Medicaid in Nebraska: what you may be able to apply for

Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).

Generally, Adults 19-64 (expansion group, Heritage Health Adult): ≤ 133% FPL; Pregnant people (Medicaid at 194%, plus the CHIP unborn-child band at 197%): ≤ 194% FPL; Parents / caretaker relatives (58% FPL): ≤ 58% FPL; Children (0-1 at 162%, 1-5 at 145%, 6-18 at 133%; higher bands via CHIP): ≤ 162% FPL. The agency makes the final determination.

Nebraska HAS expanded Medicaid (implemented in 2020), and the expansion group is branded Heritage Health Adult (HHA). The official income table (a DHHS guidance document, marked effective 1/1/2026) gives each category's %FPL and monthly ceilings by household size: HHA (adults 19-64) 133% ($1,769 for one, $3,029 for three), pregnant women 194% ($2,581 / $4,418), parent/caretaker relative 58% ($772 / $1,321), newborn to age 1 162%, children 1-5 145%, children 6-18 133%, CHIP 213% ($2,833 / $4,851), and a band labeled "599 CHIP" at 197%. 🌟🌟 That 197% band is the CHIP unborn-child option — NASHP's Nebraska CHIP fact sheet states verbatim that the state provides coverage for pregnant women through the "unborn child" option, extending eligibility up to 197% FPL. 🔴 This matters enormously for undocumented pregnant people: do NOT assume a conservative state has no prenatal pathway. The option enrolls the unborn child, so prenatal care can generally be covered without regard to the mother's immigration status. Ask DHHS (855-632-7633) how to apply, what is covered and whether it continues postpartum — we will not predict how your individual case will be decided. 🌟 Immigrant children: NASHP verbatim, "Cover lawfully residing children without a five-year waiting period? Yes" — Nebraska HAS taken the CHIPRA §214 option, so lawfully residing immigrant children do not have to wait five years. 🔴🔴🔴 The biggest change of 2026: Nebraska is the first state in the country to implement Medicaid work requirements, effective May 1, 2026. DHHS's official FAQ (April 2026) states verbatim: "Medicaid work requirements start on May 1, 2026." They apply to able-bodied adults in the expansion group (HHA) — ages 19-64, not pregnant, without a disability, not on Medicare; the traditional categories (aged, disabled, pregnant, children) are NOT subject to them. The requirement is at least 80 hours in a calendar month of work, school or apprenticeship (at least half time), a work program, or volunteering — and these can be combined — OR earning $580 in a calendar month (80 hours at the federal minimum wage). 🔴 The exemptions the state lists include: under 26 and aged out of foster care; members of a federally recognized tribe, Urban Indians, California Indians, or people who receive Indian Health Service care; a parent or caretaker of a child age 13 or younger; someone caring for a person with a disability; a veteran with a total disability rating; a medical condition that prevents you from working (blindness or disability, substance use disorder, a disabling mental health condition, a serious or complex medical condition); households receiving SNAP or TANF who are compliant with those work rules; people in a qualified drug or alcohol treatment program; people in jail or released within 90 days; and pregnancy through 12 months postpartum (if you had Medicaid while pregnant). "Temporary hardships" also apply: hospital or nursing facility stays, travel for serious medical care unavailable locally, living in a county under a federal emergency, or living in a county with high unemployment (8 percent or 1.5 times the national rate). 🔴 The step that most often costs people their coverage is answering the mail: DHHS first checks the data it already has; if that is not enough it sends a notice, and the FAQ states verbatim that "you must submit the information within 30 days of getting the notice, or you may be denied or lose coverage." Check your mail, email and texts, and respond through iServe, by phone, by mail, or at a local DHHS office. 🔴 If you are in an immigrant family, do not let fear stop you from responding — responding is what keeps coverage for you and your children; if you are unsure, call, or find accredited free legal services. 🔴🔴 Baseline immigration rules: qualified immigrants generally face the five-year bar and its exceptions (refugees/asylees exempt), though children are exempt as described above; undocumented people generally have only Emergency Medicaid (emergencies, labor and delivery) plus the CHIP unborn-child prenatal pathway above. 🔴🔴 Public charge: Medicaid is CONDITIONAL — routine Medicaid does NOT count in the current (Dec 23, 2022) test; government-funded LONG-TERM institutional care can be considered; minors, pregnancy/postpartum and Emergency Medicaid generally do not count. Consult an immigration attorney and verify with DHHS. Federal Medicaid generally requires a "qualified" immigration status, and most people must wait five years after getting that status (the "five-year bar") before applying. Refugees, asylees, and certain others are exempt from the five-year wait; emergency Medicaid is available regardless of status. Some states (such as California) use state funds to cover more people — see your state's details. 🔴 The 2025 federal law OBBBA (H.R.1, Public Law 119-21, enacted July 4, 2025) significantly narrows eligibility: effective Oct 1, 2026 (Section 71109), federal Medicaid/CHIP funding is limited to four groups — U.S. citizens/nationals, lawful permanent residents (LPRs), Cuban/Haitian entrants, and COFA migrants (Micronesia/Marshall Islands/Palau). Refugees, asylees, trafficking victims, parolees, and other "qualified aliens" who are not yet LPRs lose federal eligibility (refugees/asylees can generally regain it after becoming LPRs). Emergency Medicaid remains available regardless of status (though Section 71110 lowers its federal match to the regular FMAP effective Oct 1, 2026 — this does not change its availability); the state options for lawfully-residing children and pregnant women are preserved. Section 71119 adds community-engagement (work) requirements for ACA-expansion adults (19-64) effective Dec 31, 2026 (or sooner at state option) — at least 80 hours/month, with exemptions for pregnant/postpartum people, the medically frail, caretakers of a child under 14, and others. This is a changing area — check the latest official guidance. The agency makes the final determination.

Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. The one exception: Medicaid that pays for long-term institutional care (a long-term stay in a nursing facility or mental-health institution at government expense) DOES count. Everyday doctor visits, hospital care, prescriptions, and home- and community-based care are not this exception. Many categories are exempt by law: refugees, asylees, VAWA self-petitioners, T and U visa applicants, Temporary Protected Status (TPS), Special Immigrant Juveniles (SIJ), Cuban/Haitian entrants, and others. This is information only, not immigration, legal, or tax advice. Public charge and your personal status are complex — consult a licensed immigration attorney. We never tell you whether you "will" or "won't" be affected.

Proof of identity, Nebraska residency, household income, and the applicant's immigration documents. Apply through iServe (iserve.nebraska.gov), by phone at (855) 632-7633 (Lincoln 402-473-7000, Omaha 402-595-1178), or at a local DHHS office. 🔴🔴 If you are applying in the expansion group (HHA) and are not exempt, DHHS will check your work requirement: the state says it first uses data it already holds, and only sends you a notice if that is not enough — and you must respond within 30 days of that notice or you may be denied or lose coverage. You can respond via the QR code on the notice, iServe, mail, phone, or in person. 🔴 An undocumented pregnant person should ask separately how to apply through the unborn-child / 599 CHIP prenatal pathway. You can apply year-round. Meeting the income line is not automatic eligibility (residency, status and other non-financial criteria apply). 🔴🔴 The expansion group (HHA) must meet work requirements from May 1, 2026: for NEW applicants the review period is the calendar month you apply or the month before (a "qualifying month"); for CURRENT members it is any one calendar month since your last renewal. 🔴 The state says explicitly not to send documents now unless Medicaid asks you to — but once you receive a notice requesting information, respond within 30 days. 🔴 You cannot get an exemption in advance for a future medical procedure; it may be handled as a temporary hardship at your next renewal. Policies can change — always check the latest official information. https://iserve.nebraska.gov/