This page provides a plain-English summary of key elder care and estate planning information specific to Nebraska residents. It covers Nebraska Medicaid limits, estate and inheritance tax rules, advance directive information, and links to important Nebraska agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
Nebraska Medicaid — 2026 Eligibility Limits for Long Term Care
Nebraska’s Medicaid program is called the Nebraska Medical Assistance Program — NMAP — and is administered by the Nebraska Department of Health and Human Services — DHHS. Nebraska delivers most Medicaid services through a managed care program called Heritage Health. Nebraska expanded Medicaid under the Affordable Care Act in 2020 providing coverage to adults up to 138 percent of the federal poverty level.
Income limit — nursing home Medicaid versus AD Waiver — important difference Nebraska has two different income limits depending on the long term care program. Nursing home Medicaid uses the standard income cap of $2,982 per month in 2026 — applicants with income above this limit must establish a Qualified Income Trust — QIT — to qualify. The Aged and Disabled — AD — Waiver — Nebraska’s primary HCBS program — uses a much lower income limit of $1,330 per month which is 100 percent of the Federal Poverty Level. This difference is significant — many seniors who qualify for nursing home Medicaid may not directly qualify for the AD Waiver unless they use the medically needy spend-down pathway.
Medically needy spend-down Nebraska offers a medically needy spend-down pathway for applicants whose income exceeds the AD Waiver limit of $1,330 per month. Applicants apply excess income toward qualifying medical expenses each month to spend down to the medically needy income limit of $392 per month. Once the spend-down is met Medicaid covers remaining qualifying costs for the rest of the month.
Asset limit — single applicant — higher than most states A single applicant must have $4,000 or less in countable assets — double the $2,000 standard used by most states. This higher asset limit gives Nebraska seniors somewhat more financial flexibility. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, and irrevocable funeral trusts. Note that IRAs and 401(k)s are counted as countable assets in Nebraska.
Home and community based care — Aged and Disabled Waiver Nebraska’s primary HCBS program for seniors is the Aged and Disabled — AD — Waiver which provides home and community based services for Nebraskans aged 65 and older or adults aged 18 and older with physical disabilities who need nursing facility level care but want to remain at home. The asset limit is $4,000 for a single applicant. As of 2026 there is no waitlist — Nebraska funds services for all eligible AD Waiver applicants. Services include adult day health assisted living personal care home-delivered meals home modifications and assistive technology.
Nebraska also offers a State Plan Personal Assistance Services — PAS — program that provides in-home personal care assistance. PAS uses a lower asset limit of $4,000 for a single applicant and the same income structure as the AD Waiver. PAS does not have spousal impoverishment protections — the community spouse does not receive a Monthly Maintenance Needs Allowance or Community Spouse Resource Allowance under PAS.
Married couples — one spouse applying When only one spouse applies for Nebraska Medicaid through nursing home Medicaid or the AD Waiver the community spouse — the spouse who remains at home — may retain up to $162,660 of the couple’s combined countable assets. If the community spouse’s share is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $4,000.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,644 per month in 2026. The maximum is $4,067 per month for community spouses with high housing costs.
Personal needs allowance Nebraska nursing home Medicaid recipients are allowed to keep $60 per month as a personal needs allowance. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty Nebraska has a 60-month — five year — look-back period for nursing home Medicaid and AD Waiver applications. The look-back period does not apply to the State Plan PAS program. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The 2026 divestment penalty divisor in Nebraska is approximately $7,000 per month.
Estate recovery Nebraska requires Medicaid estate recovery for recipients aged 55 and older. After a Nebraska Medicaid recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for Nebraska Medicaid Applications can be submitted online through ACCESSNebraska at accessnebraska.ne.gov, by phone at 1-855-632-7633, or in person at your local Nebraska DHHS office.
Nebraska Medicaid administering agency Nebraska Department of Health and Human Services — dhhs.ne.gov
Nebraska Estate and Inheritance Tax — 2026
Nebraska has no state estate tax but does have a state inheritance tax — one of only six states that still imposes one. However Nebraska’s inheritance tax was significantly reformed in 2023 and as of 2026 most family inheritances are exempt.
No Nebraska state estate tax Nebraska does not impose a state estate tax. No Nebraska estate tax applies regardless of estate size.
Nebraska inheritance tax — significantly reformed in 2023 Nebraska imposes an inheritance tax based on the beneficiary’s relationship to the deceased. The 2023 reform — LB 310 — made major changes effective January 1 2023 that eliminated the inheritance tax for immediate family members.
The following beneficiaries are now fully exempt from Nebraska inheritance tax — spouses parents grandparents children grandchildren great-grandchildren and siblings. This covers the vast majority of typical family inheritances.
Distant relatives — including aunts uncles nieces nephews and cousins — pay Nebraska inheritance tax at a rate of 1 percent on amounts above $40,000 per beneficiary.
Unrelated beneficiaries — including friends domestic partners and non-family individuals — pay Nebraska inheritance tax at a rate of 15 percent on amounts above $25,000 per beneficiary.
