Long-Term Care Medicaid in Nebraska: 2026 Guide
In Nebraska, Medicaid is run by the Nebraska Department of Health and Human Services (DHHS), which also decides eligibility. Long-Term Care Medicaid can pay for nursing facility care and for care at home through the Aged and Disabled (AD) Waiver. Nebraska’s asset limit is higher than many states’. This guide explains the 2026 rules in plain language.
At a glance: Nebraska 2026 figures
| 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) |
| Penalty divisor | The actual monthly private-pay rate of the person’s care setting |
Figures last updated for 2026. Sources are listed at the end of this page.
Figures change periodically. Double-check current amounts with Nebraska DHHS before relying on them.
What Long-Term Care Medicaid covers in Nebraska
Nursing home care. Medicaid pays for care in a certified nursing facility. You pay most of your income toward the cost each month, and Medicaid pays the rest.
Aged and Disabled (AD) Waiver. For people 65 and older or people with disabilities who need a nursing facility level of care but want services in the community. After you qualify, DHHS schedules an interRAI assessment, and a service coordinator builds a person-centered plan before services begin. Services may include personal care, adult day services, respite, home-delivered meals, transportation and assistive technology.
Other programs.
How Medicare fits in. Medicare Part A covers skilled nursing facility care only for a limited time. You generally need a medically necessary inpatient hospital stay of at least 3 days in a row first (time under observation or in the emergency room does not count), and you must need daily skilled nursing or therapy. In 2026, Medicare charges nothing for days 1 to 20 after the Part A deductible ($1,736) is met, $217 a day for days 21 to 100, and nothing after day 100, when you pay all costs. Medicare limits this coverage to 100 days in each benefit period. Medicaid can be a way to pay for long-term nursing home care after Medicare coverage ends.
Who qualifies
A person generally must:
- be 65 or older, or blind or disabled;
- live in Nebraska and be a U.S. citizen or qualified non-citizen;
- meet a nursing facility level of care, and need waiver services if applying for the AD Waiver;
- meet the income and asset rules below, as decided by Nebraska DHHS.
Income rules
Once you are on Medicaid in a nursing facility, most of your income goes to the facility. You keep a personal needs allowance of $75 a month ($90 for veterans), and money can be set aside for a spouse at home and for health insurance premiums.
Asset rules
In 2026, a single applicant can have up to $4,000 in countable resources. For a couple who both need care, the limit is $6,000.
Countable resources include cash, bank accounts, CDs, stocks, bonds, mutual funds, retirement accounts that can be cashed in, life insurance cash value above set amounts and real estate other than the home.
Usually exempt:
- Your home (equity up to $752,000) if you live there or plan to return, or a spouse or dependent relative lives there
- One vehicle
- Household goods and personal belongings
- Burial plots and limited burial funds, within Nebraska DHHS rules
Spousal protections
- Assets: The spouse at home can keep half of the couple’s countable resources, at least $32,532 and no more than $162,660 in 2026, plus the home, one car and belongings.
- Income: The spouse at home keeps their own income. If it is below $2,705 a month (from July 1, 2026), part of the applicant’s income can go to them, plus an excess shelter amount for high housing costs, up to $4,067 a month.
Look-back and penalties
When you apply, Nebraska looks back at the 60 months (5 years) before the application date. This is called the look-back period. The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during that time.
Common examples of transfers that can cause a problem:
- Cash gifts to children or grandchildren, even small yearly gifts. (A gift that is fine for federal gift-tax purposes can still count for Medicaid.)
- Adding a child’s name to a house deed or bank account in a way that gives them part ownership.
- Selling a house or car to a relative for much less than it is worth.
- Paying a family member for care without a written agreement made at the time.
Some transfers are allowed, such as transfers between spouses, or transferring a home to a child who is blind or disabled.
How the penalty works. If the state finds a transfer that is not allowed, it does not deny Medicaid forever. Instead, it sets a penalty period: a stretch of time when Medicaid will not pay for long-term care. The state divides the amount given away by the penalty divisor (the actual monthly private-pay rate of the person’s care setting).
Example: Suppose you gave your daughter $50,000 three years before applying and your nursing home charged $9,000 a month. $50,000 divided by $9,000 is about 5.6 months without Medicaid payment for long-term care.
