What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through “Medicaid Waivers,” which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.
Waiver Description
This Nebraska Aged and Disabled Medicaid waiver is designed to help the elderly remain living independently (at home) or in assisted living residences instead of in nursing home facilities by providing care services and skills training. Institutional care is extremely expensive for the state of Nebraska as well as less desirable for care recipients. Therefore, the Aged and Disabled Waiver achieves the dual objectives of reducing costs for the state and increasing program participants’ quality of life.
For qualified participants, this waiver helps to meet their needs with services like adult day care, chore services, and financial assistance for assistive technology for one’s home, or even one’s vehicle, if the elder is still capable of safely driving. All of these benefits are intended to make it easier to care for a loved one at home or to help an elderly person to care for themselves.
This waiver is also referred to as Home and Community-Based Services Waiver for Aged and Adults and Children with Disabilities. It is under the administration of the Nebraska Department of Health and Human Services, Division of Medicaid and Long Term Care.
Did You Know? Nebraska is ranked in the Top 5 states for the highest rate of persons living to the age of 100.
Eligibility Guidelines
General Requirements
Nebraska residents must be 65 or older (or if younger they must be officially disabled), require nursing home level care, and be financially qualified for Nebraska Medicaid to be eligible for this waiver. Nebraska accepts individuals into its Medicaid system based on several criteria, including income, savings, and population grouping. It also offers multiple pathways into Medicaid, meaning if persons do not meet one set of criteria, they might still be accepted using a different set of criteria.
Financial Requirements
Income Limits
Applicants in 2023 can follow the “categorically needy” or “medically needy” pathway. Categorically needy applicants have an absolute income of less than 100% of the Federal Poverty Level (FPL). In 2023, this is less than $1,215 a month. Medically needy applicants can have any amount of income, but once they pay for their recurring medical and care expenses, they must have less than approximately $392 available each month. Married applicants can have their incomes assessed separately if the spouses are not both applying for Medicaid assistance.
Asset Limits
In 2023, the countable asset limit for a single applicant is $4,000. For couples with both spouses applying, the limit is $8,000 The state will allow married couples to have more savings when one of them does not need Medicaid. (This is in addition to the $4,000 in assets the applicant spouse can retain). In 2023, a non-applicant spouse can maintain up to $148,620.
One’s home, provided it is owner-occupied, and the equity is valued at less than $688,000, is considered an exempt asset. Said another way, it is not counted towards the total asset limit. Note for non-married residents of assisted living, a home will not be exempt since the owner resides in assisted living not in the home. However, if the individual has intent to return home, the home will remain exempt.
There are public and private Medicaid planning experts that help families prepare for the Medicaid application process. If one is unsure regarding their financial eligibility, it is recommended they find assistance for qualifying for Medicaid prior to application. Read about assistance options.
Benefits and Services
While individual services are determined case-by-case, potential benefits include the following:
- Adult Day Care
- Assisted Living (be aware the waiver does not pay for room & board)
- Assistive Technology for the Home and Vehicle
- Chore Services (laundry, housekeeping, and shopping for essentials)
- Home Delivered, Hot and Prepared Meals
- Home / Vehicle Modifications (for accessibility)
- Independence Skills Training
- Non-Medical Transportation
- Nutrition Services
- Personal Emergency Response Service
- Respite Care (in-home and out-of-home)
- Transitional Services (from a nursing home to a private residence)
How to Apply / Learn More
There are no geographic limitations on the availability of the Aged and Disabled Waiver in Nebraska. However, it was designed to accommodate a specific number of individuals. This number changes fairly frequently, and upon last review, it was approved for 7,200 individuals.
Should the number of eligible applicants exceed the available slots, a waiting list may be created, or in Medicaid parlance, “Services Registry.” Fortunately, in past years Nebraska has not experienced much, if any, waiting periods for waiver participants.
To find additional information, click here. To apply for this program, contact the Nebraska Department of Health & Human Services by calling 800-358-8802. Alternatively, persons can contact their local Area Agency on Aging, a county-by-county list of which is available here.
There are several other programs available to Nebraska residents who do not qualify for the Aged and Disabled Waiver; these are the SSAD, DPFS and AABD Programs. Medicaid also offers Personal Assistance Services.