Nebraska inheritance tax is county-collected — unique in the country Unlike most state taxes that are administered centrally Nebraska’s inheritance tax is collected at the county level by the county treasurer through the probate court process. This means the rules and processes can vary somewhat by county. Tax payments are due within 12 months of the date of death. Late payments accrue interest at 14 percent per year with a penalty of 5 percent per month up to a maximum of 25 percent.
Life insurance and exempt assets Life insurance proceeds paid directly to a named beneficiary — not to the estate — are exempt from Nebraska inheritance tax regardless of the beneficiary’s relationship to the deceased. This makes life insurance an important estate planning tool for Nebraska residents who want to leave assets to unrelated beneficiaries or distant relatives.
Federal estate tax Nebraska residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No Nebraska gift tax Nebraska does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
Nebraska income tax Nebraska has a progressive income tax with rates ranging from 2.46 percent to 5.84 percent — reduced from higher rates in recent years. Social Security benefits are now fully exempt from Nebraska income tax — a significant improvement from prior years when Nebraska taxed Social Security. Pension income and IRA and 401(k) withdrawals are generally taxable in Nebraska.
Nebraska property taxes — among the highest in the country Nebraska has an effective property tax rate of approximately 1.58 percent — among the highest in the nation and significantly above the national average. Nebraska’s heavy reliance on property taxes to fund local education and services makes this a significant financial consideration for Nebraska homeowners and estate planning for heirs who inherit real estate.
Nebraska Advance Directives
Nebraska law recognizes the following advance directive documents:
Nebraska Power of Attorney for Health Care Names a healthcare agent to make medical decisions on your behalf when you are unable to do so. Must be signed and witnessed by two adults or notarized.
Nebraska Declaration — Living Will Documents your wishes regarding life-sustaining treatment when you have a terminal condition or are in a persistent vegetative state. Must be signed and witnessed by two adults or notarized.
Nebraska POLST — Physician Orders for Life-Sustaining Treatment Nebraska uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
Nebraska Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. Nebraska has standardized out-of-hospital DNR protocols.
Nebraska Advance Directive Registry Nebraska does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare agent physician and any hospital or care facility where you receive care.
Free Nebraska advance directive forms Free Nebraska-specific advance directive forms are available at caringinfo.org and from the Nebraska Medical Association at nebmed.org.
Nebraska Key Agencies and Resources
Nebraska Department of Health and Human Services — DHHS Administers Nebraska Medicaid including long term care programs. Website: dhhs.ne.gov ACCESSNebraska Portal: accessnebraska.ne.gov Phone: 1-855-632-7633
Nebraska State Unit on Aging — SUA Coordinates programs and services for older Nebraskans including home care nutrition programs caregiver support and the Nebraska SHIP program for free Medicare counseling. Website: dhhs.ne.gov/aging Phone: 1-402-471-2307 Nebraska SHIP — free Medicare counseling: 1-800-234-7119
Nebraska Area Agencies on Aging Nebraska is served by 8 Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
Nebraska Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: dhhs.ne.gov/aging/ombudsman Phone: 1-800-942-7830
Nebraska State Bar Association Lawyer Referral Service Connects Nebraskans with attorneys including those who specialize in elder law and estate planning. Website: nebar.com Phone: 1-800-927-0117
Nebraska Legal Aid Provides free civil legal services to low income Nebraskans including seniors on issues related to Medicaid benefits housing and elder law. Website: nebraskalegalaid.org Phone: 1-877-250-2016
Nebraska Veterans Resources
Nebraska Department of Veterans Affairs — NDVA Provides services and benefits to Nebraska veterans and their families including free VA claims assistance and connections to Nebraska veterans resources. Website: veterans.nebraska.gov Phone: 1-402-471-2458
Nebraska Veterans Homes Nebraska operates veterans homes providing long term care to eligible veterans and their spouses. Facilities are located in Bellevue Grand Island Norfolk and Scottsbluff. Website: veterans.nebraska.gov/veterans-homes
Nebraska Senior Property Tax Benefits
Homestead Exemption Nebraska offers a homestead exemption for qualifying seniors aged 65 and older disabled individuals and disabled veterans that can significantly reduce property taxes on a primary residence. The exemption amount and eligibility criteria depend on age disability status and income. Apply through your county assessor’s office by June 30.
Property Tax Credit Nebraska provides a property tax credit for all real property owners as a credit against income taxes or as a direct credit. The credit is intended to partially offset Nebraska’s high property taxes.
Disabled Veteran Property Tax Exemption Nebraska veterans who are totally and permanently disabled due to a service-connected disability may qualify for a homestead exemption that reduces or eliminates property taxes on their primary residence. Apply through your county assessor’s office.
Finding Elder Law and Estate Planning Attorneys in Nebraska
The following resources can help you find a qualified elder law or estate planning attorney in Nebraska:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- Nebraska State Bar Association Lawyer Referral Service — nebar.com — 1-800-927-0117
- Nebraska Chapter of NAELA — Nebraska has an active NAELA chapter with members throughout the state
- Nebraska Legal Aid — nebraskalegalaid.org — free legal assistance for income-qualifying seniors — 1-877-250-2016
The information on this page is for general informational purposes only and does not constitute legal or financial advice. Nebraska Medicaid rules inheritance tax rates and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026