Nebraska Medical Assistance Program (Nebraska Medicaid ) Long Term Care Programs, Benefits & Eligibility Requirements

Summary
Medicaid’s rules, benefits and name can all vary by state. In Nebraska, Medicaid is also called the Nebraska Medical Assistance Program. This article focuses on Nebraska Medicaid Long Term Care for seniors, which will pay for care in nursing homes, beneficiary’s homes, assisted living residences and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers or ABD Medicaid. These programs are different from the regular Medicaid that is for financially limited people of all ages.

 

Nebraska Medicaid Long Term Care Programs

Nursing Home / Institutional Medicaid

Nebraska Nursing Home Medicaid will cover the cost of long-term care in a nursing home for financially limited Nebraska seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:

  • Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
  • Skilled nursing care
  • Physician’s visits
  • Prescription medication
  • Medication management
  • Mental health counseling
  • Social activities

Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.

Nebraska Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover care expenses. They are only allowed to keep a “personal needs allowance” of $75/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.

Nebraska Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.

 

Home and Community Based Services (HCBS) Waivers

Nebraska Home and Community Based Services (HCBS) Waivers will pay for long-term care services and supports that help Nebraska Medicaid recipients who require a Nursing Facility Level of Care remain, or return to, living in the community instead of residing in a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will pay for long-term care services for Nebraska residents who live in their own home, the home of loved one or an assisted living residence. While Nebraska HCBS Waivers may cover long-term care benefits in those settings, it will not pay for room and board costs.

The HCBS Waiver relevant to Nebraska seniors is the Aged and Disabled Waiver.

Aged and Disabled (AD) Waiver
Nebraska’s Aged and Disabled (AD) Waiver will provide long-term care benefits to Nebraska seniors who live in their own home, the home of a loved one or an assisted living residence. It can also be used to help Nebraska Nursing Home Medicaid recipients move out of their nursing home and return to living in the community.

AD Waiver benefits include nurse services, adult day care, home/vehicle modifications, housekeeping services, assistive technologies and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). These benefits are made available depending on each beneficiary’s needs and circumstances.

For AD Waiver beneficiaries who are moving from a nursing home to living in their own home, the home of a loved or an assisted living residence, the Waiver will cover transition expenses like movers, utility set-up fees, deposits and basic furnishings.

Unlike Nursing Home Medicaid, the AD Waiver is not an entitlement. Instead, it has a limited number of enrollment spots (about 10,000 per year as of 2024). Once those spots are full, additional applicants are placed on a waitlist.

 

Aged, Blind, and Disabled Medicaid

Nebraska’s Aged, Blind, and Disabled (ABD) Medicaid provides healthcare coverage and long-term care services and supports to financially limited Nebraska residents who are aged (65 and over), blind or disabled and live in the community. ABD Medicaid can sometimes be referred to as regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages. ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive healthcare coverage without wait. Access to long-term care benefits via ABD Medicaid depends on the availability of funds, programs and caregivers in the area where the beneficiary lives.

Nebraska ABD Medicaid beneficiaries can receive long-term care benefits through the Personal Assistance Services (PAS) program and the Program of All-Inclusive Care for the Elderly (PACE).

1. Personal Assistance Services (PAS)
Nebraska’s Personal Assistance Services (PAS) program provides long-term care benefits to Nebraska ABD Medicaid recipients who are disabled or have a chronic medical condition. To be eligible for the PAS program, individuals must need help with their Activities of Daily Living (mobility, bathing, dressing, eating, toileting). PAS program participants can live in their own home or the home of a loved one. They can also live in assisted living residences, as long as they are not already receiving personal care assistance through the residence.

Program participants can receive up to 40 hours per week of PAS services and supports. These include housekeeping tasks, meal preparation, specialized procedures (such as oxygen or insulin administration), transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). The number of hours and types of benefits will depend on each beneficiary’s needs and circumstances. PAS benefits can be delivered by a licensed caregiver, or program participants can self-direct their care by hiring caregivers of their choice. This includes family members like adult children, but spouses and legal guardians can not be hired as PAS caregivers.

Like ABD Medicaid itself, Nebraska’s PAS program is an entitlement. This means that all eligible applicants are guaranteed by law to receive the appropriate benefits.

2. Program of All-Inclusive Care for the Elderly (PACE)
Nebraska residents who are age 55 or older and have ABD Medicaid can cover their medical, social service and long-term care needs with one comprehensive plan and delivery system using the Program of All-Inclusive Care for the Elderly (PACE). PACE program participants are required to need a Nursing Facility Level of Care, but they must live in the community. Nebraska’s PACE program can be used by people who are “dual eligible” for Medicaid and Medicare, and it will coordinate the care and benefits from those two programs into one plan. PACE also administers vision and dental care, and PACE day centers provide meals, social activities, exercise programs and regular health checkups and services to program participants. PACE Nebraska is located in Omaha. To learn more about PACE, click here.

