Nebraska Medicaid for seniors and long-term care

Last verified: June 2026

What Nebraska Medicaid covers for long-term care

Nebraska Medicaid covers nursing facility care for eligible seniors and individuals with disabilities who require that level of support. The program also funds home and community-based services through waiver programs that allow members to receive care at home rather than in a nursing facility — generally the preferred option for both members and the state.

• Skilled nursing facility (nursing home) care
• Personal care services at home (attendant care)
• Home health aide visits
• Adult day health services
• Assisted living facility services (through waiver)
• Respite care for family caregivers
• Home modifications and assistive technology
• Transportation to medical appointments
• Hospice care
• Behavioral health services

Source: Nebraska DHHS Medicaid long-term care program information; Aged and Disabled Waiver documentation.

Financial eligibility for Nebraska long-term care Medicaid (2025)

Long-term care Medicaid uses different income and asset rules than the MAGI-based Heritage Health coverage. The income standard is 300% of the Social Security Federal Benefit Rate (FBR) for nursing facility care. The resource (asset) limit for a single applicant is $4,000 — higher than the federal minimum of $2,000 that many states use.

Source: Nebraska DHHS Medicaid eligibility policy; federal spousal impoverishment rules (42 U.S.C. § 1396r-5). Figures are approximate — verify current amounts with Nebraska DHHS or an elder law attorney.

Aged and Disabled Waiver: home and community-based services

Nebraska's Aged and Disabled (AD) Waiver allows Medicaid-eligible seniors and individuals with physical disabilities to receive long-term services and supports at home or in the community instead of a nursing facility. The AD Waiver is a 1915(c) Home and Community-Based Services waiver authorized under the Social Security Act.

To qualify for the AD Waiver, a person must meet nursing facility level of care criteria and financial eligibility requirements. Because waiver slots are limited, there may be a waiting list. Contact Nebraska DHHS at 855-632-7633 to inquire about waiver availability in your area.

Nebraska also operates waiver programs for individuals with developmental disabilities and brain injuries through DHHS and the Division of Developmental Disabilities. These are separate from the AD Waiver and have their own enrollment processes.

Nebraska Medicaid estate recovery

Nebraska operates a Medicaid estate recovery program. The state may seek reimbursement from the estate of a deceased Medicaid member who was age 55 or older at the time they received long-term care services, nursing facility care, or certain other Medicaid benefits. The home is generally exempt from recovery while a surviving spouse or dependent child under 21 continues to live there. Nebraska has a 60-month (5-year) look-back period for asset transfers — giving assets away within that window can result in a penalty period of ineligibility. Consult a Nebraska-licensed elder law attorney before making transfers.

Medicaid as the primary payer for long-term care

Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.

Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. Nebraska's share of that population is administered through Nebraska Medicaid. The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.

Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.

Nursing facility coverage

Nebraska Medicaid covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.

Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.

If income exceeds the institutional Medicaid limit, Nebraska may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether Nebraska uses this approach with Nebraska Medicaid.

Home and community-based services (HCBS)

HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through Nebraska Medicaid differs from what's available in neighboring states.

Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.

Contact Nebraska Medicaid to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.

Asset limits for long-term care Medicaid

Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.

Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.

Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult Nebraska Medicaid or a Medicaid planning attorney before transferring assets.

Spousal protections

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.

The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. Nebraska's current CSRA is set by Nebraska Medicaid and published on their website.

The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

What long-term care Medicaid typically covers

• Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
• Physical, occupational, and speech therapy provided in a nursing home
• Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
• Home health aide visits for those receiving care at home
• Adult day health care programs
• Respite care to give family caregivers temporary relief
• Durable medical equipment prescribed by a physician
• Transportation to and from medical appointments