Nebraska is a heartland American state with vast wheat and corn fields, high prairie and wild country where wild bison still roam. Home to just under 2 million people, nearly 16% of Nebraska’s residents are seniors aged 65 and over. Seniors in Nebraska can explore historic sites from the days of the Oregon Trail and Wild West, as well as breathtaking natural wonders such as Scotts Bluff and Chimney Rock. Though Nebraska does tax Social Security benefits, it still has some of the lowest costs for senior living, and seniors who own property and earn less than $41,101 a year may qualify for a Nebraska homestead exemption, which reduces property taxes for tens of thousands of seniors.

Seniors in Nebraska can find safe and comfortable senior living in the state’s 114 assisted living communities. Room, board and care at these facilities cost on average $232 less than seniors pay across the U.S., according to the Genworth 2019 Cost of Care Survey, but affording care can still be a challenge for seniors on fixed or limited incomes. This guide outlines the cost of care seniors face in Nebraska and some of the most helpful senior living resources seniors can access in the Cornhusker State.

The Cost of Senior Living in Nebraska

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Nebraska seniors have several long-term care options, depending on preferences, health, finances and care needs. According to Genworth’s 2021 Cost of Care Survey, Nebraska’s long-term care costs are lower than national figures.  

Nursing homes provide skilled nursing services and around-the-clock monitoring for seniors with high-level care needs. Older adults without health or personal care needs might appreciate independent living’s relaxed lifestyle and social opportunities. Individuals who can no longer live independently and need regular help with day-to-day activities may be good assisted living candidates. Assisted living communities often provide memory care, specialized cognitive support and care for dementia patients.

Nursing home care is the most expensive option at $7,483 per month. Seniors requiring memory care can expect to pay around $5,095 per month. Assisted living is more affordable at $4,076 per month. Independent living is Nebraska’s cheapest long-term care option at $2,649 per month.   

The Cost of Assisted Living in Nebraska

At $4,076 per month, assisted living is almost $400 lower than the national median of $4,500 per month. Seniors in neighboring Kansas and Colorado generally pay more than the U.S. average, with monthly fees of $4,580 and $4,750, respectively. With respective monthly rates of $4,367 and $4,169, assisted living in Iowa and Wyoming is lower than the nationwide average but higher than Nebraska. To the north, in South Dakota, assisted living costs are lower, at around $3,350 per month.

The Cost of Nursing Home Care in Nebraska

While Nebraska’s median nursing home care cost of $7,483 is lower than the U.S. average of $7,908, seniors in the Cornhusker State pay more than their peers in most neighboring states. In South Dakota, nursing home care charges $7,118 per month. Costs are lower in Wyoming and Iowa, with monthly median rates of $6,996 and $6,874, respectively. Average prices drop to $6,296 in Kansas. At $8,567, costs for nursing home care are higher in Colorado.

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

Long-term care can be expensive. Thankfully, Nebraska offers programs in Nebraska to help seniors pay for care. For many older adults, Medicaid closes the gap between what they can afford and the full cost of care.  

Nebraska Medicaid directly covers nursing home care for eligible seniors. Older adults in assisted living or memory care communities may be able to use Medicaid to cover at least partial costs. However, seniors should apply for the Aged and Disabled Waiver rather than traditional Medicaid.   

Since independent living is for individuals without health or personal care needs, Medicaid doesn’t cover this type of care.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid Waiver	No
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid Waiver	No
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in Nebraska

Nebraska’s Medicaid program funds assisted living and memory care services for eligible seniors. Services aren’t covered directly; Nebraska has waiver programs to help older people delay or avoid institutional care.  

Aged and Disabled Waiver

The Aged and Disabled Waiver program provides customized services to enable elders to stay in the community and avoid nursing home placement. Wide-ranging services may include:

• Help with personal care
• Assistance with daily activities
• Housekeeping and laundry
• Medication reminders
• Transportation
• Recreational activities
• Cognitive support
• Assistive technology
• Personal emergency alert systems  
• Meal preparation and nutrition programs
• Transportation

The waiver doesn’t pay for room or board.

To qualify for waiver services, seniors must need a nursing home care level. An assessment determines medical needs. They must also be at least 65 years old, blind or disabled, and meet financial eligibility criteria.

