Nebraska families caring for an aging parent or other relative at home can be paid through the Aged and Disabled (AD) waiver, a Medicaid program that offers family caregiver pay for help at home., Nebraska's AD waiver serves people 65 or older and people with physical disabilities, and a relative such as an adult child can be paid for personal care, respite and chore help., A spouse can be paid only through a separate service, LRI (Legally Responsible Individual) Personal Care, and only when strict conditions are met.

In This Guide

Who Can Be Paid on Nebraska's AD Waiver?

DHHS sorts paid family caregivers into three groups. Under DHHS's AD waiver guidance, a relative is anyone related to the participant by blood or marriage to the third degree, including stepparents, stepchildren and adoptive relations, so an adult child counts. A Legally Responsible Individual (LRI) is a spouse, or the parent of a minor child. A legal guardian is someone a court appointed.

Your relationship Personal Care, Respite, Chore LRI Personal Care
Adult child or other relative Yes No
Relative who lives with the person Only for care beyond the household routine No
Legal guardian New providers since July 1, 2025: only if related and agency-employed, with limited exceptions No
Spouse, or parent of a minor child No Only if Extraordinary Care is met
Power of attorney Ask the service coordinator Ask the service coordinator

Living together. DHHS has a separate Personal Care Live-in service for a provider who lives with the participant, but it doesn't cover natural supports from relatives living in the home "that would be part of a normal household routine, unless support is clearly above and beyond what is typically expected for someone without a disability."

Guardians. Since July 1, 2025, a legal guardian becoming a new AD waiver provider for their ward must be related to the ward and work as an agency employee, except in limited circumstances. Current guardian-providers may continue; an independent guardian-provider needs approval from the Central Office of DHHS's Division of Disability and Aging.

Paying a Spouse Through LRI Personal Care

DHHS says LRI Personal Care is the only waiver service an LRI can provide, and only if the participant meets Nebraska's definition of Extraordinary Care: hands-on help with daily activities beyond what a spouse would ordinarily do for someone of the same age without a disability or chronic illness. For LRI Personal Care, your spouse needs a "yes" in at least three areas of need on the Extraordinary Care Instrument (DD-26), which the service coordinator scores with your family every year.

LRI Personal Care is capped at 40 hours a week across all LRI providers. An LRI Personal Care provider must be employed by an agency, except in limited circumstances, as a W-2 employee, and LRI Personal Care may not be self-directed.

One caution: Nebraska's provider regulation, 480 NAC 4 (effective October 3, 2021), still says no one may provide services for a spouse; the spouse route rests on DHHS's 2025-2026 waiver guidance and the waiver renewal the Centers for Medicare & Medicaid Services approved effective July 1, 2026. DHHS's other LRI conditions are in our guide to getting paid to care for your spouse in Nebraska.

What AD Waiver Family Caregiver Pay Looks Like in Nebraska

The U.S. Bureau of Labor Statistics (BLS) puts the May 2025 median wage for Nebraska home health and personal care aides at about $17.38 an hour, an occupation estimate, not a rate any program pays a family caregiver. If you'll work through an agency, ask its hourly rate before cutting back at your job.

How to Get Nebraska AD Waiver Family Caregiver Pay, Step by Step

1
Step 1

Qualify for Nebraska Medicaid first

The person you care for must already receive Nebraska Medicaid, determined separately and first. In 2026, Nebraska Medicaid's countable-resource limit on the aged, blind and disabled pathway is $4,000 for one person and $6,000 for two, and for a married applicant DHHS also lists a spousal impoverishment Reserved Amount.

2
Step 2

Get the level of care assessment

Once the person has Medicaid, DHHS calls to schedule a nursing facility level of care assessment, repeated every year.

3
Step 3

Work with the service coordinator

DHHS says an AD waiver participant may have a choice of service coordination provider depending on age: DHHS Local Offices serve all ages, and someone 65 or older can also use the local Area Agency on Aging, unless they already have a DHHS coordinator and want to keep them. Ask to be named as the provider: the chosen services and who provides them are written into the participant's Person-Centered Plan.

4
Step 4

Enroll as the provider

A spouse needs the DD-26 score, an agency employer (except in limited circumstances) and full provider enrollment before LRI Personal Care can be authorized.,

Frequently Asked Questions

Does LRI Personal Care work on other Nebraska waivers?

Yes. DHHS offers LRI Personal Care on all three Nebraska Developmental Disabilities waivers and, as of July 1, 2026, the Traumatic Brain Injury waiver.

Can Mom get waiver Personal Care and Personal Assistance Services at the same time?

No. DHHS says a participant can't be authorized for waiver Personal Care and state plan personal care, Personal Assistance Services, at the same time., Ask the service coordinator which fits.

My husband scored "yes" in only two areas. Can I still be paid?

Not through LRI Personal Care, which needs three "yes" areas on the DD-26. An adult child or other relative could still be paid for AD waiver Personal Care his assessed needs call for, and if he's a veteran, see the VA options in how to get paid as a family caregiver in Nebraska.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in NebraskaHow to get paid as a family caregiver in Nebraska in 2026: VA programs, Medicaid personal care, and private caregiver agreements, and how to apply. CaregiverHow to Get Paid to Care for Your Spouse in NebraskaCan you get paid to care for your spouse in Nebraska? Yes, through LRI Personal Care if your spouse meets Extraordinary Care, or the VA for a veteran. CaregiverCaregiver Programs in NebraskaEvery caregiver program in Nebraska: paid family caregiver pathways, NFCSP respite, VA benefits, and taxes explained for family caregivers in 2026. MedicaidNebraska Medicaid HCBS WaiversNebraska Medicaid HCBS waivers cover home and community care through the Aged and Disabled (AD) Waiver for adults 65+ and people with disabilities. MedicaidHow to Apply for Nebraska MedicaidHow to apply for Nebraska Medicaid online, by phone, or in person: iServe Nebraska, asset limits, spend-down, documents, timelines, and how to appeal a denial. CaregiverRespite Care in NebraskaA 2026 guide to respite care in Nebraska: Medicaid LTSS respite, NFCSP grants through AAAs, VA options, and how to start as a family caregiver.

Find personalized help getting paid through Nebraska's Aged and Disabled waiver at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

Still have questions?

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.