You can get paid as a family caregiver in Nebraska, and which door you use turns on one question: whether you are legally responsible for the person you care for.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
On the Medicaid side there are two named services with opposite rules. Personal Assistance Services, the state plan benefit, pays a family member as long as that family member is not legally responsible for the participant, which covers an adult child or a sibling but not a spouse. LRI Personal Care, a waiver service, pays exactly the people Personal Assistance Services will not: a spouse, or the parent of a minor child.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE If your loved one is a veteran, the Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a tax-free monthly stipend directly to you, and Veteran-Directed Care and Aid and Attendance add two more veteran-based routes.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
The Short Version
If the person you care for is not a veteran, your Medicaid route depends on who you are to them. Not legally responsible for them? Personal Assistance Services can pay you. Their spouse? Your route is LRI Personal Care, which exists only on a waiver, so they have to qualify for a waiver first. Ask Nebraska DHHS for whichever fits, by name.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
If your loved one is a veteran, PCAFC, Veteran-Directed Care, and Aid and Attendance all operate under federal rules that apply the same in Nebraska as anywhere else.
If you have private assets and may need Medicaid later, a written caregiver agreement can keep payments from being treated as a gift under the look-back rules.
How to Get Paid as a Family Caregiver in Nebraska Through Medicaid
Nebraska's Two Medicaid Routes to Family Caregiver Pay
Personal Assistance Services (PAS): the State Plan Route
Personal Assistance Services is Nebraska Medicaid's state plan help with activities of daily living, such as bathing or dressing. You may qualify if you are a person of any age who receives Medicaid, lives in your own home rather than an institution, and has an assessed need for the service in order to live in the community.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Can a family member be the paid provider? Yes, with one exclusion, and DHHS states it directly: a family member may be a paid provider as long as that family member is not legally responsible for the participant. A spouse, or the parent or guardian of a minor child, cannot, and whoever does the work must meet the provider qualifications. DHHS also says a participant has the right to choose their provider and direct their own care.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
What to ask DHHS: what the provider qualifications and enrollment steps are for a family member on Personal Assistance Services, and how many hours the assessment authorizes.
LRI Personal Care and the HCBS Waivers
Nebraska has five active home and community-based waivers. Two serve adults at a nursing facility level of care: the Aged and Disabled (AD) waiver, for individuals ages 65 or older and individuals with physical disabilities ages 0 to 64, and the Traumatic Brain Injury (TBI) waiver, for individuals with brain injury ages 18 or older. The other three, for people with autism, intellectual disabilities or developmental disabilities, use an ICF/IID level of care instead.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Who may be paid depends on the service, and the pattern reverses what most families expect. On the AD waiver a relative may be paid to provide Personal Care, Respite and Chore, while a Legally Responsible Individual may not. LRI Personal Care is the one AD waiver service an LRI may be paid for, and a relative who is not an LRI may not be paid for that one. The TBI waiver follows the same pattern. LRI Personal Care is offered on the AD waiver, all three Developmental Disabilities waivers, and, as of July 1, 2026, the TBI waiver.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
To be eligible for AD waiver services a person must already receive Nebraska Medicaid, have a disability or be over the age of 65, meet nursing facility level of care, and have a need for waiver services, so Medicaid financial eligibility is a separate determination that comes first.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Lifespan Respite: Support Without a Wage
Nebraska DHHS runs the Lifespan Respite program for eligible people across the lifespan with medical, mental or behavioral special needs. It provides up to $125 per month for planned respite per client, plus up to $2,000 per eligibility period for approved Exceptional Circumstances including crisis respite. It will only serve people who are not receiving and not eligible for respite services from another government program, and a waiver participant can receive respite from only one source, so a family already getting AD waiver respite cannot also draw Lifespan Respite.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
This is not wage replacement, but if you are caregiving without pay and need hours off, it is a real and separately funded resource.
How a Family Provider Enrolls and Is Paid
Each step gates the next. Confirm the specifics with a DHHS caseworker or your service coordinator as you go.