 

Eligibility Criteria For Nebraska Medicaid Long Term Care Programs

To be eligible for Nebraska Medicaid, a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

 Just For You: The easiest way to find the most current Nebraska Medicaid eligibility criteria for your specific situation is to use our Medicaid Eligibility Requirements Finder. Anyone over their financial limits should consider working with a professional to become eligible.

 

Nebraska Nursing Home Medicaid Eligibility Criteria

Financial Requirements
Nebraska residents have to meet an asset limit and an income limit in order to be financially eligible for nursing home coverage through Nebraska Medicaid. For a single applicant in 2024, the asset limit is $4,000, which means they must have $4,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Counts the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2025 income limit for Nebraska Nursing Home Medicaid for a single applicant is $1,304.17/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. However, Nebraska Medicaid beneficiaries who reside in nursing homes must give most of their income to the state to help pay for the cost of care. They are only allowed to keep $75/month of their income as a “personal needs allowance,” and they are allowed to make Medicare premium payments if they are “dual eligible.”

For married applicants with both spouses applying, the 2025 asset limit for nursing home coverage through Nebraska Nursing Home Medicaid is $4,000 per spouse, and the income limit is a combined $1,304.17/month per spouse. For a married applicant with just one spouse applying, the 2025 asset limit is $4,000 for the applicant spouse and $157,920 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2025 income limit is $1,304.17/month for the applicant, and the income of the non-applicant spouse is not counted. Married Nebraska Nursing Home Medicaid recipients are also required to give most of their income to the state. They are allowed to keep $75/month as a personal needs allowance and enough to make Medicare premium payments. In addition, they are allowed to keep enough income to make any allowable spousal income allowance payments to financially needy spouses who are not enrolled in Medicaid.

 Caution: Nursing Home Medicaid applicants are not allowed to give away their assets to become eligible. To make sure they don’t, Medicaid uses the Look-Back Period. In Nebraska, the Look-Back Period is 60 months, which means the state will look back into the applicant’s financial history for the 60 months prior to their application date to see if they have given away any assets or sold them at less than fair market value. If they have, their application will be denied and they will face a penalty period of ineligibility.

Functional Requirements
The functional, or medical, criteria for nursing home coverage through Nebraska Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is usually associated with a nursing home. To determine if an applicant requires a NFLOC, the state will evaluate their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (cleaning, cooking, shopping, paying bills, etc.), as well as any cognitive or behavioral issues. This can include Alzheimer’s disease and other dementias, but a diagnosis of Alzheimer’s or dementia does not guarantee a NFLOC designation.

 

Nebraska Home and Community Based Services (HCBS) Waivers Eligibility Criteria

Financial Requirements
Nebraska residents have to meet an asset limit and an income limit in order to be financially eligible for Home and Community Based Services (HCBS) Waivers. For a single applicant in 2025, the asset limit for HCBS Waivers in Nebraska is $4,000, which means they must have $4,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Counts the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2025 income limit for HCBS Waivers in Nebraska for a single applicant is $1,304.17/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.

For married applicants with both spouses applying, the 2025 asset limit for HCBS Waivers in Nebraska is a combined $8,000, and the income limit is $1,304.17/month per spouse. For a married applicant with just one spouse applying, the 2025 asset limit is $4,000 for the applicant spouse and $157,920 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2025 income limit is $1,304.17/month for the applicant, and the income of the non-applicant spouse is not counted.

 Caution: HCBS Waivers applicants are not allowed to give away their assets to become eligible. To make sure they don’t, Medicaid uses the Look-Back Period. In Nebraska, the Look-Back Period is 60 months, which means the state will look back into the applicant’s financial history for the 60 months prior to their application date to see if they have given away any assets or sold them at less than fair market value. If they have, their application will be denied and they will face a penalty period of ineligibility.

Functional Requirements
The functional, or medical, criteria for Home and Community Based Services (HCBS) Waivers through Nebraska Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is usually associated with a nursing home. To determine if an applicant requires a NFLOC, the state will evaluate their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (cleaning, cooking, shopping, paying bills, etc.), as well as any cognitive or behavioral issues. This can include Alzheimer’s disease and other dementias, but a diagnosis of Alzheimer’s or dementia does not guarantee a NFLOC designation.

 

Nebraska Aged, Blind, and Disabled Medicaid Eligibility Criteria

Financial Requirements
Nebraska residents have to meet an asset limit and an income limit in order to be financially eligible for Aged Blind and Disabled (ABD) Medicaid. For a single applicant in 2025, the asset limit is $4,000, which means they must have $4,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2025 income limit for a single applicant for Nebraska’s ABD Medicaid is $1,304.17/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.

For married applicants, the 2025 asset limit for ABD Medicaid through Nebraska Medicaid is a combined $6,000, and the income limit is a combined $1,762.50/month. This applies to married couples with both spouses applying or with just one spouse applying.

The Look-Back Period does not apply to ABD Medicaid. However, ABD Medicaid applicants should be careful about Look-Back violations because they might eventually need Nursing Home Medicaid or HCBS Waivers, and those violations will make them ineligible for either of those programs.