Seniors can download an application form and return it by fax to (402) 328-6257 or by mail to:

AD APPLICATIONS (AD/TBI)
Division of Developmental Disabilities
Nebraska Department of Health and Human Services
301 Centennial Mall South
P.O. Box 98947
Lincoln, NE 68509-8947

Individuals can also call the Department of Developmental Disabilities (DDD) at (877) 667-6266 to apply for waiver services or request a mailed application form. Those who prefer to apply in person can visit their local DHHS office.  

Medicaid’s Coverage of Nursing Home Care in Nebraska

Per the Kaiser Family Foundation (KFF), 50% of Nebraska nursing home residents receive financial assistance through Medicaid. In addition to room and board, Medicaid covers a wide range of services for eligible individuals. Services may include:

• Skilled nursing
• Rehabilitation therapies
• 24/7 monitoring
• Medical supplies and equipment
• Assistive technology and accessibility adaptations
• Laundry and housekeeping
• Assistance with personal care and daily activities
• Transportation
• Meal preparation

Except for a $60 personal needs allowance each month and Medicare premiums, recipients must use their entire income to pay for nursing facility care.   

Eligibility for Medicaid in Nebraska

Although institutional Medicaid and the Aged and Disability Waiver are different programs, they share the same financial requirements.

Single applicants, including those applying from a two-person household, can’t earn more than $13,596 per annum. For couples jointly applying for Medicaid, the maximum income is $18,312.

All applicants have an asset cap of $4,000. For couples where only one spouse applies for financial aid, the non-applicant partner has an increased asset limit of $137,400.

2022 Nebraska Medicaid Income Limits 

	Income Limits*	Asset Limits
Single Person	$13,596	$4,000
Two-Person Household(Only one applicant)	$13,596 for applicant	$4,000 for applicant$137,400 for non-applicant
Two-Person Household(Two applicants)	$18,312	$8,000

*Per year

Further eligibility requirements apply, too. Applicants must:

• Be 65 or above, blind or disabled
• Reside in Nebraska on a full-time basis
• Be a U.S. citizen or legal resident
• Satisfy functional criteria related to medical need

Applying for Medicaid in Nebraska

There are several ways to apply for Medicaid in Nebraska. Seniors can submit applications online via the ACCESSNebraska portal. Alternatively, they can download an application form and return it by mail to their local DHHS office or to:

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

Individuals may also apply over the telephone by calling the DHHS customer service line at (855) 632-7633.  

Before You Apply

Medicaid has strict rules and requirements, and claimants must provide detailed information and verification documents supporting applications. It can make the application process smoother if applicants have the following information at hand:

• Proof of identification
• Proof of citizenship status
• Proof of Nebraska residency
• Social Security number
• Up-to-date bank statements
• Proof of income
• Details about all assets, including stocks, shares, bonds, trusts, property and vehicles
• Details about life and health insurance policies
• Medical expenses
• Veteran discharge papers (if applicable)

How to Get Help

Although applying for Medicaid can feel overwhelming, Nebraska seniors can take advantage of help from several sources. Organizations assist individuals in completing applications and filing appeals, comparing costs and plans, looking for ways to save money and providing information to understand coverage.

Resource	Contact	What You Should Know
Public Assistance Offices	(402) 471-3121	Nebraska’s Department of Health and Human Services has several Public Assistance Offices throughout the state where individuals can obtain information and assistance.
ACCESSNebraska	(855) 632-7633	Individuals can submit online applications through ACCESSNebraska’s online portal, which has an eligibility checking tool. Seniors can call the customer service helpline to connect with a knowledgeable advisor to discuss eligibility and general details, obtain application assistance and check the status of applications already in the system.
American Council on Aging	Online Form	The American Council on Aging’s website contains comprehensive details about Medicaid specifically for the older population. It covers eligibility requirements for each state, and individuals can use the online contact form to obtain a free eligibility check based on their personal information. The organization can also provide details of low-cost Medicaid counselors in Nebraska.

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

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Seniors seeking help with Medicare in Nebraska have several avenues of assistance. Organizations help individuals understand their health care coverage, compare health insurance plans, enroll in plans and submit appeals against adverse decisions, as well as potentially finding ways for people to save money on premiums and copays.

