing about 2027 is urgent yet, which is exactly why it is worth ten minutes now. Come November you will be choosing between Nebraska’s carriers under a deadline; today you can do it without one.
Give me a ZIP and I will tell you three things:
Two Speech Therapists on opposite sides of Nebraska can be quoted very different premiums for the same plan. Your ZIP is what decides it.