Nebraska State Guide for Medicaid Waivers/HCBS Care Coverage Benefits
Discover how in-home dementia care and other supports in Nebraska can be made accessible and affordable through HCBS and Medicaid waiver programs.
Authored By
Edited By
Tendly Home Key Takeaways
Discover how Nebraska residents can access affordable in-home dementia care and other long-term support services through Medicaid waiver and HCBS programs:
- 🏡 Nebraska's Medicaid Waivers and Home and Community-Based Services (HCBS) help residents receive care at home rather than in institutions.
These programs aim to support independence while reducing long-term care costs.
- 🤝 Services include personal care, respite care, adult day services, and specialized dementia care.
Eligibility is typically based on income, assets, and assessed care needs.
- 📄 Key waivers include the Aged and Disabled (AD) Waiver and the Developmental Disabilities Waiver.
Each targets specific populations and offers tailored services such as memory support.
- 📝 Application processes involve financial screening and functional assessments through Nebraska’s Medicaid system.
Applicants must demonstrate medical necessity and meet program criteria.
- 💡 Using HCBS waivers can significantly reduce out-of-pocket caregiving expenses.
Families can also access caregiver resources and home modifications through these programs.
Nebraska State Guide for Medicaid Waivers/HCBS Care Coverage Benefits
Discover how in-home dementia care and other supports in Nebraska can be made accessible and affordable through HCBS and Medicaid waiver programs
Caring for a loved one with dementia or a related condition can be an emotionally and financially overwhelming experience. Many families in Nebraska are faced with difficult decisions, trying to balance the desire for compassionate, in-home care with the high cost of professional services. If this sounds familiar, you're not alone—and there is help available. Through Nebraska’s Medicaid Waivers and Home and Community-Based Services (HCBS) programs, families can access much-needed long-term care supports that make staying at home not only possible, but financially feasible.
Understanding these benefits can be the key to unlocking vital services like in-home dementia care, adult day programs, personal assistance, and respite care. In this guide, we’ll explore how Nebraska’s Medicaid waiver system works, who qualifies, and how to apply—so you and your loved one can focus more on quality of life and less on managing medical costs.
Understanding Nebraska’s Medicaid Waiver and HCBS Programs
Nebraska’s Home and Community-Based Services (HCBS) programs are designed to help individuals who would otherwise require institutional care—such as nursing homes—remain safely in their own homes or communities. These programs are not one-size-fits-all; rather, Nebraska offers several types of waivers tailored to specific populations, including seniors, people with disabilities, and those with dementia or Alzheimer's disease.
Under federal Medicaid law, waivers give states the flexibility to provide services outside of traditional healthcare facilities. Nebraska currently offers several key waiver programs, including:
- Aged and Disabled (AD) Waiver
- Developmental Disabilities (DD) Waiver
- Traumatic Brain Injury (TBI) Waiver
The Aged and Disabled (AD) Waiver is the most relevant for seniors and individuals needing dementia care at home. This waiver supports services like personal care, adult day health, home-delivered meals, respite care for family caregivers, and even minor home modifications—such as grab bars or wheelchair ramps.
What sets HCBS apart from other Medicaid services is the person-centered approach. These waivers allow eligible individuals to receive care tailored to their unique needs while maintaining autonomy and dignity in their preferred living environment—whether that’s at home, with family, or in a community setting.
Importantly, these services aren’t automatically provided—you must meet certain criteria and complete the application process, which we’ll walk through in a later section. The good news is that, for many Nebraskans, these programs offer a life-changing opportunity to access high-quality, affordable care without uprooting their lives.
Who Is Eligible for HCBS and Medicaid Waiver Services in Nebraska?
Determining eligibility is often the first hurdle families face when exploring Medicaid waiver options. In Nebraska, both financial and medical requirements must be met to qualify for HCBS services under Medicaid.
Financial Requirements
Eligibility for the Aged and Disabled Waiver ties closely to Nebraska Medicaid's income and asset limits. As of 2024, an individual typically must have a monthly income below approximately $2,742 and assets under $2,000 (excluding essential items like a home, car, or certain personal property). For married couples where only one partner is applying, higher asset thresholds may be allowed to prevent the healthy spouse from becoming impoverished.
However, if income or assets exceed these limits, there are legal planning options such as "spend down" strategies, Medicaid trusts, or spousal impoverishment protections that can help you qualify without sacrificing financial security. Working with a Medicaid planner or elder law attorney can make this process smoother.