Resource	Contact	What You Should Know
Nebraska State Health Insurance Assistance Program	(800) 234-7119	Nebraska State Health Insurance Assistance Program (SHIP) provides free no-obligation advice to existing and future Medicare beneficiaries. Trained volunteers offer one-on-one counseling to enable individuals to make informed choices about their health insurance.
Senior Medicare Patrol	(800) 234-7119	Nebraska Senior Medicare Patrol is a federally funded program that helps seniors recognize and report scams and fraud within the Medicare system. Advisors can help seniors understand their medical bills and help in the case of errors or complaints.
Medicare.Gov	(800) 633-4227	Medicare.Gov is the official government Medicare website. It provides in-depth information about health insurance and allows individuals to conveniently compare providers and costs. Helpline advisors can answer questions and provide further advice and seniors can apply for Medicare online.

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

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Nebraska. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
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 Senior Living Resources for Seniors in Nebraska

Nebraska has diverse, supportive services and benefits to help its aging population. Provided by nonprofit organizations and government agencies, resources are free or subsidized for older adults.

Resource	Contact	What You Should Know
Area Agencies on Aging	(844) 843-6364	Nebraska’s eight Area Agencies on Aging (AAA) provide an array of services for senior citizens aged 60 and above. Advisors can help seniors complete benefits claims, provide options counseling and refer older adults to programs relevant to their needs.
Senior Centers	(402) 471-2307	Located throughout the state, Nebraska’s network of senior centers offers a wide range of programs to enhance the quality of life for people as they age. Services vary by location but typically include social activities, routine health checks, financial optimization advice, transportation programs, congregate meals and respite care.
Legal Aid of Nebraska	(800) 527-7249	Through its Elder Access Line, Legal Aid of Nebraska provides free civil legal advice to those aged 60 and above. Seniors can call its staff between 9 a.m. and 12 noon and from 1 p.m. and 3 p.m. Monday to Thursday and from 9 a.m. to 12 noon on Friday. Seniors can also browse a wealth of legal information online.
Alzheimer’s Association Nebraska Chapter	(800) 272-3900	The nationwide Alzheimer’s Association has a local Nebraska chapter based in Omaha. The organization arranges local events and online workshops, and its website as valuable information and education for anyone affected by dementia. Around-the-clock support and advice are available via the 24/7 hotline.
Senior Learning Passport Program	(402) 472-2030	The Senior Learning Passport Program of The University of Nebraska-Lincoln allows anyone aged 65 and above to purchase a low-cost yearly pass to attend classes for enrichment purposes. There’s a broad choice of subjects, including languages, humanities, business administration, sciences, art, music, communication and philosophy.
Long-Term Care Ombudsman Program	(800) 942-7830	The Long-Term Care Ombudsman Program educates seniors on their rights related to residential long-term care. Ombudsmen receive and investigate complaints about facilities and help seniors and their loved ones resolve issues.

Covid-19 Rules and Restrictions for Nebraska Senior Living Facilities

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

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)

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

Senior Living Laws and Regulations in Nebraska

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations. 

In Nebraska, senior living facilities are regulated by the Licensure Unit of the Department of Health & Human Services. Each facility first obtains an initial license by submitting an application to the Department as well as passing an on-site inspection verifying that it meets requirements. To renew a license, facilities must complete and submit an additional application. Read on to find out out more about the rules and regulations for assisted living facilities in Nebraska.

Scope of Care Provided

Senior living facilities provide shelter, food, and care to their residents. Care includes supervision and assistance with personal hygeine, activities of daily living (ADLs) like eating and toileting, and health maintenance activities like medication administration. Other supportive services may also be available. These communities do not offer skilled nursing or medical care. 

Admissions Requirements

Senior living communities in Nebraska admit seniors who need personal care assistance, but prospective residents must not need complex nursing interventions or have an unstable and/or unpredictable condition, as senior living facilities do not offer routine skilled nursing care. 

