Nebraska Medicaid pays for care in your own home and community instead of in a nursing facility, and it does that mainly through one program: the Aged and Disabled (AD) Waiver. Nebraska Medicaid HCBS waivers are the route to that community care, and here the route is essentially this single waiver rather than a long menu of them. The AD Waiver is the state's primary Medicaid home and community-based services (HCBS) waiver, and it serves adults age 65 and older along with people from birth to age 64 who have physical disabilities.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 To use the AD Waiver, you must qualify for Nebraska Medicaid and meet a nursing-facility level of care, which means your care needs are serious enough that you could otherwise be placed in an institution.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
In This Guide
- What Are Nebraska Medicaid HCBS Waivers?
- The Aged and Disabled (AD) Waiver in Detail
- Who Qualifies for Nebraska Medicaid HCBS Waivers?
- What the AD Waiver Covers
- How Enrollment and Your Service Coordinator Work
- How to Apply for the AD Waiver
What Are Nebraska Medicaid HCBS Waivers?
Home and community-based services (HCBS) is the part of Medicaid that pays for long-term care delivered outside an institution, in your own home, a family member's home, or another community setting rather than in a nursing facility. States deliver these services under a federal authority called a 1915(c) HCBS waiver, named for the section of federal law that created it. The "waiver" part means the state gets federal permission to waive some ordinary Medicaid rules so it can fund care in the community for people who would otherwise need institutional care.
Some states run a whole set of these waivers, one for older adults, another for people with brain injuries, another for children, and so on. Nebraska keeps it simpler for the population this guide is written for. Its primary Medicaid HCBS waiver for older adults and people with physical disabilities is the Aged and Disabled (AD) Waiver, a Section 1915(c) waiver run by the Nebraska Department of Health and Human Services (DHHS) Division of Medicaid & Long-Term Care.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 Federally, it is recorded as the "NE HCBS Waiver for Aged, Adults, and Children with Disabilities," and its status is approved.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
The idea behind the waiver is straightforward. If your needs are high enough that Medicaid would otherwise pay for a nursing-facility stay, the AD Waiver lets Medicaid instead pay for services that support you at home, where most people would rather be. That single decision, home instead of institution, is what the whole program is built around.
The Aged and Disabled (AD) Waiver in Detail
The AD Waiver is administered by the Nebraska DHHS Division of Medicaid & Long-Term Care, the same division that runs the rest of Nebraska Medicaid.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 It is a Section 1915(c) waiver, so it carries the two features every waiver of that type shares: you must meet an institutional level of care to get in, and the services are meant to be an alternative to that institutional placement.
Who the waiver is for is defined by age and disability. It covers adults ages 65 and older and people from birth to age 64 who have physical disabilities.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 A younger adult with a physical disability and an older adult who has grown frail can both be served by the same waiver, as long as each one receives Nebraska Medicaid, meets a nursing-facility level of care, and has a genuine need for waiver services.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
One point worth stating plainly: the waiver pays for care and services, not for your housing. The AD Waiver does not pay a participant's room and board, and a participant pays any applicable Medicaid share of cost.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 So the program covers the help you need to live safely at home, while your ordinary living costs stay your own.
Who Qualifies for Nebraska Medicaid HCBS Waivers?
There are two eligibility tests, and you have to clear both. The first is functional, about your level of need. The second is financial, about your income and assets.
The functional test: nursing-facility level of care
To be eligible for the AD Waiver, you must meet a nursing-facility level of care and have a need for waiver services.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 In plain terms, your daily needs, help with bathing, dressing, medications, mobility, and similar tasks, have to be serious enough that you could qualify for care in a nursing facility. If your needs are lighter than that, the AD Waiver is not the right door, though other community programs might be. A DHHS assessment is how this level of care gets determined.
