If you are caring for an aging parent, a spouse, or an adult child with a disability in Nebraska, the state can pay you. Nebraska caregiver programs split along one line: Personal Assistance Services pays a family member who is not legally responsible for the person they care for, and a spouse is paid instead through a waiver service called LRI Personal 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 The Aged and Disabled waiver adds respite and other supports, and for veterans, VA programs open a separate route.
Knowing that help exists is rarely the hard part. Knowing what it is and where to start is. This guide maps every major caregiver program in Nebraska for 2026, from paid-caregiver pathways to free respite grants and VA benefits.
You don't have to figure this out alone, and you don't have to fund all of it from your savings.
In This Guide
- Nebraska Caregiver Programs at a Glance
- Who Pays Family Caregivers in Nebraska?
- How to Start Paid Caregiver Support
- Respite Care Programs
- Where to Get Help
- VA Caregiver Programs in Nebraska
- Taxes for Nebraska Caregivers
- Frequently Asked Questions
- Learn More
Nebraska Caregiver Programs at a Glance
| Program | What It Offers | Pay a spouse? | Cost to You |
|---|---|---|---|
| Personal Assistance Services (Medicaid state plan) | Pays a family member to provide in-home personal care | No, a spouse is legally responsible | Free (paid by Medicaid) |
| LRI Personal Care (Medicaid waiver) | Pays a legally responsible individual to provide personal care | Yes | Free (paid by Medicaid) |
| NFCSP respite grants | Free in-home respite, adult day vouchers, training, counseling | N/A | Free |
| VA PCAFC | Monthly tax-free stipend; pays spouses | Yes | Free (VA benefit) |
| VA Aid and Attendance | Pension up to $29,093/yr to veteran; caregiver paid from it | Pension to veteran | Free to apply (VSO help) |
Who Pays Family Caregivers in Nebraska?
If you are already doing the hands-on work of bathing, dressing, or supervising a loved one, Nebraska Medicaid may be able to pay you for it. In-home care runs through the Nebraska Department of Health and Human Services (DHHS), which funds personal care through two main pathways.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
- Personal Assistance Services (PAS) is the Medicaid state plan benefit: help with activities of daily living such as bathing or dressing, for a person of any age who receives Medicaid, lives in their own home rather than an institution, and has an assessed need for the service in order to live in the community. DHHS 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
- LRI Personal Care is a waiver service, and it is the route for a spouse. DHHS defines a Legally Responsible Individual as a spouse or the natural or adoptive parent of a minor child, and offers LRI Personal Care on the Aged and Disabled waiver, all three Developmental Disabilities waivers, and, as of July 1, 2026, the Traumatic Brain Injury 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
- The Aged and Disabled (AD) waiver is a 1915(c) home and community-based services waiver for older adults and adults with physical disabilities who would otherwise need nursing-facility care. It layers on respite, adult day health care, and other supports beyond personal care, and it is managed regionally through Nebraska's eight Area Agencies on Aging.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Sep 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
The question most Nebraska families are really asking is whether a relative can actually be the paid worker, and Nebraska publishes the answer. Under Personal Assistance Services, 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. On the Aged and Disabled waiver the pattern reverses: a relative may be paid for Personal Care, Respite and Chore but not for LRI Personal Care, while a Legally Responsible Individual may be paid for LRI Personal Care and none of the others. So a spouse can be paid, through LRI Personal Care, on a waiver. Whoever is paid must be able to meet the qualifications to become a provider.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
Getting to that answer runs through an assessment. DHHS determines the person's functional need for help with daily activities, weighing cognition, behavior, safety, and frailty, and Medicaid confirms financial eligibility. Personal care is then authorized in a care plan built from that assessment.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Sep 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program For the full walkthrough of who can be paid and how the paychecks work, see How to Get Paid as a Family Caregiver in Nebraska.
How to Start Paid Caregiver Support
Getting paid feels bureaucratic from the outside, but it comes down to a few steps, and the first phone call is free.
Contact Nebraska DHHS
Request a screening for Medicaid home and community-based services. This is the front door for Personal Assistance Services and for the Aged and Disabled waiver, and there is no cost or obligation to ask.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 the eligibility determination
DHHS assesses the functional need for help with daily activities, weighing cognition, behavior, safety, and frailty, while Medicaid confirms financial eligibility.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Sep 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
Ask for the service that matches your relationship, by name
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, ask about LRI Personal Care on a waiver. Asking the general question, "can a family member be paid," gets the general answer, which is the wrong one for a 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
Build the care plan and start
Personal care is authorized in a care plan drawn from the assessment. See the Nebraska paid family caregiver guide for the full walkthrough.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Sep 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
Respite Care Programs
Caregiving without a break is how burnout starts, and respite exists precisely because no one can be on call around the clock indefinitely. Nebraska funds it whether or not your loved one is on Medicaid.
The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through Nebraska's Area Agencies on Aging. Services include in-home respite, adult day vouchers, caregiver training, and counseling, with no income test for respite services. Because NFCSP is a caregiver-support grant program separate from Medicaid, you qualify based on the caregiving relationship (caring for an adult 60 or older, or a person of any age with Alzheimer's or a related dementia) rather than on your loved one's Medicaid status. Reach your regional agency through the Eldercare Locator, or dial 211.Office of the Law Revision Counsel, U.S. House of Representatives. (n.d.). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E). uscode.house.gov. Retrieved Sep 2, 2026, from https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section3030s-1&num=0&edition=prelim
State Medicaid waivers can also authorize respite within the care plan: the Aged and Disabled waiver includes respite care to give the usual caregiver temporary relief.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Sep 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program Separately, Nebraska DHHS runs Lifespan Respite, which 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 serves only people who are not receiving and not eligible for respite from another government program, and a waiver participant can receive respite from only one source, so a family already drawing 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 For the full respite guide, see Respite Care in Nebraska.
