Stretching across the Great Plains, Nebraska is home to wide-open prairie landscapes, beautiful big blue skies and more than 1.96 million residents, of whom 16.2% are seniors age 65 and older. Nebraska’s increasing popularity with retirees is largely due to the state’s overall affordability, safety and access to quality health care. Not only can seniors benefit from a low cost of living, but care costs are also affordable. Compared to the U.S. national average of $4,500, assisted living care only costs $4,076 per month in Nebraska. Those in need of assisted living may be eligible for help paying for care through the Aged and Disabled waiver and the Nebraska Program of All-Inclusive Care for the Elderly (PACE). 

This guide is designed to help seniors and their families navigate planning for long-term care services in Nebraska. It includes a breakdown of what assisted living services typically cost in the state compared to nearby regions and how these costs vary. It also provides information about applying for health care benefits, where to go for financial assistance and some of the long-term care resources available to seniors.

How Much Does Assisted Living Cost in Nebraska?

According to the Genworth Cost of Care Survey 2021, seniors typically pay $4,076 per month for assisted living services in Nebraska. This means seniors are likely to save between $400-500 per month for these services compared to the average U.S. city. In fact, compared to nearby states, Nebraska is one of the more affordable options. Wyoming is almost $100 more expensive, and costs in Kansas are more than $500 higher. The most expensive option is Colorado, where monthly costs average around $4,750. Conversely, Missouri is the most affordable nearby state at $3,000 per month.

The Cost of Assisted Living in Nebraska’s Top Cities

Depending on where a senior is living in the state, the cost of assisted living can be higher or lower. Rates are highest in the capital city of Lincoln at an average of $4,715 per month. Assisted living services in the Omaha area are only slightly lower at $4,652. Seniors looking for the most affordable long-term care may opt for a city close to Grand Island, where assisted living costs just $2,906 per month.

The Cost of Assisted Living vs. Other Types of Care

Seniors may find themselves in need of varying levels of care at different stages of their aging journey. A range of options is available in Nebraska, depending on the degree of assistance required and the environment. Adult day care is a good choice for seniors who need minimal help and supervision. It’s also the most affordable option at $1,842. Homemaker services and home health aide assistance are ideal for seniors who want to age in place, and they cost $5,148 and $5,339 per month, respectively. Nursing home facilities offer a greater scope of care than assisted living facilities and are therefore the most costly option at an average rate of $7,483 per month for a semiprivate room.

Can You Use Medicaid to Pay for Assisted Living in Nebraska?

While assisted living in Nebraska is not directly covered by the Medicaid State Plan, it is covered indirectly through the Aged and Disabled Waiver program. Through this waiver, seniors have access to financial support that can help offset the costs of medical needs and personal care services. Room and board expenses are not included. Additional long-term care support may be available to seniors in certain counties through the Nebraska Program of All-Inclusive Care for the Elderly (PACE).

Medicaid’s Coverage of Assisted Living in Nebraska

The Aged and Disability Waiver program provides support to seniors living in assisted living facilities by helping to cover the cost of many personal care and medical services. These may include assistance with activities of daily living, social and recreational programming, housekeeping, laundry, medication reminders and non-medical transportation. Depending on an applicant’s income, a small cost may be assessed on a sliding scale to cover some of these services.

While it isn’t a waiver program, PACE is available to Medicaid-qualifying seniors aged 55 and up who require a nursing home level of care. The program is designed to provide support for seniors who wish to remain living at home or in a community-based setting rather than a nursing facility. This includes financial assistance with assisted living expenses such as prescription medications. physical and occupational therapies, dentistry work, specialized medical care and hospice.

Waiver Programs for Assisted Living in Nebraska

Aged and Disabled Waiver

One of Medicaid’s Home and Community-Based Services (HCBS) waivers, the Aged and Disability Waiver program, helps cover the cost of assisted living services for seniors who require a nursing home level of care but wish to remain living at home or in an assisted living facility. A range of services is included under this waiver, including socialization activities, housekeeping, personal care services, transportation and medication assistance. To qualify for this waiver program, individuals must be at least 65 years of age or have a physical disability. Seniors work with a trained AD Waiver Service Coordinator to determine the services they are qualified to receive.

