Medicaid waiver
Aged and Disabled (AD) Waiver
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- Who qualifies
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People who have Nebraska Medicaid, have a disability or are over the age of 65, meet Nursing Facility Level of Care, and have a need for waiver services.
A Service Coordinator, from an Area Agency on Aging or DHHS, helps you plan and oversee your waiver services.
Source: HCBS Waiver Eligibility (Nebraska Department of Health and Human Services)Checked
- Can a family member be paid
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Yes. Yes. A relative can provide Personal Care and most other AD Waiver services, including Respite. A relative is anyone related to you by blood or marriage to the third degree, including step and adoptive relatives.
- Can a spouse be paid
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Depends. Only through LRI Personal Care. A spouse is a legally responsible individual (LRI), and LRI Personal Care is the only waiver service an LRI can provide. You must meet Nebraska's definition of Extraordinary Care on the Extraordinary Care Tool (DD-26), and only the needs that qualify can be authorized.
Extraordinary Care means hands-on help with daily activities beyond what a spouse would ordinarily do for a person of the same age without a disability or chronic illness. LRI Personal Care is used when no other services or providers are available to meet your needs, and the spouse must be employed by an agency, except in limited circumstances.
Source: LRI and Extraordinary Care Resource (Nebraska Department of Health and Human Services, Division of Disability and Aging, October 2025)Checked
- Can a legal guardian be paid
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Yes. Yes, with limits. A legal guardian can provide Personal Care and most other AD Waiver services. After July 1, 2025, a legal guardian who wants to become an AD Waiver provider for their ward must be related to the ward and work as an agency employee, except in limited circumstances.
Guardians who were already providers can continue regardless of relationship or independent provider status.
- Hours limit
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LRI Personal Care, the service a spouse can provide, cannot exceed 40 hours a week. It cannot be billed while the spouse is working at another job.
The July 2026 LRI Personal Care service summary adds that if more than 40 hours are assessed, only 40 are authorized across all LRI providers.
Source: LRI and Extraordinary Care Resource (Nebraska Department of Health and Human Services, Division of Disability and Aging, October 2025)Checked