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Assisted Living in Nebraska

With its wide-open plains and prairies, Nebraska serves as a gateway between the West and the Midwest, but it’s also become a promising destination for older adults who need assisted living. The Cornhusker State claimed fourth place in our 2024 Senior Living Report, beating out neighboring states such as Colorado, Iowa and Kansas. Nebraska received top-10 rankings for health care, transportation and affordability, and the state offers plenty of opportunities for community involvement, which may increase seniors’ well-being.

Nebraska is home to nearly 320,000 adults aged 65 and older, and the state expects its senior population to increase by 36% by 2035. Fortunately, the state’s retirees are in an excellent position. Top-rated medical facilities, such as the Nebraska Medical Center and Bryan Medical Center, are located in Nebraska’s major cities. The cost of living here is about 11% lower than the national average, and this includes assisted living, which averages just $4,076 per month.

This guide is designed to help you learn more about assisted living in Nebraska, including average prices, relevant state regulations and Medicaid programs that cover these costs. You’ll also find a directory of resources that are available in your community.

The Cost of Assisted Living in Nebraska

When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Nebraska and its 11 cities.

The Cost of Assisted Living in Nebraska's Top Cities

Each of Nebraska's top cities showcases its own cost structure for assisted living, presenting multiple options for seniors and their families.

Take Omaha, for instance, where the median cost is roughly $5,068. Bellevue, on the other hand, offers more affordable costs, averaging around $3,448. Floating higher is the city of Lincoln at $5,228, with Grand Island costs settling in the moderate range, averaging out at about $4,296. 

Nebraska

$5,043

Omaha

$5,068

Bellevue

$3,448

Lincoln

$5,228

Grand Island

$4,296

Inflation's Impact on the Cost of Assisted Living in Nebraska

Inflation has significantly influenced the cost of assisted living in Nebraska. Within a year, from 2022 to 2023, the state saw a considerable 12.57% rise in costs, a 4% difference from the U.S. average increase within the same period.

Nebraska's neighbors also witnessed changes in their assisted living costs, with Kansas being the hardest hit by inflation—experiencing an 18.89% increase. While Iowa and Colorado's costs increased by 2.29% and 5.42%, respectively, South Dakota's average decreased by 1.57%. Looking ahead to 2024, Nebraska's estimated costs may reach $5,304. However, this figure may change based on future economic conditions.

Location2022 Cost (Historical)2023 Cost (Current)2024 Cost (Estimated)
Nebraska$4,480$5,043$5,304
U.S. Average$4,070$4,459$4,802
Kansas$4,066$4,834$5,149
Iowa$4,770$4,879$5,006
Colorado$4,392$4,630$5,063
South Dakota$4,514$4,443$4,732

The Costs of Other Types of Senior Living

Assisted living costs in Nebraska are in the middle range at $5,043, with memory care costs ranging higher at $5,997. On the lower end, independent living stands at $3,040.

Several factors contribute to the cost disparities among these senior care types. Memory care, for example, requires specialized services and a higher staff-to-resident ratio, leading to increased costs. Independent living, however, offers a greater degree of freedom, thus reflecting a lower price point. 

Assisted Living

$5,043

Memory Care

$5,997

Independent Living

$3,040

Does Medicaid Cover Assisted Living in Nebraska?

Nebraska covers assisted living indirectly through its Aged and Disabled Waiver. This Home- and Community-Based Services program is an extension of Medicaid that allows the state to cover additional services that aren’t normally available to beneficiaries. Individuals must meet medical and financial eligibility criteria since services are designed to provide a community-based alternative for residents who require a nursing home level of care. Here are some of the services covered under the Aged & Disabled Waiver. Your case manager will determine which supports you need.

 

  • Adult day health care
  • Assisted living
  • Assistive technology
  • Companionship
  • Delivered meals
  • Emergency response systems
  • Help with errands 
  • Home modifications
  • Housekeeping and chore assistance
  • Non Medical transportation
  • Personal care
  • Respite care
  • Skills training
  • Transition from a nursing home

What Assisted Living Services Are Covered by Medicaid in Nebraska?

