Medicaid Long-Term Care Guide in Nebraska
Long-term care eligibility, benefits, and how to apply through the Nebraska Department of Health & Human Services (DHHS).
What makes Nebraska Medicaid different
In Nebraska, Medicaid is called the Nebraska Medical Assistance Program (NMAP). While it is jointly funded by the state and federal government, it is administered by the state under federally set parameters. The DHHS is the administering agency. In addition to nursing facility care and assisted living services, NE Medicaid pays for non-medical services and supports to help frail seniors remain living at home or that of a loved one.
Administered by the Nebraska Department of Health & Human Services (DHHS).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. It is provided in Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services (HCBS)
Not an entitlement; the number of program participants is limited and waiting lists may exist. Intended to delay the need for nursing home admissions, services are provided at home, adult day care, or in assisted living.
Level of care: Nursing Home
Regular Medicaid / Aged Blind and Disabled
An entitlement; anyone who meets the eligibility requirements will receive services. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care benefits, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Nebraska Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged Blind and Disabled
*All of a beneficiary's monthly income, with the exception of a Personal Needs Allowance of $75 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
Explore Nebraska Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Nebraska.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Nebraska
How the main LTC programs available in Nebraska compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $14–17/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Nebraska | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Nebraska Medicaid programs
HCBS Medicaid Waiver
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Nebraska
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in NebraskaHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: DHHS · dhhs.ne.gov
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Nebraska
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Nebraska. The process typically takes 45–90 days from application to first paycheck.
Apply in Nebraska: DHHS · dhhs.ne.gov
Medicaid Eligibility Screener — Nebraska
Answer 7 quick questions — we'll check the financial and care requirements for Nebraska and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted towards Medicaid's income limit, including cash gifts, employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In NE, the VA Aid & Attendance Allowance, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Institutional Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,644 (eff. 7/1/25 – 6/30/26). If a non-applicant spouse's income falls under this amount, income can be transferred from the applicant spouse.
- A non-applicant spouse can increase their Spousal Income Allowance if housing/utility costs exceed a shelter standard of $794 / month (eff. 7/1/25 – 6/30/26), up to a Maximum MMMNA of $4,066.50 / month.
- For Regular Medicaid, both spouses' income is counted. There is no Spousal Income Allowance for a non-applicant spouse.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside.
- In Nebraska, IRAs are counted as assets.
- Non-countable (exempt) assets include personal belongings, household furnishings, an automobile, irrevocable burial trusts up to $6,696 (eff. 9/1/25), and generally one's primary home.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660 (2026). If the non-applicant's portion is under $32,532, up to $32,532 can be retained.
- There is no CSRA for Regular Medicaid.
- The home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Nebraska's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Nebraska has a 60-month Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications.
- Medicaid checks all asset transfers, including those by a spouse, to ensure none were gifted or sold for less than fair market value.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The Look-Back Rule does not apply to Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,644 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Institutional Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,644 (eff. 7/1/25 – 6/30/26). Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- A non-applicant can increase their Spousal Income Allowance if housing/utility costs exceed the shelter standard of $794 / month, up to a maximum of $4,066.50 / month.
- The CSRA allows the non-applicant spouse to retain 50% of assets up to $162,660 (min $32,532) in 2026.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Medically Needy Pathway — Nebraska has a Share of Cost Program. The MNIL is $392 / month for both individuals and couples. One's 'share of cost' is the difference between income and the MNIL. Medical expenses (past due bills, Medicare premiums, home health services, private insurance premiums) can be used. Once the share of cost is met, one is Medicaid-eligible for the remainder of the month. The medically needy asset limit is $4,000 (individual) and $6,000 (couple).
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, stair lifts), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Nebraska does not use Qualified Income Trusts (Miller Trusts) for Nursing Home Medicaid or Waiver applicants who are over the income limit. The Medically Needy / Share of Cost program is available for persons over the income limit.
Nebraska Medicaid Programs
Nebraska Aged & Disabled (A&D) Waiver
Provides supportive services for elderly and disabled individuals in their homes and in assisted living facilities to prevent unnecessary nursing home admissions. Available benefits include adult day care, home modifications, personal emergency response systems, meal delivery, and more.
State Plan Personal Assistance Services (PAS)
Intended for those who are disabled or have a chronic medical condition, personal assistance services are provided in one's home. Program participants are able to self-direct their own care, including hiring select family members, such as one's adult child.
Program of All-Inclusive Care for the Elderly (PACE)
The benefits of Medicaid, including long-term care services, and Medicare are combined into one program. Additional benefits, such as dental and eye care, may be available.
How to Apply
- Apply online at iServe Nebraska
- Apply in person at a local DHHS office
- Call Medicaid Eligibility Customer Service at 855-632-7633 to apply by phone or request a paper application
- Contact a local Area Agency on Aging Office for information and application assistance
It is vital that Nebraska Medicaid applicants be certain that all eligibility requirements are met prior to applying. Seniors who do not meet the income and/or asset limit(s), or are unsure, should strongly consider Medicaid Planning.
More Nebraska Long-Term Care Resources
Take the Next Step for Nebraska Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Nebraska Department of Health & Human Services (DHHS) — Nebraska Medicaid — Official site