Nebraska Medicaid Income Limits 2026: Eligibility & Assets

Two numbers decide most Nebraska Medicaid long-term-care cases, and both run friendlier than the national default. Nebraska lets a single applicant keep $4,000 in countable assets (twice the federal Supplemental Security Income (SSI) default of $2,000), and a married couple $6,000, and it never simply turns away an applicant for earning too much.1,2 If your income is above the line, Nebraska lets you spend the excess down on care instead of shutting the door.

Those Nebraska Medicaid income limits are the long-term-care answer, though, and Nebraska runs a second, completely separate income test for everyone else. This guide covers both. For seniors and people with disabilities applying for long-term care: the asset limit, how the medically needy share-of-cost spend-down works, what a nursing-home resident keeps, and what a spouse at home is protected from.1 For people under 65, including a grandparent raising a grandchild, the MAGI limits, Heritage Health Adult at 138% of the poverty level with no asset test at all, and what changes on the 65th birthday.3,4

Which Nebraska Medicaid income limit applies to you?

Nebraska runs two different Medicaid income tests, and they can return opposite answers for two people with identical bank statements. Which one you face depends on your age and on why you need coverage.

• The aged, blind, and disabled (ABD) track covers people 65 or older, blind, or disabled, and everyone applying for nursing-facility or other long-term-care coverage. It uses the income methodology of the federal SSI program, and it applies an asset test. Every number in the section above is an ABD number.1,4
• The MAGI track covers people under 65 who are not disabled and not pregnant, plus children, pregnant women, and parents and caretaker relatives. Income is measured as Modified Adjusted Gross Income (MAGI), household size follows federal tax-filing relationships rather than the ABD household rules, and federal law bars Nebraska from applying any asset test at all.4,6

Most people who search for Nebraska Medicaid income limits are not applying for nursing-home care, so the MAGI figures below are the ones that answer their question. If you are helping a parent qualify for long-term care, the ABD sections are yours.

The $4,000 asset limit, and why it's higher than you'd expect

For most of Medicaid's history, the countable-asset limit for a single aged or disabled applicant has been the SSI default of $2,000.2 Nebraska sits above it. The Nebraska Department of Health and Human Services sets the countable-asset limit at $4,000 for a single applicant and $6,000 for a married couple when both spouses are applying (per DHHS standard 477-000-012, effective 2026).1

"Countable" is the word doing the work. Nebraska, like every state, exempts a long list of assets from the count: your home (subject to an equity cap, covered below), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $4,000 ceiling applies to things like bank balances, a second car, and investments, not the roof over your head.1

The couple figure matters when both spouses need coverage. When only one spouse needs care and the other stays in the community, a separate and far larger set of spousal-impoverishment allowances applies instead, which is the section below on protecting the at-home spouse.

Nebraska Medicaid income limits and the share-of-cost spend-down

Nebraska is a medically needy state. Its medically needy income limit for 2026 is $392/month for an individual and $392 for a couple.1 That number is low, and on its own it would lock out most seniors living on a monthly retirement check. It doesn't, and here's why.

Being over the $392 medically needy limit does not disqualify you.1 The amount your monthly income runs above $392 becomes your share of cost (the spend-down). The arithmetic is straightforward: a retiree with $1,400/month in Social Security runs $1,008 over the $392 limit, so $1,008 is their share of cost for that month.1 Once you have incurred that much in medical and care expenses within a given month, Nebraska Medicaid covers the rest of that month. You qualify by spending the excess down on care, not by clearing a hard income cliff. A nursing-facility bill alone clears most applicants' share of cost in a single month. For the broader set of approaches, see our guide to Medicaid planning strategies.

This is also why Nebraska does not require a Qualified Income Trust, also called a Miller Trust. In a strict income-cap state, an applicant a dollar over the limit is shut out unless they route the excess through a special trust. Nebraska sets no such ceiling for long-term-care Medicaid. Higher monthly income means a larger share of cost, never an outright denial for being over an income line.

Long-term care: what a nursing-home resident keeps

When Nebraska Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of care. What they hold back is the Personal Needs Allowance (PNA), money set aside for the resident's own small expenses such as clothing, a haircut, or a phone. Nebraska sets its PNA at $75/month, above the federal floor of $30.1,7

The same $4,000 asset limit applies to nursing-home applicants.1 And because Nebraska uses share-of-cost spend-down rather than an income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care. For the national picture on how the PNA is calculated and what it can be spent on, see our explainer on the Medicaid personal needs allowance.

The five-year look-back

Nebraska reviews asset transfers made in the 60 months before a long-term-care application.1,8 Giving away money or property for less than fair market value during that window, signing a house over to a child for a dollar or handing a grandchild a down payment, can trigger a penalty period during which Medicaid won't pay for long-term-care services even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Nebraska applies the federal figures for 2026:1,5,9

So a married couple sits in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets and keep monthly income up to the maintenance allowance while the other spouse receives Medicaid-funded care.5

Nebraska Medicaid income limits under 65: the MAGI rules

Nebraska has adopted the ACA Medicaid expansion, and it runs its expansion coverage under a state program name: Heritage Health Adult, for adults ages 19 to 64.3,10 That matters, because it means a low-income adult under 65 in Nebraska has a Medicaid category to apply for, which is not true in the ten states that declined the expansion.10 Nebraska DHHS sets these MAGI limits as a percentage of the Federal Poverty Level, effective January 1, 2026:

None of these groups face an asset test.3

On the two numbers you may see for Heritage Health Adult. Nebraska's own standards chart lists the group at 133% FPL, while this guide and most federal sources say 138%. Both are correct and describe the same rule: 133% is the statutory base, and federal law applies a MAGI income disregard equal to 5 percentage points of the poverty level at the top of the group, which makes the effective ceiling 138% FPL.3,11 For one person in 2026, 138% FPL works out to roughly $1,835/month, which is 138% of the $15,960/year federal poverty guideline for a one-person household in the 48 contiguous states and the District of Columbia, the schedule Nebraska uses. (Alaska and Hawaii run on separate, higher guidelines.)12,11

Parents and caretaker relatives: 58% of poverty

Parents and other caretaker relatives are a federally mandatory Medicaid group, but they are the one MAGI group federal law does not peg to the poverty line. Under 42 CFR 435.110, the floor a state must cover them to is its own pre-welfare-reform cash-assistance standard: the AFDC income standard the state had in effect on May 1, 1988, converted to a MAGI equivalent and frozen there. That floor is typically far below FPL.13 Nebraska sets its parent/caretaker-relative level at 58% FPL, well under the poverty line.3

This is the group an eldercare reader is most likely to land in without expecting to: a grandparent raising a grandchild would look to the parent/caretaker-relative category rather than to a senior pathway. Whether a specific grandparent meets the caretaker-relative definition is a determination Nebraska DHHS makes on the application, so ask rather than assume.

The 58% figure reads harsher than it works out to be in Nebraska, and the reason is the expansion. A grandparent under 65 whose income clears the 58% caretaker level can still qualify through Heritage Health Adult, whose 138% ceiling is more than twice as high.3 It is in the states without an expansion group that the frozen caretaker standard does real damage, leaving a working parent over the income limit at a very low income with nothing underneath them.13,10

No asset test on the MAGI track

The $4,000 asset limit at the top of this guide does not exist on the MAGI side. Federal law bars a state from applying any asset or resource test to the MAGI groups, and Nebraska applies none; the asset test survives only on the SSI-related ABD and long-term-care pathways, which the statute expressly excepts from that rule.4,3

The practical effect inside one family: a 60-year-old with $50,000 in savings and income under $1,835/month qualifies for Heritage Health Adult, because her savings are not counted at all. Her 70-year-old mother, with the same $50,000, is far over Nebraska's $4,000 countable-asset limit and must spend down.4,1

Children and CHIP, briefly

Coverage for children under 19 is federally mandatory down to at least 133% FPL, and states may go higher.14 Nebraska does, on a sliding scale by age: Medicaid covers newborns to age 1 up to 162% FPL, ages 1–5 up to 145% FPL, and ages 6–18 up to 133% FPL, with CHIP picking up children above those thresholds to 213% FPL.3 So the combined Medicaid-and-CHIP ceiling is 213% FPL for every age band, which is why the national medicaid.gov eligibility table reports Nebraska children at 213% across the board while the state chart shows the lower Medicaid-only figures.3

Turning 65 changes which test you face

This is the transition that catches families off guard, and it is worth naming plainly: turning 65 can end Medicaid coverage even though nothing about the person's income changed. Heritage Health Adult, like every state's expansion group, is written for people under 65 who are not entitled to or enrolled in Medicare.11 On the 65th birthday that pathway closes, and the same person is reassessed on the SSI-related ABD track, the track federal law excepts from the no-asset-test rule.4

Two things change at once in Nebraska:

• The income yardstick drops. The measure stops being 138% FPL (roughly $1,835/month) and becomes the SSI-related standards. For reference, the 2026 SSI Federal Benefit Rate is $994/month for an individual, and Nebraska's medically needy income level is the $392/month figure at the top of this guide.2,1
• An asset test appears where there was none. Nebraska counts resources against a $4,000 limit for a single applicant on the ABD track. That is double the $2,000 federal SSI default, but it is a limit that did not apply to that person the day before their birthday.1,2

The income half of the cliff lands more gently in Nebraska than it would in an income-cap state. Because Nebraska is a share-of-cost spend-down state, being over the line does not shut the door: a 64-year-old covered at $1,600/month does not get denied at 65 for being over $392, they get a monthly share of cost.1 The asset half is the harder edge. The same person with $10,000 in savings held Medicaid with no asset test at all at 64; at 65 that $10,000 sits over Nebraska's $4,000 limit and has to be spent down before coverage resumes.1,4

Age is not the only trigger. The expansion group also excludes anyone entitled to or enrolled in Medicare, so someone under 65 who reaches Medicare through disability leaves the 138%, no-asset-test group the same way.11 If a birthday or a Medicare enrollment is coming up for someone in your family who is on Heritage Health Adult, that is the moment to plan, not the month after.

After death: estate recovery

Like every state, Nebraska runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. Federal exceptions apply, and an undue-hardship waiver exists.1,15 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply for Nebraska Medicaid

Nebraska Medicaid is run by the Nebraska Department of Health and Human Services through its Division of Medicaid and Long-Term Care. There are three steps to getting a long-term-care decision.

Learn More

Find personalized help working through Nebraska Medicaid eligibility and the share-of-cost spend-down for your family 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.