The Aged & Disabled Waiver covers a variety of personal care services provided in assisted living facilities. However, beneficiaries are still responsible for the cost of room and board, and there may be a sliding-scale share of cost based on the applicant’s income. Here are a few of the assisted living services it covers.

 

  • Personal care
  • Help with daily activities
  • Health maintenance support
  • Social and recreational programs
  • Help with shopping and errands
  • Housekeeping
  • Medication reminders
  • Transportation
  • Laundry

 

Similar benefits may be available through the Program of All-Inclusive Care for the Elderly. This Medicare-Medicaid alternative is available to adults aged 55 and older who require a nursing home level of care and live in the greater Omaha area.

Assisted Living Waiver Programs in Nebraska

Aged and Disabled Waiver

The Aged and Disabled Waiver is the primary source of funding for Medicaid-eligible seniors who require assisted living. This program is available to individuals who meet Medicaid’s income and asset limits and who require a nursing home level of care as determined by a personal needs assessment. The state will review your medical records as part of the application process. You can apply for waiver services by completing the paper application provided by the Department of Health and Human Services. You can submit your completed form by email to DHHS.ADwaiverApp@nebraska.gov or by mail or fax 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
Fax: (402) 328-6257

To apply by phone or to have an application mailed to you, contact the Department of Developmental Disabilities at (877) 667-6266. You can also visit your nearest Department of Health and Human Services office to ask for assistance. 

How To Know If You’re Eligible for Medicaid in Nebraska

Medicaid is a safety net program for adults and families who have limited resources and may be unable to afford insurance or medical care. For this reason, Nebraska has strict financial eligibility requirements. Income limits are the same whether you’re applying for regular Medicaid for the Aged and Disabled or long-term care benefits, including home- and community-based services and coverage for nursing homes. However, you must meet additional medical or functional needs requirements before the state will cover these supports.

For 2022, the income limit for individual applicants is $14,580 per year, and the limit for couples applying together is $19,728 per year, which is 100% of the federal poverty level. When counting assets, the state may exclude certain items, such as a car, personal effects and a home that’s occupied by you or your spouse. The state may let you use a portion of your excess income for medical bills, which can help you meet the qualification requirements.

 

Household SizeNumber of ApplicantsIncome Limits Per Year*Asset Limits: Applicant(s)Asset Limits: Non-Applicants
One Person1$14,580$4,000
Two People1$14,580**$4,000$148,620
Two People 2$19,716$6,000***

*Depending on the facility setting, a recipient may not be able to keep income up to this level.

**Income limit is for applicant only.

***Assets are limited to $4,000 per spouse

Medicaid is available to individuals in target groups based on their age, health needs and other factors. To qualify, you must:

  • Be a U.S. citizen or legal immigrant residing in Nebraska
  • Be aged 65 and older or have a disability or visual impairment
  • Have a need for health insurance or waiver services
  • Require a nursing facility level of care

How To Apply for Medicaid in Nebraska

The easiest way to get started is by completing an online application using the ACCESSNebraska self-service portal. This system will screen you for Medicaid and other benefits and will send your application to the relevant agency for processing. You can also complete a paper application and mail it to your   nearest DHHS office or to:

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

For assistance with your application or to apply over the phone, call the customer service hotline at (855) 632-7633. The Area Agency on Aging serving your area can provide more information or make a referral.

Information You Will Need

If you’re aged 65 or older or are applying for services that require a disability determination, you must complete an Application for Nebraska Medicaid for the Aged and Disabled. This document asks for a variety of information about your household, income, assets and expenses, as well as consent to release your medical records. Have the following items ready when you apply.

 

  • Citizenship or residency information
  • Personal details
  • Contact information
  • Social Security number
  • Date of birth
  • Previous names
  • Monthly expenses
  • Information about existing insurance coverage
  • Income and tax information
  • Assets and resources, including property
  • A list of vehicles
  • Details about any items sold or given away in the past 5 years

 

How to Get Help Applying for Medicaid

If you have questions about Medicaid, the easiest way to get help is by contacting the Department of Health and Human Services, which is responsible for administering the program. Senior centers, legal aid societies and Area Agencies on Aging can also provide assistance.

