Nebraska Personal Assistance Services: Nebraska 2026 Guide
Nebraska Medicaid’s Personal Assistance Services (PAS) program pays for help with everyday personal care tasks for people who live at home. It is a regular state plan Medicaid benefit, run by the Nebraska Department of Health and Human Services, and is often used by older adults who need some hands-on help but do not need, or are waiting for, a full waiver.
This page explains who can get Personal Assistance Services in 2026, what kind of help it pays for, how to request it, and how it compares with waivers and nursing home Medicaid. 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 Personal Assistance Services is
Under PAS, a DHHS staff member assesses the person’s needs and authorizes a number of hours of help. The person, or a representative, can choose a provider, and Nebraska allows many types of independent providers, including some relatives other than a spouse, to be enrolled and paid. The provider helps with activities of daily living and related household tasks listed in the service plan.
The core of Personal Assistance Services is hands-on help with daily activities: bathing, dressing, eating, toileting and getting around, plus household tasks tied to that care. When personal care is part of a state’s regular Medicaid program (the “state plan”), it is an entitlement: anyone who qualifies gets it, without waiver enrollment caps. The trade-off is that state plan services are narrower than waiver services, and hours are set by an assessment.
Who qualifies in 2026
Generally, to qualify for Personal Assistance Services a person must:
- be enrolled in Nebraska Medicaid;
- live in their own home or a family home in Nebraska;
- need help with activities of daily living or related tasks, as shown by a DHHS assessment; and
- have a service plan that can be met within program limits.
The money test. Because Personal Assistance Services is a regular Medicaid service, the applicant must first be on Nebraska Medicaid, and for older adults the regular income limit is often lower than the special long-term care limit used for nursing homes and waivers. Some people who would qualify for nursing home care therefore qualify for state plan services only through a spend-down, or not at all.
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) |
If married. Spousal impoverishment protections may not apply to regular Medicaid in the same way as for waivers, so couples can see different results between programs.
Services Personal Assistance Services can cover
Hours are set by the assessment. Covered tasks include:
- bathing, grooming and dressing
- eating and meal preparation
- toileting and continence care
- transfers and mobility
- medication reminders
- light housekeeping and laundry related to the person’s care
- help with shopping and errands for the person
Limits. Personal Assistance Services is not 24-hour care and does not cover room and board or general housekeeping; skilled nursing and therapy are separate Medicaid services. People needing more help often move on to a waiver or managed long-term care.
How to apply for Personal Assistance Services
Getting started usually looks like this:
- Make sure the person is on Nebraska Medicaid, or apply online or through a local DHHS office.
- Request a Personal Assistance Services assessment from DHHS.
- A DHHS staff member assesses needs and authorizes hours.
- Choose an enrolled provider, or help a chosen independent provider enroll with Nebraska Medicaid.
- Services start under the plan, with periodic reviews.
Tips for the paperwork. Keep a folder of copies, and log every call with the date and name. 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
PAS is a state plan service, so there is no enrollment cap. The main delays come from the Medicaid application and from finding and enrolling a provider.
As an entitlement, Personal Assistance Services has no enrollment cap. Delays still happen: the Medicaid application, the assessment and finding a worker can each take weeks.
How it relates to nursing home Medicaid
If needs exceed what PAS can cover, the Aged and Disabled Waiver adds services such as adult day, respite, assisted living and home changes, and it uses long-term care financial rules that can be easier for married couples.
Personal Assistance Services reaches people earlier, often before they would qualify for nursing home care. When needs grow beyond it, a waiver or nursing home becomes the next step. Nursing home coverage uses different, often more generous income rules.
Planning around Personal Assistance Services
The need for Personal Assistance Services often arrives suddenly, after a hospital stay or a fall. Some preparation goes a long way. Begin with a list of daily tasks, the people who handle them, and the gaps that appear when a caregiver is away. The same list helps at the assessment and makes it clear where paid help matters most.
Paperwork usually includes bank statements, income letters, insurance cards, and proof of identity and residence in Nebraska. Keep older statements too: if a waiver or nursing home becomes necessary, the five-year look-back applies. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.
Check in on how the arrangement is working every few months; a reassessment can adjust hours or services. Notes on falls, hospital visits and new diagnoses make later reviews easier.
Tips for families
A simple list of tasks, frequency and time helps the assessment reflect real needs. Rules on paying relatives vary, so check them before counting on a family worker. If hours seem too low, a written decision and a fair hearing are the remedy.
We encourage families to consult a Certified Medicaid Planner before filing for Personal Assistance Services. A planner can compare Nebraska’s programs side by side, protect a spouse’s share where the rules allow, and prepare the paperwork. Typical fees vary widely: help with an application alone often runs about $500 to $6,000, full planning about $2,500 to $15,000 or more, and hourly advice about $150 to $600.
Related pages
- Nebraska Medicaid guide
- Nebraska Aged and Disabled Waiver
- In-home care and Medicaid
- Activities of daily living
- Consumer-directed care
- Paid family caregivers
- HCBS waivers explained
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.