Medicaid for nursing home and home care in Nebraska

Who qualifies

You must be 65 or older, or blind or disabled, and live in Nebraska. For nursing home care or the Aged and Disabled (AD) Waiver, you must also meet Nursing Facility Level of Care. That means you need help with daily activities, medical treatment or supervision the way a nursing home resident does.

Income: the share of cost

Nebraska uses a "medically needy" system. If your income is above the regular Medicaid limit, you can still qualify when your medical costs are high. A nursing home costs far more than most people's income, so most people who need nursing home care meet this rule.

In a nursing home, DHHS starts with your monthly income and subtracts:

• your personal needs allowance ($75 a month; if you are a veteran, a $90 VA personal needs payment is not counted),
• money for a spouse or dependent family at home, if any,
• health insurance premiums and medical bills that Medicaid does not pay,
• guardian or conservator costs of up to $10 a month, plus court-ordered accounting and bonding fees,
• for up to six months, the cost of keeping up your home (rent or mortgage, utilities, taxes, insurance) if you may return home.

What is left is your share of cost. You pay it to the nursing home each month, and Medicaid pays the rest.

What counts and what does not

• Not counted: your home, one car, business property such as farm machinery, and an irrevocable burial fund.
• Counted: cash, checking and savings, other real estate, stocks, bonds and certificates of deposit, IRAs and 401(k)s, annuities, trusts, and the cash value of life insurance.
• Annuities: DHHS must be named as the remainder beneficiary of any annuity.
• Gifts and transfers: The application asks about anything you or your spouse sold, traded or gave away in the past 60 months (five years). Giving away assets to qualify can delay coverage.

Home equity

Federal law lets a state refuse long-term care to a person whose home equity is very high. This does not apply if your spouse, a child under 21, or an adult disabled child lives in the home. The limit goes up each year. Ask DHHS for the current amount.

If you are married

When one spouse needs long-term care and the other stays at home, Nebraska protects some money for the spouse at home.

• Savings: The spouse at home can keep a share of the couple's resources, at least $32,532 and at most $162,660 in 2026.
• Income: If the spouse at home has little income, part of your income can go to them. The most a spouse at home can be raised to is $4,066 a month in 2026. DHHS works out the exact amount based on housing and utility costs.

What Medicaid pays for

Nursing home care

Medicaid pays the nursing home's Medicaid rate after your share of cost. It also covers doctor visits, drugs and other Medicaid services.

Aged and Disabled (AD) Waiver: care at home or in assisted living

The AD Waiver helps you stay at home or live in an assisted living facility instead of a nursing home. Services include:

• personal care (help with bathing, dressing and eating),
• chore help, companion care and home-delivered meals,
• adult day health,
• respite care so a family caregiver can take a break,
• home and vehicle changes, and assistive technology,
• emergency response buttons,
• transportation to community services,
• "Home Again" help with set-up costs when you move from a nursing home back to your own home,
• Supported Residential Living (assisted living).

In assisted living, you pay room and board and any share of cost. For 2026, Nebraska's standard for assisted living waiver room and board is $919 a month, and you keep $75 for personal needs.

A Service Coordinator helps you make a care plan and find providers. If you are 65 or older, this is usually your Area Agency on Aging.

How to apply

1. Apply for Medicaid. Go to iserve.nebraska.gov, or call 1-855-632-7633 (Lincoln 402-473-7000, Omaha 402-595-1178), 8 a.m. to 5 p.m. weekdays. You can also visit a local DHHS office. If you are 65 or older, you also fill in the Supplemental Application (form MILTC-63). You can mail paper forms to DHHS, Medicaid Eligibility Program, PO Box 2992, Omaha, NE 68103-2992.
2. For the AD Waiver, send a separate waiver application. Apply through iServe or use form DD-10. Mail it to HCBS Waiver Eligibility, PO Box 98947, Lincoln NE 68509-8947, email [email protected], or fax 402-328-6257. To get a paper copy mailed to you, call 1-877-667-6266.
3. Level of care assessment. Once you have Medicaid, DHHS calls you to schedule an assessment of your daily needs, health, medicines and home.
4. Make your care plan. Services start once you are approved and your plan names who will provide each service.

Bring or send proof of income, bank and investment accounts, life insurance, burial funds, vehicles, and any property sold or given away in the past five years. If you cannot get a paper, tell your worker who can supply it.

After you apply

• Report changes within 10 days, such as a move, a change in income or a change in your resources.
• Appeals: If you disagree with a decision, you can ask for a fair hearing within 90 days of the action. If you ask within 10 days of the notice date, you can usually keep your current benefits until the decision.
• Estate recovery: Nebraska may seek repayment from your estate for Medicaid paid after age 55. It waits until both you and your spouse have died, and does not collect if you leave a child under 21 or a blind or disabled child. Nebraska does not put liens on your property for this. Questions: 402-471-1614.

Things people miss

• A waiver application is separate from the Medicaid application. You may need to file both.
• Assisted living is not free on the waiver. You still pay room and board.
• Being away from home in a nursing home does not by itself mean you lose your homestead exemption on property taxes if you plan to return.

Free help

• Aging and Disability Resource Center (ADRC): 1-844-843-6364.
• Area Agencies on Aging: Your local agency can be your AD Waiver Service Coordinator. Find yours through the ADRC.
• Nebraska SHIP: Free Medicare counseling, 1-800-234-7119.
• AD Waiver questions: 1-877-667-6266.

See also paying for a nursing home, Medicare and all benefits in Nebraska.

Phone numbers: Free help lines for Nebraska agencies

Check what you may qualify for