ProgramContactServices provided
Department of Health and Human Services(855) 632-7633If you need help completing your application or would like to apply over the phone, contact the ACCESSNebraska customer service hotline for assistance. Free interpreter services are available if you require help in another language.
DHHS Public Assistance Offices(402) 471-3121To locate an office where you can apply in person or speak to a case manager, contact the DHHS switchboard. The agency’s online locator tool provides a directory of locations by county and community.
Medicaid Appeals(877) 667-6266If you've applied for Medicaid and received a notice that you aren’t eligible, you can speak to the agent who reviewed your application. You may be able to submit additional information by reapplying. You also have a right to request a fair hearing.

Does Medicare Cover Assisted Living in Nebraska?

The short answer is that no, Medicare does not cover the cost of assisted living in Nebraska. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Nebraska.

Other Financial Assistance Options for Assisted Living in Nebraska

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

NameHow To ApplyHow It Works
Aid and AttendanceLearn more and apply online at va.gov.Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Reverse MortgagesLearn more about your options and how to apply at ftc.govIf you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Nebraska

There are many resources in Nebraska that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Program NamePhone NumberDescription
Nebraska Area Agencies on AgingThere are eight Area Agencies on Aging (AAA) throughout Nebraska. Help typically falls under one of five areas: nutritional services, access to services, elder rights, in-home services and community-based services. Seniors can receive assistance if they are aged 60+. Contact information for each AAA is available via the Nebraska Department of Health and Human Services website.

Cash Assistance Programs

Cash assistance programs in Nebraska provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Program NamePhone NumberDescription
Nebraska Lifeline Program800-234-9473The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones.

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Nebraska seniors afford the nutritious food they need.

Program NamePhone NumberDescription
Nebraska Emergency Food Assistance ProgramNebraska seniors can turn to the state's Emergency Food Assistance Program to receive donated food. The EFAP distributes its food to two Nebraska food banks, Food Bank for the Heartland and Food Bank of Lincoln. Nebraska seniors in need of assistance may contact these facilities for information on food distribution points in their local area.
Nebraska Meals on WheelsNebraska Meals on Wheels provides well-balanced meals to eligible seniors statewide. To qualify, seniors must be aged 60 and over. Those mobile enough can enjoy meals with peers at their local congregate meal site, while those who are immobile receive daily meal delivery with an accompanying safety check to monitor their well-being. Services are offered on a sliding-fee scale. Additional services are also available and vary from program to program, including transportation to doctor appointments, telephone reassurance and pet food delivery.
Nebraska Senior Farmers' Market Nutrition Program (SFMNP)402-471-6857The state departments of Agriculture and Health and Human Services administer the Nebraska Senior Farmers Market Nutrition Program. Seniors aged 60 and over whose income is at or below 185% of the federal poverty level can receive limited funds annually via this program. Older adults can use SFMNP coupons at markets to acquire unprepared fruits and vegetables, honey and other locally produced and seasonal foods.
Nebraska Supplemental Nutrition Assistance Program (SNAP)800-221-5689The Nebraska Supplemental Nutrition Assistance Program helps eligible seniors over age 60 obtain healthy food. To qualify, applicants must meet certain resource and income requirements. SNAP benefits are placed on an electronic benefits transfer card, and they can only be used for food. Most supermarkets and grocery stores statewide and some Meals on Wheels services accept SNAP funds. Liquor, wine, beer, tobacco products and prepared foods, such as restaurant meals, can't be paid for using SNAP benefits.

Free Used Medical Equipment

Due to the high cost of purchasing new medical equipment, several organizations in Nebraska collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Program NamePhone NumberDescription
Nebraska Methodist's Equipment Loan ProgramThe Equipment Loan Program, offered by Methodist Health Partners, accepts donated used medical equipment, inspects and sanitizes it according to Centers for Disease Control (CDC) guidelines, and offers it for free or on loan to Nebraskans who need the equipment but cannot afford it or get it covered by their public or private health insurance plan.
Nebraska ReUse NetworkThe Nebraska ReUse Network helps seniors retain their independence at home by providing access to needed medical equipment that might not be covered by Medicare, Medicaid or the individual's private health insurance plan.