The quickest way to apply is by completing an online application through ACCESSNebraska. Seniors may also fill out a paper application and submit it in person to their local Department of Health and Human Services office or mail it to:

301 Centennial Mall South
P.O. Box 98947
Lincoln, NE 68509-8947

Questions about applying for this waiver program can be directed to ACCESSNebraska’s toll-free helpline or seniors can contact an AD Waiver Service Coordinator at their local DHHS office.

Eligibility for Medicaid in Nebraska

As it is designed to serve individuals with limited income and resources, Medicaid sets certain limits on the amount of income and assets a senior can have in order to be eligible to receive benefits. If applying as an individual, a senior’s annual income cannot exceed $13,596 per year, and they may not have more than $4,000 in countable assets. If the applicant has a spouse who is not applying, the spouse’s asset limit is $137,400. Couples applying together cannot exceed a combined annual income of $18,312 and have no more than $6,000 in assets. Some items may be exempt from being counted as assets, including one vehicle, household effects and family heirlooms.

2022 Medicaid Income Limits for Seniors in Nebraska

	Income Limits*	Asset Limits
Single Applicant	$13,596	$4,000
Two-Person Household (Only One Person Applying)	$13,596	$4,000 for applicant $137,400 for non-applicant
Two-Person Household (Both People Applying)	$18,312	$6,000

*per year

In addition to these financial limitations, seniors must also meet the following requirements to qualify for Medicaid:

• Be 65 years of age or older,
• Or be blind, disabled or living in a household with someone disabled
• Be a legal resident of Nebraska
• Be a U.S. citizen or permanent resident
• Have a  functional need for long-term care assistance

Applying for Medicaid in Nebraska

To apply for Medicaid in Nebraska, seniors can complete an online application via ACCESSNebraska. The convenient, self-service portal screens applicants to determine their eligibility for Medicaid and other state programs. Applications are then forwarded to the corresponding agency to be processed. If they prefer, seniors may apply in person at their local Department of Health and Human Services (DHHS) office or mail a completed paper application to:

Medicaid Eligibility Program
P.O. Box 2992
Omaha, NE 68103-2992 

Any questions or concerns seniors have about their application can be directed to ACCESSNebraka’s customer service hotline at (855) 632-7633. An Automated Benefit Inquiry service is available 24 hours a day.

Before You Apply:

Seniors should have the following information on hand when completing their Medicaid application form:

• Full legal name
• Date of birth
• Proof of U.S. citizenship or applicable residency information
• Proof of residency in Nebraska
• Social Security number
• Current health insurance policy numbers
• Full list of assets
• Proof of household income, including all retirement accounts and trusts

Where to Go to Get Help

If seniors have questions about their health care coverage options are need assistance applying for Medicaid, they can contact one of the following agencies:

Resource	Contact	Service
ACCESSNebraska	(855) 632-7633	Seniors can call ACCESSNebraska’s toll-free hotline for information about eligibility requirements, questions about coverage options and assistance with their Medicaid applications. The agency also operates an Automated Benefit Inquiry service that’s available 24 hours a day to guide seniors through their options.
Department of Health and Human Services Local Offices	(402) 471-3121	Department of Health and Human Services offices are available across all 93 counties in Nebraska. At these locations, seniors can speak to case managers who can help guide them through the application process and their options. Seniors can use the department’s online locator tool to find the DHHS office nearest to them.
Enroll Nebraska	Online	Enroll Nebraska is a statewide network of over 50 community organizations and advocacy groups dedicated to helping Nebraskans sign up for health care coverage. The organization offers free assistance with the enrollment process, including an interactive online map that seniors can use to find local Medicaid assisters. The site also has a page with answers to frequently asked questions about Medicaid.
Health Center Association of Nebraska	(402) 932-3389	The Health Center Association of Nebraska (HCAN) is a nonprofit organization committed to helping Nebraskans understand their health insurance options. Certified Application Counselors can help seniors understand the health care coverage options available to them, provide consultations about what programs might be best suited for their needs and assist them with the application process.

