Nebraska Medicaid Long-Term Care Overview

Nebraska Medicaid Long-Term Care Overview

Medicaid is a health care program designed to support low-income individuals of all ages. This guide focuses on Medicaid eligibility for Nebraska seniors aged 65 and older seeking long-term care. Nebraska Medicaid covers nursing home care, assisted living, and non-medical services to help seniors remain at home or with loved ones. Nebraska’s Medicaid long-term care options fall into three categories:

Institutional / Nursing Home Medicaid: This entitlement program provides coverage for eligible seniors requiring nursing home care. All who qualify receive assistance.
Medicaid Waivers / Home and Community-Based Services (HCBS): These non-entitlement programs have limited slots, often with waiting lists. They aim to delay nursing home placement by offering care in homes, adult day centers, or assisted living facilities.
Regular Medicaid / Aged, Blind, and Disabled (ABD): Also an entitlement, this program provides long-term care services like personal care assistance or adult day care to eligible individuals.

Nebraska’s Medicaid program, known as the Nebraska Medical Assistance Program (NMAP), is jointly funded by state and federal governments but administered by the Nebraska Department of Health and Human Services (DHHS).

Income and Asset Eligibility for Long-Term Care

Eligibility varies by program and is influenced by annual updates, marital status, and multiple eligibility pathways. Simplified 2024 criteria for a single applicant for Nursing Home Medicaid include:

Income: Under $1,255/month.
Assets: Under $4,000.
Need: Must require a Nursing Home Level of Care (NHLOC).

Quick Tip: Not meeting these criteria doesn’t automatically disqualify someone. Additional pathways to eligibility exist, such as Medicaid Planning or spend-down strategies.

Treatment of Income and Assets

Income Guidelines

Countable Income: Includes wages, pensions, Social Security benefits, and more. Some exceptions, like VA Aid & Attendance Allowances, are not counted.
For Couples: Only the applicant’s income is considered for certain programs, protecting the non-applicant spouse’s financial stability. A Minimum Monthly Maintenance Needs Allowance (MMMNA) may be provided to the non-applicant spouse.

Asset Guidelines

Countable vs. Exempt Assets: Countable assets include savings, stocks, and non-primary residences. Exempt assets may include personal belongings, a primary home (with conditions), and irrevocable burial trusts.
Couples: Assets are considered jointly owned. Spousal Impoverishment Rules allow the non-applicant spouse to retain a portion of the couple’s assets.

Look-Back Period and Gifting

Nebraska enforces a 60-month “look-back” period for asset transfers. Violating this rule may result in a penalty period of ineligibility. Proper documentation and planning are crucial to avoid disqualification.

Pathways to Eligibility

Medically Needy Pathway: For individuals with high medical expenses exceeding income limits, a “share of cost” or spend-down can help qualify for Medicaid.
Asset Spend Down: Excess assets can be spent on non-countable items, such as home modifications or prepaid burial expenses.
Medicaid Planning: Professional planners can help families navigate eligibility and protect assets from Medicaid’s Estate Recovery Program.

Key Nebraska Medicaid Programs

Aged & Disabled (A&D) Waiver: Offers in-home and community-based services, such as meal delivery and personal emergency response systems, to prevent nursing home placement.
State Plan Personal Assistance Services (PAS): Provides home care services, allowing participants to hire family members as caregivers.
PACE (Program of All-Inclusive Care for the Elderly): Combines Medicaid and Medicare benefits with additional services like dental and vision care.

How to Apply

Applications can be submitted:

Online at iServe Nebraska.
By phone at 855-632-7633.
In-person at a DHHS office.

For assistance, contact your local Area Agency on Aging. Thorough preparation and Medicaid Planning are highly recommended to ensure eligibility and streamline the application process.

For further guidance, consider consulting a Medicaid Planner or using tools like the Medicaid Eligibility Test to determine your initial eligibility.