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Getting paid to care for a parent in Nebraska

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Nebraska's door is Aged and Disabled (AD) Waiver — Independent Provider option (participant hires and directs the caregiver; DHHS pays them as a Medicaid independent provider), run by Nebraska Department of Health and Human Services (DHHS). Medicaid eligibility and provider enrollment go through the Division of Medicaid & Long-Term Care. The Aged and Disabled Waiver itself is run by the Division of Disability and Aging — that is the new name, effective July 18, 2026 (LB733 and LB867), for what used to be called the Division of Developmental Disabilities, so older letters, PDFs and web links may still say 'DDD.' Day-to-day service coordination comes from your local DHHS office, or from your Area Agency on Aging if your parent is 65 or older (Eastern Nebraska Office on Aging in the Omaha area).. Pay: State-plan PAS: $15.00/hr, billed as $3.75 per 15-minute unit under MMIS code 4475. Confirmed on both the SFY2026 fee schedule (effective July 1, 2025) and the SFY2027 fee schedule (effective July 1, 2026), which says outright there was no increase because the Legislature appropriated no rate money. What that means for you: if you enroll as an independent provider, that $15.00 is paid to you — it is your gross hourly pay before payroll taxes, not an agency's markup. If a home care agency employs you instead, the agency bills the $15.00 and pays you less out of it. AD Waiver personal care: there is no published flat rate. Each independent provider's hourly rate is negotiated one-on-one with the DHHS Resource Developer, reviewed annually, and cannot exceed what you would charge a private-pay client (Personal Care Service Handbook, updated July 2024). In practice family caregivers land at or near Nebraska's minimum wage, which is $15.00/hr from January 1 through December 31, 2026 under Neb. Rev. Stat. 48-1203, then rises 1.75% each January.

One or more details on this page could not be fully confirmed against official sources at publish time — confirm specifics with the agency below.

Who can be the paid caregiver

Adult children, other relatives, and friends can be hired and paid under both the AD Waiver and state-plan PAS by enrolling as a Medicaid Independent Provider. That means an application, a fingerprint criminal background check run through Maximus (NebraskaMedicaidPSE@Maximus.com), and a signed MC-19 Service Provider Agreement. The rule that actually disqualifies people is the legal-support rule: under 480 NAC 4, no one may be paid to provide waiver services to a spouse, a minor child, or any participant they have a legal obligation to support. Nebraska has no law making an adult child financially responsible for a parent, so an adult child caring for a parent is in the clear. Spouses get around the support rule only through the AD Waiver's LRI Personal Care service — there is no such route in state-plan PAS, where 471 NAC 15.003.02(A) flatly bars spouses and parents of minor children. Important: being your parent's power of attorney, guardian, or authorized representative does NOT disqualify you from also being the paid caregiver. No Nebraska rule says otherwise, and the participant or their representative is expected to act as the employer of an independent provider.

The spouse question

Split answer. State-plan PAS: NO — spouses are "legally responsible persons" and are barred. AD Waiver: YES — Nebraska pays Legally Responsible Individuals (including spouses) through "LRI Personal Care"; DHHS's Dec 2025 renewal draft tried to cap LRI/live-in family hours (40-70 hrs/week) and Gov. Pillen had the caps scrapped on Jan 27, 2026. Because the 2026-2031 waiver renewal was still finalizing with CMS (effective ~July 1, 2026), a spouse should confirm current enrollment rules with the Service Coordinator before counting on it. For this page's core question — an adult child caring for a parent — the LRI issue doesn't apply at all.

Waitlist reality

PAS (state plan): this is an entitlement — if your parent qualifies, there is no waitlist. AD Waiver: not an entitlement. Enrollment is capped at roughly 10,000 people statewide, and that number is how many Nebraskans the waiver actually serves — it is NOT the number of people waiting. As of early 2026 there was no statewide AD Waiver waiting list, and DHHS's own division director said the state was proposing changes precisely so it would not have to start one. If a list does form, priority goes to people whose health or safety is at risk, not to whoever applied first. The wait you should actually plan for is processing time: commonly 1-3 months from application to a decision. Watch item: the waiver renewal taking effect around July 2026 keeps a modified 150% institutional cost limit, which caps the dollars spent per person but does not by itself create a waitlist.