Where to Get Help
You do not need to know which program you qualify for before you call. A counselor will identify what is available in your area and help you start an application. These are the front doors, and every call below is free.
VA Caregiver Programs in Nebraska
If the person you care for is a veteran enrolled in VA health care, an entirely separate and often more generous set of benefits opens up, on top of anything Medicaid offers.
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. The stipend starts from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, so the dollar amount varies by where the veteran lives and is not an hourly wage. 38 CFR 71.40(c)(4)(i) then multiplies that monthly base by a factor, and there are four factors across two schedules, not two. It is federal tax-free and allows a spouse to serve as the paid caregiver. To qualify, the veteran needs a VA disability rating of 70 percent or higher, a need for at least six continuous months of in-person personal care, and enrollment in VA health care.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Final Rule, 85 FR (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Which schedule applies turns 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. In the current program the factor is 0.625, or 1.00 if VA determines the veteran is "unable to self-sustain in the community." On the legacy route the factor comes instead from the sum of the veteran's 2019 clinical ratings: 1.00 at a sum of 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12, with no self-sustain determination required. A legacy Nebraska household rated 21 or higher therefore reaches the full 1.00 on the rating sum alone, and should not treat 0.625 as its ceiling. A veteran who meets both sets of criteria is paid whichever of the two amounts is higher, and a legacy participant's stipend cannot fall below 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. The legacy schedule lapses October 1, 2028.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Final Rule, 85 FR (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
VA Aid and Attendance Pension
Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. The VA publishes these rates as annual maximums: a single veteran with Aid and Attendance receives up to $29,093 a year (about $2,424 a month, the annual rate divided by 12); a veteran with one dependent up to $34,488 a year (about $2,874 a month). These are ceilings, not flat payments: VA pays the difference between the veteran's or survivor's countable income and the applicable maximum, so someone with other income receives less than the amount shown here. The pension goes to the veteran, who typically pays a family caregiver from it.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/
The Nebraska Department of Veterans' Affairs and county Veterans Service Officers help file at no cost. For caregiver-specific questions, the VA Caregiver Support Line is listed under Where to Get Help above.
Taxes for Nebraska Caregivers
Once you are being paid to provide care, the natural next question is how that income is taxed. The rules are often more favorable than families expect.
IRS Notice 2014-7
If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under IRS Notice 2014-7. The exclusion does not apply if you keep a separate home where you regularly reside. Talk to a tax preparer familiar with the rule before filing.Internal Revenue Service. (n.d.). Certain Medicaid waiver payments may be excludable from income. irs.gov. Retrieved Aug 1, 2026, from https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Nebraska State Income Tax
State income tax treatment of caregiver wages varies. Confirm the current rate and how it applies to Medicaid waiver payments with the Nebraska Department of Revenue or a tax preparer.
VA PCAFC Stipend
The PCAFC monthly stipend is a federal tax-free benefit and is not reported on a W-2.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Final Rule, 85 FR (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Not sure which Nebraska caregiver program fits your family? Chat with Brevy's care navigator for a personalized comparison based on your loved one's Medicaid enrollment, veteran status, and whether you are a spouse or non-spouse caregiver.
Frequently Asked Questions
Can I get paid to care for my spouse in Nebraska?
Yes, through a waiver service named LRI Personal Care. DHHS defines a Legally Responsible Individual as a spouse or the parent of a minor child, and LRI Personal Care is the one Aged and Disabled waiver service an LRI may be paid to provide; it is also offered on all three Developmental Disabilities waivers and, as of July 1, 2026, the Traumatic Brain Injury waiver. What will not work is Personal Assistance Services, the state plan benefit, where a family member may be paid only if they are not legally responsible for the participant. Ask for LRI Personal Care 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, the VA PCAFC program can also pay a spouse.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Final Rule, 85 FR (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Do I have to qualify for Medicaid to be paid as a caregiver in Nebraska?
The person receiving care does. Paid-caregiver pathways run through Nebraska Medicaid, so your loved one must meet both a functional need for daily-living help, determined by a DHHS assessment, and Medicaid financial eligibility. See the Nebraska paid family caregiver guide for the details.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
Is there free respite in Nebraska without Medicaid?
Yes. The National Family Caregiver Support Program provides respite through Nebraska's Area Agencies on Aging with no income test, and it is separate from Medicaid. You qualify based on the caregiving relationship, not on Medicaid enrollment. Reach your regional agency through the Eldercare Locator or dial 211.Office of the Law Revision Counsel, U.S. House of Representatives. (n.d.). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E). uscode.house.gov. Retrieved Sep 2, 2026, from https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section3030s-1&num=0&edition=prelim Nebraska's separate Lifespan Respite program is another route, though only for people who are 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
Which VA programs pay family caregivers in Nebraska?
The PCAFC stipend (for veterans with a 70%+ VA disability rating, tax-free, pays spouses) and the Aid and Attendance pension (for wartime veterans and surviving spouses under the net-worth limit). Call the VA Caregiver Support Line at 1-855-260-3274.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Final Rule, 85 FR (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf,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/
How do I reach my Area Agency on Aging in Nebraska?
Reach your regional agency through the Eldercare Locator, or dial 211. They handle NFCSP respite grants, adult day referrals, and caregiver training.Office of the Law Revision Counsel, U.S. House of Representatives. (n.d.). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E). uscode.house.gov. Retrieved Sep 2, 2026, from https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section3030s-1&num=0&edition=prelim If your loved one is 65 or older on the Aged and Disabled waiver, your Area Agency on Aging also provides service coordination unless you already have a DHHS service coordinator and want to keep them.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
Learn More
Find personalized help navigating Nebraska caregiver programs 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.