Confirm the care recipient's Medicaid eligibility
The person receiving care must qualify for Nebraska Medicaid first. Nebraska uses an AABD/MA resource limit of $4,000 for a single applicant, and it is a medically needy (share-of-cost) state rather than one that requires a Miller trust. Apply through iServe Nebraska or by calling 1-855-632-7633.U.S. Government Publishing Office. (n.d.). ecfr.gov. Retrieved Aug 8, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-H/section-435.725
Request an assessment
DHHS determines whether the person has an assessed need for Personal Assistance Services in order to live in the community, or meets the nursing facility level of care a waiver requires. That finding sets which route is open to you.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Name the service that matches your relationship
If you are not legally responsible for the person you care for, ask about becoming their Personal Assistance Services provider. If you are their spouse, or the parent of a minor child, ask about LRI Personal Care on a waiver, by name.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Complete provider enrollment
Whoever is paid must be able to meet the qualifications to become a provider, and LRI Personal Care in particular cannot be authorized until the provider is fully enrolled, so finish this before you count on any hours.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Understand how you are paid and tracked
People delivering LRI Personal Care are W-2 employees, and the service is tracked with an Extraordinary Care Tool and Electronic Visit Verification.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
What if you are told a spouse cannot be paid? That answer is correct about Personal Assistance Services and wrong about the waivers, so ask the follow-up in these words: is LRI Personal Care available on the waiver my spouse qualifies for, and what does provider enrollment require? If they do not meet nursing facility level of care and no waiver is open to them, Personal Assistance Services can still pay a family member who is not legally responsible for them, so the covered hours are not lost.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE If your loved one is also a veteran, the VA pathways below pay a spouse without a level-of-care test.
How to Get Paid as a Family Caregiver in Nebraska Through the VA
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Who can be paid: A designated primary family caregiver: spouse, adult child, parent, stepfamily member, or extended family member of an eligible veteran. Up to two secondary caregivers can be designated as well.
2026 stipend: The stipend starts from a monthly base, which is the OPM GS-4 Step 1 annual rate for the locality where the veteran lives, divided by 12. It is not an hourly wage. 38 CFR 71.40(c)(4)(i) then multiplies that base by a factor, and there are four factors across two schedules, not two. Which one applies depends first on whether the veteran is in the current program under 38 CFR 71.20(a), or is a legacy participant or legacy applicant under 38 CFR 71.20(b) or (c), meaning a household whose connection to PCAFC predates the program's October 1, 2020 restructuring.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
| Route | What sets the factor | Multiplier |
|---|---|---|
| Current program, 38 CFR 71.20(a) | Default | 0.625 |
| Current program, 38 CFR 71.20(a) | VA determines the veteran is "unable to self-sustain in the community" | 1.00 |
| Legacy participant or applicant, 38 CFR 71.20(b) or (c) | Sum of the veteran's 2019 clinical ratings is 21 or higher | 1.00 |
| Legacy participant or applicant, 38 CFR 71.20(b) or (c) | 2019 rating sum is 13 to 20 | 0.625 |
| Legacy participant or applicant, 38 CFR 71.20(b) or (c) | 2019 rating sum is 1 to 12 | 0.25 |
Three rules sit on top of that grid. First, the legacy schedule reaches the full 1.00 on the rating sum alone, with no self-sustain determination required, so a legacy household whose 2019 ratings total 21 or higher should not treat 0.625 as its ceiling. Second, a veteran who meets both the current-program and the legacy criteria is paid whichever of the two amounts is higher. Third, a legacy participant's stipend is held at not less than what the caregiver was eligible to receive the day before October 1, 2020, so long as the veteran still resides at the address on record with PCAFC on that date. That schedule runs eight years from October 1, 2020 and lapses October 1, 2028.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Most of Nebraska falls under the Rest of US or Omaha locality pay area, so the base differs across the state. Confirm your locality's GS-4 Step 1 figure and which of the five rows above your household falls in with your VA Caregiver Support Coordinator.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Veteran eligibility: Service-connected disability rating of 70% or higher (single or combined); enrolled in VA health care; needs in-person personal care services for at least 6 continuous months. Both pre-9/11 and post-9/11 eras qualify.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Additional benefits for the primary caregiver: CHAMPVA health insurance if otherwise uninsured; at least 30 days of respite per year; mental health counseling; legal and financial planning; travel reimbursement.
How the caregiver is paid: Direct deposit from the VA after approval. The stipend is federal tax-free.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Apply: Through the VA Program of Comprehensive Assistance for Family Caregivers portal, or work with your VA Caregiver Support Coordinator at the VA Nebraska-Western Iowa Health Care System.
VA Veteran-Directed Care
Who can be paid: Any caregiver the veteran chooses, including a spouse, adult child, or friend.
How it works: The veteran receives a flexible monthly budget based on their VA-assessed care needs. The veteran directs who to hire and sets the hourly rate within that budget, working with a Financial Management Services agency contracted with the VA.