Worth knowing: Disqualifiers and fine print: (1) Money facts are verified, but Veteran-Directed Care availability in Nebraska could not be confirmed from an official VA page — hence "partial." (2) AD Waiver requires nursing-facility level of care AND Medicaid financial eligibility; parents in assisted living can use the waiver but the family-caregiver option is for people at home. (3) The caregiver must pass enrollment/background screening; the participant (or their representative) acts as employer of an "independent provider." (4) Big recent scare, resolved: in Dec 2025 DHHS proposed capping family/live-in caregivers at 40 hrs/week and legally-responsible-individual care at 70 hrs/week combined for the waiver's 5-year renewal; after public backlash Gov. Pillen had DHHS scrap both caps on Jan 27, 2026. A modified 150% institutional cost limit (with health/safety exceptions) stays — very high-hour care plans can still be squeezed by that dollar cap. Renewal takes effect ~July 1, 2026 pending CMS approval, so rules are freshly settled; confirm details with the Service Coordinator. (5) PAS hours are capped by assessed need and the caregiver cannot bill for time the parent is hospitalized/in a facility. (6) New money: Nebraska Caregiver Tax Credit (tax years 2025+) — 50% of out-of-pocket caregiving costs up to $2,000 ($3,000 if the parent is a veteran or has dementia); income limits $50,000 single/$100,000 joint; statewide pot is only $1.5M/yr through mid-2027 and applications (Form 3165) are first-come, first-served.

Other doors in Nebraska

ProgramWhat to know
Medicaid Personal Assistance Services (PAS) — state planNo waiver slot and no waitlist. Family members (adult children yes, spouses no) enroll as independent providers at $15.00/hr ($3.75 per 15 min, DHHS fee schedule eff. 7/1/2025, unchanged 7/1/2026). For parents who need daily-living help but not nursing-home level of care. Same DHHS application channel: iServe or (877) 667-6266.
Nebraska Caregiver Tax Credit (Caregiver Tax Credit Act, LB 937)State income tax credit starting tax year 2025: 50% of eligible caregiving expenses, max $2,000 (or $3,000 if the parent is a veteran or has dementia). Income limits $50K single/$100K joint; parent must live in a private home and need help with 2+ ADLs. Capped statewide at $1.5M/yr, first-come first-served — file Forms 3165/3165C with the Dept. of Revenue early.
Nebraska Lifespan Respite SubsidyUp to $125/month (plus up to $2,000/eligibility period for crisis/exceptional circumstances) for UNPAID primary caregivers to buy respite — it pays a break for you, not wages to you, and you lose eligibility if you become the paid caregiver. DHHS: (866) 737-7483, DHHS.respite@nebraska.gov.
Veteran-Directed Care (VD-HCBS)If your parent is a veteran in VA care: a monthly flexible budget to hire caregivers, including family and spouses. ARIS Solutions lists a Nebraska veteran program fiscal-agent operation ((866) 970-3301), but availability through VA Nebraska-Western Iowa could not be confirmed on an official VA page — ask your parent's VA social worker or the Caregiver Support Line (855) 260-3274. VA Aid & Attendance (up to ~$2,424/mo for a single veteran, 2026) can also fund family-provided care informally.
No structured family caregiving / caregiver stipend modelNebraska has no Georgia/Indiana-style per-diem Structured Family Caregiving program; the hourly independent-provider model above is the route.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Apply for Medicaid and the AD Waiver together online at iServe Nebraska (iserve.nebraska.gov), or call (877) 667-6266 to have a paper application mailed. Return it to HCBS Eligibility, PO Box 98947, Lincoln NE 68509-8947, scan it to dhhs.hcbswaiverapp@nebraska.gov, or drop it at any DHHS office.
  2. 2. DHHS checks financial eligibility (2026 waiver limits are higher than regular Medicaid) and whether your parent meets nursing-facility level of care under 471 NAC 12. Plan on 1-3 months from application to decision.
  3. 3. Once approved, a Service Coordinator does the in-home assessment and writes the care plan, including Personal Care hours. That coordinator comes from your local DHHS office or, if your parent is 65 or older, your Area Agency on Aging — in the Omaha area that is the Eastern Nebraska Office on Aging, (402) 546-1870 or (888) 554-2711.
  4. 4. Tell the coordinator you want a family member as the paid caregiver. That person enrolls as a Medicaid Independent Provider: application plus fingerprint criminal background check through Maximus (NebraskaMedicaidPSE@Maximus.com) and a signed MC-19 Service Provider Agreement. Their hourly rate is then negotiated with the DHHS Resource Developer.
  5. 5. Care starts and the caregiver logs every visit in Nebraska Medicaid's Electronic Visit Verification system, which is Netsmart (some DD waiver providers use Therap as an approved alternate vendor instead — ask your coordinator which one applies to you). EVV questions: (833) 483-5587 or DHHS.MedicaidFA-EVV@Nebraska.gov. DHHS pays the enrolled independent provider directly.
  6. 6. If your parent does not meet nursing-home level of care but still needs daily-living help, ask the same DHHS office about state-plan Personal Assistance Services (PAS) instead — no waiver slot needed and no waitlist.

Where to start: Nebraska DHHS HCBS/AD Waiver line: (877) 667-6266, or apply online at iserve.nebraska.gov (email: dhhs.hcbswaiverapp@nebraska.gov). Omaha-area service coordination: Eastern Nebraska Office on Aging (402) 546-1870 / (888) 554-2711

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

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Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.