Functional Requirements
The only functional requirement to receive basic healthcare coverage – physician’s visits, prescription medication, emergency room visits and short-term hospital stays – through Nebraska ABD Medicaid is being aged (65 and over), blind or disabled. For ABD Medicaid applicants and beneficiaries who require long-term care services and supports, the state will administer an assessment of their ability to perform Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and Instrumental Activities of Daily Living (which include shopping, cooking, housekeeping and medication management) to determine the kind of long-term care benefits the state will cover. Behavior and cognitive issues will also be considered.

 

How Nebraska Medicaid Treats the Home for Eligibility Purposes

One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:

  • If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $730,000 (as of 2025) then the home is exempt.
  • If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
  • If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $730,000.

These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status. To learn more about the impact of home ownership on Medicaid eligibility, click here.

Nebraska Medicaid Long Term Care applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Nebraska and how you can protect your home from it, click here.

 

Qualifying with Medicaid Planning

Even if Nebraska residents don’t meet their financial limits for Medicaid eligibility, there are still ways they can qualify. If they are over their asset limit, they can reduce their assets by “spending down” or using a Medicaid Asset Protection Trust. While the Look-Back Period prevents Nursing Home Medicaid and HCBS Waivers applicants from simply giving away their home, they could use the Child Caregiver Exemption or Sibling Exemption to transfer their home to a qualified family member, which would prevent the home from counting against the asset limit.

Nebraska residents who are over their income limit can use the Medically Needy Pathway to reduce their income and become eligible. It works like an insurance deductible. Nebraska Medicaid applicants/beneficiaries must pay for their medical expenses during their “spend down period” until they meet their “spend down” amount, which is calculated using their income and Nebraska’s Medically Needy Income Limit, which is $392 for both an individual and a couple. Once they have reached their spend down amount, Medicaid will cover their medical expenses for the remainder of the spend down period, which is one month in Nebraska.

These Medicaid Planning strategies tend to be complicated, so consulting with a professional like a Certified Medicaid Planner or an Elder Law Attorney before attempting any of them on your own is recommended.

 

Applying For Nebraska Medicaid Long Term Care Programs

The first step in applying for Nebraska Medicaid Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Service (HCBS) Waivers or Aged Blind and Disabled (ABD) Medicaid.

The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Nebraska Medicaid when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Nebraska Medicaid applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.

After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Nebraska residents can apply online at ACCESS Nebraska. They can also apply over the phone by calling the Department of Health and Human Services at 855-632-7633, or by calling their local Public Assistance Office.

For a comprehensive guide that will take you through the application process for all three types of Medicaid Long Term Care, click on the program you want: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.

  Professional Help: Many seniors need support when it comes to Medicaid Long Term Care’s rules, benefits and application process. These are all complicated, constantly changing and vary by state. To get expert help with every facet of Medicaid Long Term Care, consult with a professional.

 

Choosing a Nebraska Medicaid Nursing Home

After being approved for nursing home coverage through Nebraska Medicaid, a senior needs to choose which Medicaid-accepting nursing home best fits their needs and situation. Even though Nebraska Medicaid nursing home coverage is an entitlement, not all nursing homes accept Medicaid, and those that do may not have available spaces. Finding the right nursing home can be a challenge, especially if you’re looking in a specific area.

Nebraska has about 180 total nursing homes, and almost all of them accept Medicaid. These facilities are spread throughout the state with some clusters around the largest cities. There are roughly 30 nursing homes that take Medicaid within 10 miles of Omaha, which includes Bellevue and Papillion. There are about 20 more nursing homes a little further west in Lincoln. The choices narrow from there, with a dozen or so facilities in the Grand Island area and just four around North Platte.

Residents in some Nebraska communities may cross the state line on a regular basis for personal or business reasons, including healthcare. Medicaid coverage, however, does not cross state lines. So, someone with Nebraska Medicaid would not be covered for a stay in a nursing home in Council Bluffs, Iowa, for example, even that facility is well-suited and convenient for the Nebraska Medicaid beneficiary.

 Toolbox: To find and compare nursing homes, Nebraska residents can use Nursing Home Compare, which is a search tool administered by the Centers for Medicare & Medicaid Services (CMS) that has information on more than 15,000 nursing homes across the country. They can also use this roster of Long Term Care Facilities from the state.

When you’ve found nursing homes in your area that accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Compare can be filtered by staffing, health inspections, quality measures and overall rating, which can be a good place to start. The healthcare professionals who work with you can be a great source of information. You can also contact your local Area Agency on Aging find out more information about nursing homes in the state.

After doing some research, you or someone you trust should visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive with a list of questions, like: Does the residence offer social activities? How does it help residents with vision and dental care? Who are the staff doctors? What is the food like? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.

Data collected by CMS from 2018-2023 shows that Nebraska nursing homes averaged 18.5 health deficiencies that led to violations, which is well below the national average of 27.2 during the same sample time frame. are near the national averages when it comes to health standards and fire safety. The data also shows that only 4.4% of residents in Nebraska nursing homes have depressive symptoms, which is less than half the national average of 9%.