Veteran eligibility: Enrolled in VA health care; needs help with ADLs; Veteran-Directed Care must be offered through the veteran's local VAMC, and availability varies by facility.
VA Aid and Attendance Pension
Who is paid: The veteran or surviving spouse receives the pension. Family caregivers are typically compensated from it under a written private arrangement.
2026 benefit maximums (Maximum Annual Pension Rate, effective Dec 1, 2025 through Nov 30, 2026). These are ceilings, not guaranteed payments: VA pays the difference between the claimant's countable income and the applicable MAPR, so a veteran or surviving spouse who has other income receives less than the maximum shown here. VA publishes these as yearly amounts; a monthly figure below is that annual ceiling divided by 12, not a separately published rate.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
- Veteran with no dependents, with Aid and Attendance: up to $29,093/year (about $2,424/month)
- Veteran with one dependent: up to $34,488/year (about $2,874/month)
- Two veterans married to each other who both qualify for Aid and Attendance: up to $46,143/year (about $3,845/month)
- Surviving spouse with Aid and Attendance: up to $18,697/year (about $1,558/month)
- Each additional dependent adds $2,984/year
Net worth limit (2026): $163,699. The calculation counts the claimant's and dependents' assets and income for VA purposes; assets exclude the primary residence, the car, and basic home items.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
Eligibility: Wartime veteran (90+ days active duty with at least one day during a recognized wartime period) or surviving spouse; needs help with ADLs, is housebound, resides in a nursing facility, or is legally blind.
36-month look-back: VA pension is subject to a 36-month look-back on asset transfers for less than fair market value made on or after October 18, 2018, under 38 CFR 3.276.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
Apply: Through va.gov/pension/aid-attendance-housebound or free of charge through a Nebraska Veterans Service Officer. Avoid for-profit pension consultants who charge a percentage.
Private Caregiver Agreement (Personal Services Contract)
A written caregiver agreement can formalize the payment of a family member from private funds. Used primarily as a Medicaid planning tool when the care recipient has assets and may eventually need Medicaid.
The look-back issue: Nebraska applies a 60-month (5-year) Medicaid look-back to uncompensated asset transfers. Without a written contract, informal payments from an elder to a family caregiver can be treated as uncompensated gifts and trigger a transfer penalty. A properly written personal services contract at a fair market rate converts the arrangement into a documented exchange of value.U.S. Government Publishing Office. (n.d.). ecfr.gov. Retrieved Aug 8, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-H/section-435.725
What the contract must include:
- A start date (the contract must be signed before services begin)
- Specific services to be provided and a weekly schedule
- A reasonable and customary hourly rate, documented against local market rates
- Payment terms and method
- Daily caregiver logs of hours and tasks performed
- The caregiver reports wages as income on their tax return
Not for spouses: Transfers between spouses are generally disregarded under Medicaid's community-spouse rules, so the Medicaid look-back protection that a contract provides for adult children does not apply the same way for spouses.
Comparison Table
| Pathway | Pay spouses? | Pay non-spouse family? | 2026 pay | Waitlist? | Key step |
|---|---|---|---|---|---|
| PAS personal care (Medicaid state plan) | No | Yes, if not legally responsible | Confirm with DHHS | Confirm with DHHS | Ask DHHS for a PAS assessment |
| LRI Personal Care (HCBS waiver) | Yes | No | Confirm with DHHS | Confirm with DHHS | Ask for LRI Personal Care by name |
| VA PCAFC | Yes | Yes | GS-4 Step 1 annual rate, locality-adjusted, divided by 12, then times 0.25, 0.625, or 1.00 depending on current-vs-legacy route; tax-free | None | 70%+ service-connected rating |
| VA Veteran-Directed Care | Yes | Yes | Vet-set within VA budget | Varies by VAMC | Enrolled in VA health care |
| VA Aid and Attendance | Paid to veteran | Paid to veteran | Up to $29,093/yr, about $2,424/mo (veteran, no dependents) | None | Wartime service, A&A criteria |
| Private Caregiver Agreement | Not for look-back purposes | Yes (with written contract) | Fair market rate | None | Elder-law attorney required |
How to Choose
Caring for a veteran? Start with VA programs. The PCAFC stipend is tax-free and comes with CHAMPVA. Contact your VA Caregiver Support Coordinator at the Nebraska-Western Iowa VA or the Grand Island VA Clinic.