Can You Use Medicare to Pay for Assisted Living in Nebraska?

Unfortunately, Medicare does not cover the cost of assisted living in Nebraska. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Nebraska?

	How to Apply	How It Works
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Nebraska

In Nebraska, there are numerous government-sponsored agencies and nonprofits offering free or low-cost services and programming to help seniors age with dignity and independence. Some of these services include benefits counseling, care coordination, financial advice, legal support and long-term care referrals.

Resource	Contact	Service
State Unit on Aging	(402) 471-2307	Through the State Unit on Aging, Nebraskan seniors can access a wide range of programs and services designed to help them maintain their overall health, safety and sense of independence. A partnership between the Older Americans Act, Nebraska Community Aging Services Act and Nebraska Area Agencies on Aging, this agency can direct seniors to their local senior center or organization providing social services, recreational programming and community-based personal care.
Nebraska Aging and Disability Resource Center (ADRC)	(844) 843-6364	The Aging and Disability Resource Center (ADRC) helps connect Nebraskan seniors who are aged 60 and older with long-term services and supports in their local community. Trained specialists can provide information, referrals and assistance with long-term care arrangements, financial advice, adult protective services, mental health services and options counseling. These services are administered through the state’s Area Agencies on Aging, of which there are eight.
State Long-Term Care Ombudsman Program (SLTCOP)	(800) 942-7830	Operated by the Department of Health and Human Services, the Nebraska State Long-Term Care Ombudsman Program (SLTCOP) operates on behalf of seniors residing in long-term care environments, including assisted living facilities and nursing homes. Its staff members advocate for seniors’ rights, offer one-on-one consultations for seniors and their families, host educational sessions and serve as third-party representatives to resolve complaints and concerns.
Nebraska Department of Veterans’ Affairs	(402) 471-2458	Nebraska Department of Veterans’ Affairs provides a number of programs and support services to serve the needs of veterans and their dependents. This includes assisting seniors who’ve served with understanding the state and federal benefits they’re entitled to, such as health care coverage, Aid and Attendance payments, pensions and disability compensation. Seniors can contact their local County Veterans Service Office for additional county-specific benefits. The department also operates veterans’ homes in several locations across Nebraska, including Bellevue, Norfolk, Kearney and Scottsbluff.
Legal Aid of Nebraska	(800) 527-7249	Legal Aid of Nebraska provides free legal assistance for low-income and vulnerable individuals, including the elderly and aging. The organization operates in all 93 counties across Nebraska. Seniors aged 60 and older can utilize the organization’s ElderAccessLine for advice and assistance with Medicare and Medicare, wills, collections, consumer protection, power of attorney and any other legal concerns they may have.
Nebraska SHIP	(402) 471-2841 or (800) 234-7119	Nebraska SHIP helps seniors make informed decisions about health insurance through a variety of outreach efforts and educational programming. A division of the Nebraska Department of Insurance, the program features a statewide network of certified counselors and affiliate organizations that can provide information and one-on-one counseling to seniors looking to enroll in Medicare. A toll-free hotline is also available to answer questions, schedule consultations and connect seniors with their local SHIP office.

COVID-19 Rules for Assisted Living in Nebraska

The following information is based on research done on several government websites, including dhhs.ne.gov and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Not Available*
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Assisted Living Laws and Regulations in Nebraska

The licensing and regulation of assisted living facilities in Nebraska is overseen by the Department of Health and Human Services, Division of Public Health. Facilities are inspected both prior to and following licensure. The department conducts annual inspections of 25% of all facilities chosen by random selection to ensure they are complying with federal and state regulations.