An exception to this is when the care for an individual with complex medical needs is secured through private personnel or through a licensed agency and is unlikely to be disruptive or dangerous to other residents. In these cases, admission must also be approved by a medical professional. Facility administrators ultimately decide whether or not to admit applicants, but must follow all rules and regulations during the decision-making process. 

Care Plan Requirements

After a resident evaluation and with the input of the resident or an authorized representative, facilities must provide a written service agreement that meets the resident’s needs. This agreement must outline a plan of care that includes what services will be provided, a schedule for these services, and details on who will be administering them. It must also include costs and terms of payment, facility and resident rights and responsibilities, and terms and conditions of residency.

Staff Requirements

Communities must ensure they have sufficient qualified staff to provide the care and supportive services to residents as defined in their resident service agreements. Facilities must also maintain documentation verifying that they obtained critical employee information, including results of a criminal background check and important health status details that could prevent disease transmission. Proof that staff completed job-related training is also required.

Staff Training

Within two weeks of employment, direct care staff must complete orientation covering resident’s rights, infection control practices, emergency procedures, special resident care needs, disaster preparedness plans, and more. Further, they must complete a minimum of 12 hours of ongoing training each year that is directly related to their job duties at the facility. Facility resources and training must prepare staff to provide the care outlined in resident’s service agreements.  

Memory Care Regulations

Appropriate numbers of qualified direct care staff must be present at the facility at all times to provide or assist memory-impaired residents with personal care, activities of daily living, health maintenance activities, and/or other supportive services. The administrator and direct care staff must have training on the progression of Alzheimer’s disease and the skills to help care for individuals with behavior problems or wandering tendencies as well as knowledge of the facility’s care and supervision policies for persons with Alzheimer’s. 

Medication Management Rules

Residents may administer their own medications with or without supervision if they are assessed to be cognitively and physically capable. Facilities must provide these individuals with counseling on potential adverse health effects due to self-administration, ensure they can store their medications securely, and encourage them to have their medications reviewed by a licensed professional. 

When residents request assistance or are not capable of self-administration, staff members can administer medications for them as long as they have received training and met competency standards. 

Each facility must also have policies in place so residents only receive medications as legally prescribed and must have a registered nurse review its medication administration policies annually. 

How to Report Abuse/Neglect      

The Nebraska Department of Health and Human Services urges individuals who suspect abuse or neglect of an elder to call Nebraska’s Adult Protective Services’ hotline at 800-652-1999. This number is toll-free and operates 24 hours a day.

Frequently Asked Questions

How much does assisted living cost in Nebraska?

Assisted living in Nebraska costs seniors in the state an average of $3,819 a month. This is more than $200 a month less than the $4,051 national average. It’s also somewhat less than the average monthly cost in nearby states, such as Colorado and Iowa, where monthly costs average $4,095 and $4,078, respectively. Assisted living in Nebraska is still somewhat more expensive than in South Dakota, where costs average $3,500 a month.

Does Nebraska Medicaid pay for assisted living?

Medicaid in Nebraska pays much of the cost of basic health services for seniors. This does not include the board and care costs of assisted living communities. Medicaid does, however, pay for many of the expenses seniors in assisted living need help with, such as medication and medical supplies.

Does Medicare pay for assisted living?

Original Medicare offers coverage for qualifying seniors who need short-term inpatient care and many outpatient services. It does not pay for long-term nonmedical care options, such as assisted living. Many seniors opt into a Medicare Advantage, or Part C, plan. Details of these plans vary, and many include services not provided by Original Medicare. Plan details vary, so it’s best to consult with a plan representative before moving into assisted living.

What are “activities of daily living”?

Activities of daily living are regular chores that personal caregivers help seniors perform. These activities include personal hygiene, grooming, personal care and light housekeeping. Meal preparation, shopping and transportation are also sometimes included as activities of daily living.

What is the difference between assisted living and nursing homes?

Assisted living differs from nursing home care principally in the level of medical care offered in each. Skilled nursing care often includes IV treatments, blood glucose monitoring and administration of prescription drugs. Residents of assisted living communities do not typically receive medical treatment in their community, though personal caregivers do assist with activities of daily living.

Learn More About Senior Living in Nebraska

For more information about specific types of senior living in Nebraska read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Nebraska

Learn more about the cost of senior living in the top Nebraska cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.