Medicaid-eligible, not a veteran? Ask Nebraska DHHS about Personal Assistance Services if you are not legally responsible for the person you care for, or about LRI Personal Care on a waiver if you are their spouse.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Want maximum flexibility in who you hire? VA Veteran-Directed Care, if available at your Nebraska VAMC, lets the veteran choose any caregiver including a spouse. Ask the VAMC social work team about referral.
Have private assets and concerned about Medicaid later? Work with a Nebraska elder-law attorney to draft a personal services contract before any large informal payments start. The 60-month look-back applies.U.S. Government Publishing Office. (n.d.). ecfr.gov. Retrieved Aug 8, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-H/section-435.725
Unpaid caregiver needing a break? Ask Nebraska DHHS about Lifespan Respite, described above, for people not receiving and not eligible for respite from another government program.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Not sure where to start in Nebraska? Chat with Brevy's care navigator for a personalized look at veteran status, Medicaid eligibility, and which pathway fits your family's situation.
Tax Considerations
- Medicaid personal care wages (Personal Assistance Services, or a waiver service such as LRI Personal Care): confirm tax treatment with DHHS and a tax preparer.
- VA PCAFC stipend is federal tax-free income and does not count as income for most federal benefit programs.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
- VA Veteran-Directed Care wages are paid through an FMS agency, generally as W-2 wages.
- VA Aid and Attendance is tax-free to the veteran; a family caregiver paid from that pension receives ordinary taxable income.
- Private caregiver agreement wages are ordinary taxable income; employment classification matters.
IRS Notice 2014-7: Medicaid waiver payments to a caregiver who lives with and provides care to the Medicaid recipient may be excluded from the caregiver's federal gross income. LRI Personal Care is a waiver service and a spouse shares a home by definition, so ask a tax preparer familiar with the rule.
Common Misconceptions
"Nebraska will not pay a spouse." True of Personal Assistance Services, the Medicaid state plan benefit, and that is where the belief comes from. On the waiver side, LRI Personal Care exists precisely to pay a Legally Responsible Individual, meaning a spouse or the parent of a minor child. Ask for it by name.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
"Medicare pays family caregivers." Medicare does not pay family caregivers. Medicare covers short-term skilled home health through certified agencies for homebound beneficiaries. Family caregiver pay comes from Medicaid, the VA, or private arrangements.
"I can start paying myself from my parent's savings and document it later." Documentation must precede services. For both Medicaid look-back protection and IRS purposes, the caregiver agreement must be written and signed before services begin. Backdating does not work.
Frequently Asked Questions
Can a family member get paid to care for a Nebraska Medicaid recipient?
Yes, and which service pays you depends on whether you are legally responsible for them. Under Personal Assistance Services, Nebraska's Medicaid state plan benefit, a family member may be a paid provider as long as that family member is not legally responsible for the participant; a spouse, or the parent or guardian of a minor child, cannot. A spouse is paid instead through LRI Personal Care, a waiver service offered on the Aged and Disabled waiver, all three Developmental Disabilities waivers, and, as of July 1, 2026, the Traumatic Brain Injury waiver. Whoever is paid must meet the provider qualifications.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
How much does the VA PCAFC pay in Nebraska?
The PCAFC stipend is the OPM GS-4 Step 1 annual rate for the locality where the veteran lives, divided by 12, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). There are four possible factors, not two. A veteran in the current program under 38 CFR 71.20(a) draws 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community. A legacy participant or applicant under 38 CFR 71.20(b) or (c) is scored instead on the sum of the veteran's 2019 clinical ratings: 1.00 at 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12. A veteran who meets both sets of criteria is paid whichever amount is higher, and the legacy schedule lapses October 1, 2028. Most of Nebraska falls under the Rest of US or Omaha locality, so confirm your locality figure and your factor with your VA Caregiver Support Coordinator before counting on a number.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Can I get paid through both VA PCAFC and Nebraska Medicaid at the same time?
They are separate programs, and layering them may be possible, but how they interact depends on how each counts income and whether services overlap. Talk to your VA Caregiver Support Coordinator and a Nebraska elder-law attorney before combining them.
Does Nebraska help unpaid caregivers get a break?
Yes, through Lifespan Respite, a Nebraska DHHS program that provides up to $125 per month for planned respite per client, plus up to $2,000 per eligibility period for approved Exceptional Circumstances. It does not pay you a wage, and it will only serve people who are not receiving and not eligible for respite services from another government program.Centers for Medicare & Medicaid Services. (n.d.). Nebraska Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NE
Where to Get Help in Nebraska
Learn More
Find personalized help navigating Nebraska paid family caregiver options 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.