Nebraska is close to 2,000,000 in total population, according to the latest Census estimates, and that includes 313,374 people aged 65 and over. At some stage, many of these older residents will need assistance from family and caregivers to stay independent and in familiar surroundings for as long as possible. The average cost of full-time home care in Nebraska is $4,671 per month, which is roughly 9% higher than the national average. The state Medicaid program and waiver services provide coverage for in-home care to varying degrees based on income, age and disability status.

Keep reading for more detailed cost comparisons of home care in Nebraska and nearby states, as well as the alternative levels of care available. This guide also provides information that may help low-income residents pay for care and useful links to resources and state regulations.

The Cost of In-Home Care in Nebraska

In-Home Care Costs in Nearby States

Nebraska’s average monthly cost of $4,671 for in-home care is based on 44 hours of paid assistance per week. According to the Genworth 2019 Cost of Care Survey, the national average for this level of care is $4,290. In comparison to neighboring states, Nebraska is much more affordable than South Dakota, with a monthly average of $5,339, and also slightly cheaper than Iowa at $4,767. Missouri and Kansas offer significantly lower costs, with averages of $4,195 and $4,004 per month, respectively.

$4671

Nebraska

$4290

National

$5339

South Dakota

$4767

Iowa

$4195

Missouri

$4004

Kansas

Cost of Other Types of Care in Nebraska

Home health care provides an additional level of medical services from licensed personnel, and in Nebraska, this adds roughly $300 to the cost of in-home care for a total of $4,957 per month. Generally, the alternatives are adult day care — much more affordably priced at $1,820 per month and useful for active seniors — and assisted living facilities, which provide 24/7 care and accommodation for an average of $3,819 per month. Nursing home care has the highest cost, at an average of $7,003 per month, although there are more financial assistance programs available for this level of care.

$4671

In-Home Care

$4957

Home Health Care

$1820

Adult Day Care

$3819

Assisted Living Facility

$7003

Nursing Home Care

The Cost of In-Home Care in Nebraska’s Top Cities

Comparing Costs Across Nebraska

Home care for seniors in Nebraska can vary in cost by over 16%, depending on the city. Lincoln is ranked second in population count, but it’s the highest in cost for this level of care at $5,077 per month. The state’s most populous city, Omaha, is more affordable at $4,624 per month, and Grand Island’s average of $4,242 is the lowest of the three Nebraskan cities included in the survey. Nearby in Sioux City, Iowa, the cost is considerably higher, with a monthly average of $5,529 per month. In Missouri, home care costs for Kansas City residents are approximately 10% lower than in Nebraska.

$5077

Lincoln

$4624

Omaha

$4242

Grand Island

$5529

Sioux City (IA)

$4195

Kansas City (MO)

Financial Assistance for In-Home Care in Nebraska

Aged and Disabled Waiver for Nebraska Medicaid

Nebraska Medicaid provides cover to residents aged 65+ and people with disabilities for a wide range of services, including long-term support such as home care and nursing, medical supplies and equipment, physical and other therapies. These core Medicaid services are entitlements and can be covered immediately upon eligibility. Some care can be self-directed by the Medicaid member, such as Personal Assistance Services, which allows them to designate paid caregivers.

Seniors who qualify for the Aged and Disabled Waiver are eligible for an even higher level of in-home care, adult day care, assisted living programs and other services designed to help seniors stay out of nursing homes. Waiver services aren’t considered entitlements, which means there could be waiting lists for certain services.

Who is Eligible?
Applicants for waiver services must meet Nebraska Medicaid eligibility requirements, which include a maximum of $4,000 in countable assets and a maximum income of $12,760 per year (100% of the federal poverty level as of 2020). The applicant must have a need for nursing facility care that can be safely managed elsewhere, such as their own home, if additional services are provided.

How to Apply
Residents can check eligibility and apply online via ACCESSNebraska or the toll-free Medicaid hotline on 855-632-7633. In-person applications can be made at DHHS offices throughout Nebraska, with locations and contacts available on the website.

Lifespan Respite Subsidy Program

Nebraska Department of Health and Human Services can provide up to $125 per month in respite funding to cover care received in the applicant’s own home or another non-institutional setting via the Lifespan Respite Subsidy Program. The applicant must have a special need that requires additional care, which may include Alzheimer’s and other types of dementia, stroke or other functional impairments. This program won’t subsidize services already covered by Medicaid and the A&D Waiver, although it allows for a higher income.

Who is Eligible?
Residents of Nebraska must meet functional and financial eligibility requirements, such as having a special need for services and a maximum income of $39,811 per year (312% of the federal poverty level as of 2020).

How to Apply
Applications for the Lifespan Respite Program can be submitted via mail, email or fax, or by calling 866-737-7483.