Home Repair and Modifications

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Nebraska have different eligibility criteria and often assist retirees by providing grants or loans.

Program NamePhone NumberDescription
Nebraska 504 Home Repair ProgramRural Development housing repair loans and grants help low-income and elderly Nebraska homeowners procure funds to remove health or safety hazards from their homes, and modernize or weatherize their dwellings. The funds from these loans or grants can be used on projects such as HVAC repair, insulation and water supply repair or replacement.

Many organizations offer free or low-cost legal services to Nebraska seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.

Program NamePhone NumberDescription
Legal Aid of Nebraska877-250-2018Legal Aid of Nebraska helps seniors with various civil law issues, including disputes regarding evictions, disability and Medicaid benefits and utility shutoffs. Walk-ins are welcome at LAN's Omaha, Lincoln, Grand Island and Scottsbluff offices. The Omaha office is open Monday through Wednesday, 1 to 4 p.m., and the Lincoln location is staffed Monday and Wednesday during the same hours. The Grand Island and Scottsbluff offices hold hours on Tuesdays, 12 to 3 p.m. and 1 to 4 p.m., respectively.

Senior Centers

Senior centers in Nebraska bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.

Program NamePhone NumberDescription
Nebraska State Unit on Aging402-471-2307A division of the Nebraska Department of Health and Human Services, the State Unit on Aging offers a variety of services to help older adults, individuals with cognitive and physical disabilities, and caregivers. The center has a list of supportive resources for those with Alzheimer's disease and other types of dementia. Guidance with insurance coverage and Medicare is provided, and legal services are available for low-income seniors. An elder abuse awareness program is also offered.

Senior Engagement

Senior engagement resources and programs in Nebraska help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.

Program NamePhone NumberDescription
Alzheimer's Association of Nebraska Chapter402-502-4300The Nebraska chapter of the Alzheimer's Association helps individuals with dementia-related impairments. Seniors and their caregivers have access to early-stage services, such as care consultations, safety programs and social engagement activities. In-person and online workshops are offered, and there are support groups available for those impacted by cognitive conditions.

Medicaid Resources

Navigating the Medicaid system is often difficult and confusing. Several Nebraska resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.

Program NamePhone NumberDescription
Nebraska Aged and Disabled Medicaid Waiver877-667-6266Nebraska's Aged and Disabled Medicaid Waiver provides funding for seniors who require a nursing home level of care. This funding can be used to pay for nursing home or assisted living costs. If the recipient prefers to live independently, the Aged and Disabled Medicaid Waiver can cover the costs of home or vehicle modifications to enable them to age in place.
Nebraska Traumatic Brain Injury Medical Waiver877-667-6266The Traumatic Brain Injury Medical Waiver provides financial assistance to Nebraska residents who require nursing home or assisted living care because of a traumatic brain injury that was caused by an external mechanical force.

Social Security Offices

Social Security offices in Nebraska help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Program NamePhone NumberDescription
Nebraska Social SecuritySocial Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working.

Tax Assistance

Seniors can apply for tax assistance from several Nebraska resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.

Program NamePhone NumberDescription
Nebraska Homestead Exemption402-471-5984The Homestead Tax Exemption provides property tax relief for Nebraska seniors as well as for homeowners who fit into several additional categories, such as disabled veterans and individuals with physical or developmental disabilities.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Nebraska retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.

Program NamePhone NumberDescription
Nebraska Low Income Home Energy Assistance (LIHEAP)800-383-4278The Nebraska Low Income Home Energy Assistance Program (LIHEAP) provides financial assistance to low-income Nebraskans, helping them offset the cost of high heating and cooling bills. Residents can turn to LIHEAP for help with HVAC and furnace repair, along with home weatherization services.