Medical Requirements
In addition to financial limits, applicants must also demonstrate a need for institutional-level care. For the Aged and Disabled Waiver, this typically means the individual must require a level of care equivalent to that provided in a nursing home. This includes substantial needs in one or more areas such as daily living activities (bathing, eating, dressing), supervision due to cognitive decline, or mobility issues.
A comprehensive medical assessment is conducted by Nebraska’s Department of Health and Human Services (DHHS) or its partners to determine this level of care. The goal is to make sure supports are going to those who truly need them—and to ensure the care plan can be safely implemented outside of an institutional setting.
Understanding these eligibility parameters upfront can save you time and frustration in the long run. And remember—just because someone doesn’t immediately qualify doesn’t mean they won’t ever qualify. Needs evolve, and so do opportunities for support.
What Services Are Covered Under Nebraska’s HCBS Waiver Programs?
One of the greatest strengths of Nebraska’s HCBS Medicaid waivers is the breadth and flexibility of services covered. For families caring for someone with dementia, this can transform a stressful caregiving experience into a sustainable, compassionate plan of support.
In-Home Services
The Aged and Disabled Waiver covers a wide range of in-home supports designed to make daily life safer and more manageable. This includes personal assistance for bathing, dressing, medication reminders, and general mobility. It also covers housekeeping, laundry, grocery shopping, and meal preparation through homemaker services.
Respite Care and Caregiver Support
Family caregivers are heroes—but even heroes need relief. Respite care is vital to preventing burnout, and under Nebraska’s Medicaid waivers, families can access short-term relief services that allow them to rest, attend appointments, or take a needed break. This is especially critical for dementia caregivers, who may be providing 24/7 supervision for a loved one at risk of wandering or becoming disoriented.
Specialized Dementia Services
While HCBS waivers don't directly diagnose or categorize dementia care as a unique service, many of the supports funded under the waiver are directly applicable. For instance, adult day programs offer structured environments where individuals with memory loss can engage in safe, supervised activities that promote socialization and cognitive engagement. Some programs are specifically designed for dementia participants and are staffed by trained professionals.
Assistive Devices and Home Modifications
Safety in the home is a serious concern for individuals with advanced memory loss or mobility issues. Nebraska’s Medicaid waivers can fund interventions like medical alert systems, grab bars, stair lifts, and wheelchair-accessible ramps. This reduces fall risks and allows individuals to safely age in place.
Because each waiver participant receives a person-centered service plan, there’s flexibility to incorporate the right combination of supports at the right time. That means your family member can age with dignity—without relocating to an institutional care facility unless absolutely necessary.
Nebraska's Medicaid Waivers and Home and Community-Based Services (HCBS) are vital for individuals needing long-term care. These programs help ensure that residents can receive necessary medical and support services while living in their communities. Understanding the eligibility criteria and application processes is crucial; approximately 30% of qualifying individuals do not take advantage of these resources due to lack of awareness. Explore the details to secure essential care and support for yourself or loved ones.
How to Apply for a Medicaid Waiver in Nebraska
Navigating the Medicaid waiver application process in Nebraska can feel daunting, but you're not alone. Thousands of families go through it every year, and there are experienced professionals available to guide you from beginning to end.
Step 1: Start with Medicaid Eligibility
Before applying for any waiver, confirm basic Medicaid eligibility through Nebraska’s AccessNebraska portal (accessnebraska.ne.gov). You’ll need to submit financial documents like tax returns, bank statements, and proof of income. If your income or assets are close to the limit, consider consulting a Medicaid planner or eldercare expert to explore qualification strategies.
Step 2: Contact DHHS or Your Local Area Agency on Aging (AAA)
To access the Aged and Disabled Waiver, reach out to the Nebraska Department of Health and Human Services (DHHS) or your local Area Agency on Aging. These agencies can conduct the required medical assessment and help you complete the waiver application. You may be asked to provide medical records or consent for a care assessment from a nurse or social worker.
Step 3: Create a Person-Centered Service Plan
Once approved, an assigned case manager works with your family to develop a care plan based on your loved one’s individual needs. This may include a mix of in-home services, adult day health, respite care, or therapy, depending on their medical and emotional condition.
