Nebraska Aged and Disabled Waiver: Nebraska 2026 Guide
Nebraska’s Aged and Disabled (AD) Waiver pays for home and community-based care for older adults and people with disabilities who need a nursing facility level of care. It is run by the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care, and lets people get help at home, in an adult family home or in an assisted living facility instead of moving to a nursing home.
Below we cover the 2026 eligibility rules for the AD Waiver, the services it can pay for, the steps to apply, how waiting lists work, and how the program sits alongside nursing home Medicaid in Nebraska. For the full statewide rules on income, assets, spouses and the look-back, see our Nebraska Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What the AD Waiver is
The AD Waiver is a 1915(c) waiver that serves people of any age with a qualifying need, with separate rules for children, adults with disabilities and adults 65 and older. After financial eligibility is set, DHHS arranges an interRAI assessment, and a services coordinator (through a local Area Agency on Aging for older adults, or through other contracted agencies for younger adults) builds a person-centered service plan. Participants choose providers from those enrolled with Nebraska Medicaid, and in many cases can choose an independent provider, including some relatives.
In federal terms, the AD Waiver is a home and community-based services (HCBS) waiver. That label means Nebraska received approval to bend some usual Medicaid rules, most importantly the link between long-term care and a nursing home bed. Since no state has to offer a waiver, each program’s services and size are set by the state and its federal agreement. Unlike regular Medicaid, a waiver is usually not an entitlement: qualifying does not guarantee an opening.
Who qualifies in 2026
Nebraska looks at both how much help a person needs and what they own and earn. In general, to qualify for the AD Waiver an applicant must:
- be 65 or older, or have a disability (children and younger adults have separate standards);
- live in Nebraska;
- meet a nursing facility level of care, based on an interRAI assessment;
- be eligible for Nebraska Medicaid under the financial rules;
- need at least one waiver service and have a plan that can be safely carried out in the community; and
- choose waiver services instead of nursing facility care.
Income and assets. The financial side of the AD Waiver follows Nebraska’s long-term care Medicaid rules. Countable assets include bank accounts, investments and property other than the home, while the home, one car, personal belongings and certain burial funds are usually not counted. The five-year look-back on gifts and below-value transfers applies here too, so large gifts in the past five years can delay services.
Nebraska does not use a fixed income cap for nursing home care. For the waiver, income above the Medicaid standard is generally handled through a share of cost. The single-person asset limit is $4,000.
Nebraska’s 2026 long-term care Medicaid numbers, from our state guide:
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | No fixed cap for nursing home care (income goes toward the cost of care) |
| Asset limit (single applicant) | $4,000 |
| Asset limit (couple, both applying) | $6,000 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Half the couple’s resources, minimum $32,532 / maximum $162,660 |
| Spouse at home: monthly income allowance | Minimum $2,705 (from July 1, 2026) / maximum $4,067 |
| Personal needs allowance (nursing home) | $75 a month ($90 for veterans) |
| Look-back period | 60 months (5 years) |
Couples. Spousal impoverishment rules generally apply to waiver applicants in Nebraska, protecting a share of assets and income for the spouse at home. The spousal allowance pages explain how these amounts are figured.
Services the AD Waiver can cover
Services are listed in a written plan of care, built from the assessment and the person’s goals. Not everyone gets every service. Depending on need, the AD Waiver can include:
- services coordination
- personal care and chore services
- adult day services
- respite care
- home-delivered meals
- assisted living services
- adult family home services
- non-medical transportation
- assistive technology and home modifications
- personal emergency response systems
- independence skills building
What is usually not covered. Waivers pay for care and support, not rent, food or other living costs, so in an assisted living or residential setting the person usually pays room and board from their own income. Plans of care are built around any unpaid help family already gives, and doctor, hospital and drug coverage continue separately.
How to apply for the AD Waiver
The steps below describe the usual path. Many people apply for Medicaid and request the waiver at the same time, so that the money and care tests run side by side.
- Apply for Nebraska Medicaid online through the state’s benefits portal or with a local DHHS office.
- Request the Aged and Disabled Waiver at the same time. An Area Agency on Aging or the Aging and Disability Resource Center can help start the referral.
- DHHS schedules an interRAI assessment to decide level of care.
- A services coordinator meets with the person and family to build the service plan.
- Choose providers, and services begin once the plan is authorized.
Staying organized. Copy every form before you send it and keep a simple call log. At the assessment, talk about the hardest days, not the best ones, and bring someone who sees the care needs firsthand. Memory problems, falls and the need for supervision all count, even when the person can still do some tasks alone. If the answer is no, the written notice explains how to request a fair hearing and the deadline.
Waiting lists and timing
Nebraska’s AD Waiver has generally not used a long waiting list for older adults, but processing the Medicaid application and assessment can take several weeks. Timing varies by area.
Starting the process early keeps options open if a wait develops. Stopgaps can include state plan home care, adult day centers, PACE where it operates and local aging services. The waiver waiting lists page explains common rules.
How it relates to nursing home Medicaid
the AD Waiver serves people who meet the same care-need standard as nursing home residents, so it is an alternative to a nursing home rather than a lower level of care. One practical difference: nursing home Medicaid has no enrollment cap in Nebraska, while a waiver can. A participant who later needs a nursing home keeps Medicaid, though more of their income then goes toward care. People leaving a nursing home often get priority for waiver openings, with help from Money Follows the Person.
Tips for families
Start early, because the money test, the assessment and any wait can all take time. Pull together five years of financial statements and keep a short care log ahead of the assessment. Higher income may call for a Miller trust or spend-down; past gifts may cause a penalty, so review them first. A reassessment can be requested whenever needs change.
We encourage families to consult a Certified Medicaid Planner before filing for the AD Waiver. A planner can compare Nebraska’s programs side by side, protect a spouse’s share where the rules allow, and prepare the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.
Related pages
- Nebraska Medicaid guide
- Nebraska Personal Assistance Services
- HCBS waivers explained
- Applying for a waiver
- Nursing home level of care
- Waiver waiting lists
- The five-year look-back
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.