The financial test: Nebraska Medicaid eligibility
You also have to qualify for Nebraska Medicaid itself. Nebraska is a medically needy state, sometimes called a "share of cost" state, which changes how the income side works. Instead of a hard income cutoff, there is no fixed income cap: a person whose income is above Nebraska's limit can still qualify by spending the excess down on medical and care expenses.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 As of 2026, the medically needy income level DHHS uses is $392 per month for a one-person household, and income above that goes toward your share of cost.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
Assets are tested separately. For the aged, blind, and disabled category, the countable-resource limit is $4,000 for one person and $6,000 for two people.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 Countable resources are things like bank accounts and other savings; certain assets are treated differently under Medicaid's rules, which is worth confirming with DHHS for your own situation.
| Standard | Amount |
|---|---|
| Medically needy income level (1 person) | $392 per month |
| Countable-resource limit (1 person) | $4,000 |
| Countable-resource limit (2 people) | $6,000 |
| Room and board | Not paid by the waiver |
The figures in that table are the ones that most often decide whether a family thinks they qualify.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 Because Nebraska is medically needy, being over the income level is not automatically a "no"; it usually means a share of cost rather than a denial. For a fuller walk through the numbers, see our guide to Nebraska Medicaid income and asset limits.
What the AD Waiver Covers
The AD Waiver funds a broad set of home and community supports, chosen to fit what a particular person needs to stay safely at home. Covered services include:Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
- Personal care, meaning help with activities of daily living such as bathing and dressing, along with health-related tasks.
- Respite care, which pays someone to step in and care for the participant so the primary caregiver gets a temporary break.
- Adult day health, structured daytime care and supervision outside the home.
- Home-delivered meals and chore services for the household.
- Companion and non-medical transportation services.
- Assistive technology, home and vehicle modifications, and a personal emergency response system (PERS), the wearable or in-home device that summons help in an emergency.
- Independence skills building and home again, the waiver's nursing-facility transition support for people moving from an institution back into the community.
Not every participant receives every service. Your DHHS Service Coordinator helps determine which of these you qualify to receive, based on your assessed needs and your person-centered plan.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 The through-line is consistent: each service exists to replace a reason someone might otherwise have to enter a nursing facility.
How Enrollment and Your Service Coordinator Work
Enrollment in the AD Waiver runs through a DHHS Service Coordinator, and understanding that role early makes the rest of the process clearer. After you apply, you work with a Service Coordinator who develops your person-centered plan and helps determine which services you qualify to receive.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 The plan is built around you, your needs, your goals, and the supports that let you stay at home, rather than around a fixed package handed to everyone.
Availability of waiver services can change over time, so it is worth confirming current openings and timelines directly with DHHS when you start. Your Service Coordinator is also your ongoing point of contact: as your needs shift, the plan can be revisited and the mix of services adjusted. If you are weighing the waiver against a nursing-home stay, our guide to Nebraska Medicaid and nursing home care walks through how the institutional side works.
How to Apply for the AD Waiver
Applying for the AD Waiver starts with applying for Nebraska Medicaid, since Medicaid eligibility is the foundation the waiver sits on. There are two straightforward ways to begin.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
- Apply online. File through iServe Nebraska, the state's online application portal.
- Apply by paper. Call DHHS at 877-667-6266 to have a paper application mailed to you.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
Once your application is in, DHHS reviews it and a Service Coordinator helps develop your person-centered plan and determine which services you qualify to receive.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 Federal Medicaid rules set outer limits on how long the state may take to decide: a Medicaid application generally must be decided within 45 calendar days, and within 90 calendar days when eligibility is based on disability.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf Those are ceilings, not typical timelines, but they tell you the state cannot leave your application open indefinitely.
For a step-by-step look at the Medicaid application itself, see our guide on how to apply for Nebraska Medicaid.
Frequently Asked Questions
Does the AD Waiver mean I have to go into a nursing home?
No, it is the opposite. The Aged and Disabled (AD) Waiver exists so that Medicaid can pay for care in your own home and community instead of in a nursing facility.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441 You do have to meet a nursing-facility level of care to qualify, meaning your needs are serious enough that institutional care would otherwise be on the table, but the waiver then lets you receive services at home rather than moving into one.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
What if my income is too high for regular Medicaid?
Being over the income limit is not an automatic denial. Because Nebraska is a medically needy, or "share of cost," state, someone whose income sits above the state's threshold can still reach the Nebraska Medicaid coverage the AD Waiver depends on by spending the excess down each month on medical and care expenses, rather than being turned away outright.Centers for Medicare & Medicaid Services. (n.d.). NE HCBS Waiver for Aged, Adults, and Children with Disabilities (0187.R08.00) - Medicaid.gov waiver record. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82441
Learn More
Find personalized help understanding Nebraska Medicaid HCBS waivers 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.