The penalty period starts only once you have applied, are otherwise eligible, and are in (or need) long-term care. This is why gifts made while someone is healthy can still matter years later. If a gift is returned in full, the penalty can be removed.
Estate recovery in Nebraska
Nebraska’s estate recovery program is run by DHHS.
- What is recovered: Medicaid paid for long-term care and related services received at age 55 or older, and for some people of any age in a nursing facility.
- When it is put off: federal rules prevent recovery while a spouse is alive, or if there is a child under 21 or a child who is blind or disabled.
- Hardship waivers: the state must have a way to waive recovery when it would cause undue hardship. Ask Nebraska DHHS for the current rules.
- Family members and personal representatives can contact Nebraska DHHS with questions.
How to apply
- Online: through iServe Nebraska. You can apply for Medicaid and the AD Waiver together.
- For more on waiver eligibility: see the DHHS HCBS waiver eligibility page.
Applying for a spouse or parent. If you are applying for someone else, you may need legal authority to act for them, or you can be named as an authorized representative on the application. Gather statements for every account, not just the main one, and write down when the person’s care needs began. If the person is already in a nursing home, ask the facility’s business office or social worker which Medicaid forms they need from you and when, and tell the agency if any requested document is hard to get, since agencies can often give extra time when you ask before the deadline.
After you apply. Nebraska DHHS will send you a written notice saying whether you qualify, from what date, and how much of your income goes toward your care each month. If you disagree with a decision, you have the right to ask for a fair hearing (appeal). The notice explains how to ask and the deadline for asking. Keep copies of everything you send and receive, and report changes in income, assets or address when they happen.
Gather what you can before you apply. The caseworker may ask for:
- Photo ID, Social Security card and Medicare card
- Proof of age and of U.S. citizenship or immigration status
- Proof that you live in the state (for example, a utility bill or lease)
- Proof of all income: Social Security award letter, pension statements, annuity statements
- Bank, credit union and investment statements (often for the full 60-month look-back period)
- Deeds, property tax bills and the value of any real estate
- Life insurance policies (showing cash value) and prepaid funeral or burial contracts
- Vehicle titles
- Health insurance cards and long-term care insurance policies
- Power of attorney or guardianship papers, if someone is applying for you
- For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start
If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.
Free public help in Nebraska
- Nebraska DHHS: applications, eligibility and program questions.
- Area Agencies on Aging: local information on long-term care options.
- SHIP (State Health Insurance Assistance Program): free Medicare counseling.
- Long-Term Care Ombudsman Program: free advocates for residents of nursing homes and other long-term care settings.
Recent and upcoming changes
A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including Nebraska:
- Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
- Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). Nebraska’s 2026 home equity limit, $752,000, is already below the new cap, so this change is not expected to affect Nebraska’s limit.
The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.
State programs
Each program below has its own page with who qualifies, services, how to apply and waiting lists:
Frequently asked questions
What is the AD Waiver? Nebraska’s Medicaid program for care at home for people 65 and older and people with disabilities who need a nursing facility level of care.
Why is Nebraska’s asset limit $4,000? That is Nebraska’s 2026 resource limit for a single applicant.
How much can my spouse keep? In 2026, half of the couple’s assets, at least $32,532 and up to $162,660, plus the home, a car and belongings, and income of at least $2,705 a month.
How long is the penalty for a gift? Nebraska divides the gift by the current private-pay cost of nursing home care.
Will the state take my home after I die? Nebraska DHHS can seek repayment for long-term care paid after age 55, which can include the home. Recovery is put off while a spouse or a young or disabled child survives, and hardship waivers exist.
Figures change periodically. Double-check current amounts with Nebraska DHHS before relying on them.
Sources
- Nebraska DHHS, Calculation of Resources Reserved for Community Spouse
- Nebraska DHHS, 477-000-014 Resource Provisions
- Nebraska Department of Insurance, Spousal Impoverishment Protection Law 2026
- Nebraska DHHS, Eligibility for Medicaid HCBS Waiver Services
- Nebraska DHHS, Services on the Aged and Disabled Waiver
- iServe Nebraska
- Medicare.gov, Skilled nursing facility care
- CMS, 2026 SSI and spousal impoverishment standards
- Public Law 119-21 (2025)
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.