Veteran's Services

Nebraska retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.

Program NamePhone NumberDescription
Nebraska VA Benefits and Health CareNebraska VA Benefits and Health Care supports qualifying senior veterans through a range of clinical services, medical equipment supply, benefits assistance, loans and more. Alongside Omaha and Grand Island VA Medical Centers, it operates an outpatient clinic in Lincoln and seven community-based outpatient clinics throughout the state. Vet Centers are located in Lincoln and Omaha, with advice and assistance also available from Papillion Community Living Center.

Assisted Living Laws and Regulations in Nebraska

Nebraska has strict licensing requirements for assisted living facilities. These regulations are enforced by the Licensure Unit at the Department of Health & Human Services, Division of Public Health. Some of the most important provisions are highlighted below.

TopicRule
Assisted Living Service Plan RequirementsAssisted living facilities must establish records for each resident within 5 business days of admission. Records must include personal information, medical needs, allergies and monthly documentation showing any personal assistance the facility has provided. Facilities must evaluate each resident to prepare a written service agreement that’s approved by the resident or their authorized representative.
Assisted Living Admission RequirementsAssisted living facilities may admit adults who want or require food, shelter and personal assistance due to age, disability, illness or functional limitations. Facilities may not admit residents who have complex or unpredictable medical needs that require skilled nursing care. The resident must have sufficient mental capacity to make rational decisions about their care, and the person must not pose a danger to others.
Assisted Living Scope of CareAssisted living facilities are licensed to provide 24-hour care to four or more residents. These services include food, shelter, supervision and assistance with the activities of daily living. Additionally, facilities must provide social and recreational activities to meet residents' physical and emotional needs. Supplemental services include transportation, laundry, housekeeping, hair care, spiritual services, case management and bill pay assistance.
Assisted Living Medicaid PolicyNebraska’s Medicaid program may pay for services provided in an assisted living facility if the applicant meets financial and medical requirements. The facility must be authorized to accept Medicaid. Help with room and board may be available for individuals who receive SSI.
Assisted Living Facility RequirementsAssisted living facilities must provide properly equipped bedrooms or apartments and common areas. For newly built facilities, rooms must include at least 80 square feet for a single resident or 60 square feet per resident if shared. Private apartments must have at least 150 square feet of living space or at least 260 square feet if shared with a companion. Additionally, the facility must provide at least one toilet for every four to six beds or one en suite bathroom per apartment as well as sufficient storage.
Medication Management RegulationsAssisted living residents may self-administer medications if they are competent. Otherwise, medications must be administered by a licensed health professional or certified medication aide. Facilities must have a registered nurse review all medication administration policies and train unlicensed medication aides. Providers must maintain detailed records of all medications they administer.
Staffing RequirementsNebraska doesn't have a minimum staffing ratio. However, facilities must maintain a sufficient number of staff to provide personal care and supervision as described in each resident's service agreement. At least one staff member must be on-site at all times to meet residents’ personal needs. Facilities must employ a registered nurse to oversee staff training, review policies and complete other routine tasks.
Staff Training RequirementsIn addition to completing a 75-hour training program to become a certified nursing assistant, direct-care staff members must complete a comprehensive orientation program within 2 weeks of employment to become familiar with the facility’s procedures. Staff must complete 12 hours of annual in-service training. Administrators are also required to complete annual continuing education after completing an initial 30-hour certification program. Additional training is required for staff who care for special populations.
Background Checks for Assisted LivingFacilities must conduct a criminal background check on all unlicensed direct-care staff at the time of hiring. This screening process includes a search of the nurse aide registry and other databases. Facilities may not employ staff who are associated with findings of abuse, neglect or misappropriation of property.
Requirements for Reporting AbuseFacilities must establish written procedures for reporting and investigating allegations of abuse, neglect or exploitation in accordance with the Adult Protective Services Act. Reports of abuse can be made to the Department of Health Facility Investigations. Individuals can call the complaint intake line at (402) 471-0316 or Adult Protective Services at (800) 652-1999. The state also provides an online complaint form.

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The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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