Nursing facilities remain a covered route
Nebraska Medicaid covers services in nursing facilities, intermediate-care facilities for people with developmental disabilities, and certain other long-term-care arrangements. DHHS describes nursing-facility coverage as including the facility’s regular room, diet, nursing services, required social services, many medical supplies and equipment, oxygen, and other routine services (Nebraska DHHS Nursing Facilities).
The nursing-facility route is not solely a financial application. DHHS says the person must meet nursing-facility level-of-care and medical-necessity requirements, and a person requesting admission to or continuing in a Medicaid-certified nursing facility must have an active Preadmission Screening and Resident Review, or PASRR, by the admission date (Nebraska DHHS Nursing Facilities).
Home care and PACE are different routes
Nebraska’s HCBS system uses waivers to add services beyond ordinary Medicaid coverage. The Aged and Disabled, or AD, Waiver is the central community route for an older adult: DHHS says it requires Nebraska Medicaid, age 65 or older or disability, nursing-facility level of care, and a need for waiver services (Nebraska DHHS AD Waiver).
PACE is another community alternative, not the same as the AD Waiver. DHHS describes PACE as coordinated health care and long-term services for voluntarily enrolled people age 55 or older and says Immanuel Pathways is the state’s currently approved provider, serving Douglas and Sarpy counties and portions of Cass, Dodge, Saunders, and Washington counties (Nebraska DHHS HCBS and PACE overview).
Practical starting point: Ask DHHS to evaluate both financial Medicaid eligibility and the requested care setting. A nursing-facility applicant needs the facility criteria and PASRR, while an AD Waiver applicant needs the waiver’s Medicaid and nursing-facility-level-of-care requirements (
DHHS Nursing Facilities;
DHHS AD Waiver).
Keep the program decision current
DHHS accepts Medicaid applications online through iServe Nebraska, by phone, or on paper. Coverage categories, service availability, and individual authorizations can change, so an application and current assessment are more reliable than assuming an out-of-state Medicaid rule applies in Nebraska (Nebraska DHHS Medicaid application information).
Not mutually exclusive. Most families combine two or three funding pillars — this one rarely stands alone.
The
Journey Assessment ranks all ten pillars against your specific situation and
recommends the top three.