Disabled Persons and Family Support

The Nebraska Department of Social Services is responsible for the DPFS program that uses state funds to help eligible residents pay for the care required to stay independent. This program pays for a maximum of $3,600 in support services per year. The services available include home modifications, housekeeping, home health and attendant care, special equipment, respite and transportation.

Who is Eligible?
Applicants must meet eligibility requirements based on living arrangements, disability and financial status. As of 2020, an individual can have up to $1,364 in countable monthly income. They must also show medical need, such as additional disability-related expenses in the household.

How to Apply
Seniors and family can call the DPFS hotline on 402-471-9220 or request an application via mail, email or fax, as well as local Department of Social Services offices.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Nebraska

There are many useful sources of information and assistance available for Nebraskans who need help to remain independent. In most cases, these resources are free for seniors on a low income.

ContactServices Provided
Area Agencies on AgingSee website for contactsNebraska’s State Unit on Aging is responsible for eight regional agencies that develop and provide access to many useful services for independent seniors, such as in-home care and other independent living options.
Nebraska Senior CentersSee website for contactsThere are dozens of senior centers around the state that provide activities, health and wellness services, meals, socialization and more. Area Agency on Aging services are regularly offered in or accessed via these centers.
State Unit on Aging402-471-2307This division of Health and Human Services is responsible for federal and state funds designated for low-income seniors and people with disabilities. Residents can find information on insurance, legal rights, Alzheimer’s support and in-home services.
Alzheimer’s and Dementia SupportSee website for contactsCaregivers and family members of Nebraskans with Alzheimer’s or other types of dementia can find appropriate services and information at the local and national level.
Legal Aid of Nebraska – Elder Access Line800-527-7249Nebraskans aged 60+ and on a low income can call for free legal assistance and representation in civil cases. Common issues include access to benefits, guardianship, housing and consumer law.
Adult Protective Services800-652-1999APS is the state agency responsible for investigating allegations of abuse against elderly Nebraskans. Anyone concerned can call to report physical, emotional and financial abuse, whether it took place in a facility or private home.
Aging Partners402-441-7070This agency serves the elderly and people with disabilities in all eight counties across Nebraska. Staff can provide information and referrals for services such as home handyman visits, medical equipment, meals and long-term care.

In-Home Care Laws and Regulations in Nebraska

Home health agencies are licensed and regulated by the Nebraska DHHS Licensure Unit with the provisions outlined in Title 175, Chapter 14. In-home care agencies that provide non-medical care, such as homemakers and companionship, aren’t bound by these regulations. A summary of important points is included here for convenience.

Scope of CareThe individual’s needs must be assessed and deemed appropriate and safe for management outside of an institution. Home health agencies may provide all manner of services, including skilled nursing, whereas home care agencies are restricted to non-skilled services such as assistance with activities of daily living.
Care Plan and CoordinationCare must be provided following a written plan that is developed by an appropriately qualified professional and based on an assessment in the recipient’s home. This plan must be updated every 62 days at a minimum. Home health agencies that provide multiple services must coordinate and ensure each service is safe and effective when combined.
Medication Management and AdministrationIn-home care includes medication reminders and basic assistance. Home health agencies are permitted to administer medication.
Staff Background and TrainingAll home health agency staff must receive pre-employment screening that includes a criminal background and various statewide registry checks. The agency must maintain evidence of staff employment records, initial orientation and ongoing training that is relevant to each individual’s job.
Medicaid CertificationNebraska Medicaid and the Aged and Disabled Waiver covers home health agency services for eligible residents.
Reports and ComplaintsNebraska DHHS handles complaints and allegations of abuse via the Adult Abuse and Neglect Hotline on 800-652-1999. The complaints page also has information on specific issues such as Medicaid fraud.

Frequently Asked Questions

How much does in-home care cost in Nebraska?

In-home care has an average monthly cost of $4,671 in Nebraska. Home health agencies cost $4,957 per month and provide additional services. The differences between the two styles are described below.

Does Nebraska Medicaid pay for in-home care?

Yes. Seniors and people with disabilities may be eligible for coverage of in-home care and home health agency services under Nebraska Medicaid and the Aged and Disabled Waiver.

Are there programs to cover home modifications in Nebraska?

Yes. The Disabled Persons and Family Support program detailed in this guide covers up to $300 per month in services, including home modifications, for eligible Nebraskans. Local assistance programs may also be available via Area Agencies on Aging.

What are “Activities of Daily Living”?

ADLs are common tasks that make up everyday life. Many of these tasks are universal, such as meal preparation, eating, cleaning, hygiene and mobility, while others such as wheelchair assistance, medication reminders and other forms of hands-on assistance are appropriate in certain situations.

What is the difference between in-home care and home health care?

In-home care is focused on maintaining or improving independence by assisting with activities of daily living, as outlined above. Home health care refers to skilled nursing or therapeutic services such as physical, speech and occupational therapy.