Step 4: Choose Approved Providers
Families must choose from Medicaid-approved providers for the services to be covered. Nebraska maintains a directory of licensed HCBS providers, including home care agencies, nurse aides, therapists, and day programs. Use this opportunity to find caregivers that align with your values, budget, and location preferences.
Pro Tip: Don’t be afraid to ask questions. Many qualified providers are used to working with waiver-funded families and can help navigate billing, compliance, and ongoing service updates.
The process may take several weeks to a few months, especially if documentation is incomplete or medical reviews are delayed. The key is to stay persistent and ask for help when needed—whether from DHHS, your healthcare provider, or local senior service organizations.
Conclusion: Dignified Care Is Within Reach
No family should have to choose between quality care and financial stability. Fortunately, Nebraska’s Medicaid waivers and HCBS programs offer a path to compassionate, sustainable, and affordable in-home care—especially for those caring for loved ones with dementia, disabilities, or aging-related needs. These programs embody a powerful belief: that people thrive best when they’re able to age in place, surrounded by comfort and care.
If you or a loved one is struggling with daily living tasks or the financial strain of long-term care, now is the time to explore your options. The system may be complex, but support is out there—through state agencies, professional advocates, and a community of families just like yours.
Don’t let paperwork or red tape stand in the way of the care your loved one deserves. Start your application, reach out for guidance, and take the first step toward a safer, more supported future at home. Nebraska’s Medicaid waiver programs are here to help you move forward—with dignity, clarity, and hope.
Frequently Asked Questions
To qualify for Medicaid waivers in Nebraska, individuals must meet specific income, asset, and functional criteria. Generally, these waivers are designed for people who are elderly, have disabilities, or require support to live independently in the community rather than in institutional settings. Eligibility factors include age, residency in Nebraska, level of care needs (such as needing nursing home-level care), and income and asset limits. Some waivers may also have waiting lists or limited enrollment capacity, so applying early and consulting the Nebraska Department of Health and Human Services can be helpful in the process.
Medicaid waivers in Nebraska, also known as Home and Community-Based Services (HCBS) waivers, provide funding to help individuals with disabilities or mental health challenges receive care in their own homes or communities instead of institutional settings. These waivers allow states to tailor their Medicaid programs to better meet the needs of specific populations, promoting personalized care plans and supporting independence.
Eligibility for Medicaid waivers in Nebraska generally includes individuals who meet specific criteria based on age, disability status, and income level. Applicants must be Medicaid-eligible and often need to demonstrate a level of care that indicates they would require institutional care if waivers were not available. This allows them to access needed services in community settings.
To apply for HCBS waivers in Nebraska, you must contact the Nebraska Department of Health and Human Services or an authorized service provider. The application process typically involves submitting documentation of your medical condition, financial status, and other relevant information that demonstrates your need for waiver services. A caseworker will then assist you in the assessment process and guide you through the next steps.
Nebraska's Medicaid waivers cover a variety of services designed to support individuals in community settings. These may include personal care services, respite care, transportation, and skill-building activities. The exact services available can vary based on the specific waiver program, so reviewing each program's details will provide clarity on the offered assistance.
Renewing your Medicaid waiver in Nebraska typically occurs annually or biannually, depending on the specific waiver program you are enrolled in. To maintain your waiver, you will need to submit updated documentation showing continued eligibility and any changes to your care needs. It's essential to stay in touch with your caseworker to ensure that all necessary documentation is submitted on time.
Dr. Alan Lee is a board-certified geriatrician specializing in neurodegenerative conditions including Alzheimer’s disease, Parkinson’s, and Lewy Body dementia. With more than two decades in clinical practice and research, Dr. Lee is a trusted authority in personalized care planning for aging adults. He serves as a medical reviewer for several national caregiving organizations and frequently lectures on aging in place and ethical dementia care.
Emily Sanders is a Dementia Practitioner and educator who trains in-home caregivers and family members in person-centered dementia care. With a background in occupational therapy and caregiver training, Emily creates practical tools and care plans that improve everyday life for people living with Alzheimer’s and related conditions. She is passionate about preserving identity, dignity, and connection in home-based settings.
Maria Torres is a social worker with a focus on elder care, family systems, and caregiver mental health. She has worked in both hospice and community health settings and currently supports family caregivers navigating long-term care decisions. Maria brings an empathetic lens to her writing and advocates for proactive planning, emotional resilience, and equitable access to home care resources.
