Omaha Senior AdvisorWhat is the difference between the AD Waiver and PACE?
The AD Waiver adds home and community services, coordinated by a services coordinator, on top of a person's regular Medicaid and Medicare coverage, while PACE, offered in the Omaha area by Immanuel Pathways, replaces the whole system with one team that provides or arranges every service and is paid a fixed amount by Medicare and Medicaid.
Both require nursing facility level of care. The waiver requires Nebraska Medicaid eligibility and age 65 or a disability; PACE requires age 55 or older and an address in its service area, and does not require Medicaid, though Medicare-only participants pay a premium.
Which keeps my parent's current doctors?
The AD Waiver does: waiver participants keep their usual Medicare and Medicaid providers, while PACE participants generally use the PACE program's own doctors and contracted providers, with the PACE team authorizing outside care except in emergencies.
For a parent attached to long-time doctors, that difference often decides the question. For a parent with many unmanaged conditions and appointments, PACE's single team can be a relief.
Which works in assisted living?
The AD Waiver pays for Supported Residential Living in waiver-certified ALFs, with the resident paying room and board; PACE is designed for participants living in the community, and its team decides where care is delivered, so ask Immanuel Pathways how it serves participants in assisted living.
36 of the 79 licensed ALFs in the five Omaha-area counties (46%) are marked on the DHHS roster of October 15, 2026 as certified for the Medicaid Aged and Disabled Waiver. If assisted living is the goal and Medicaid will be the payer, the waiver is the more common path.
How do Omaha families apply for each?
Apply for the AD Waiver through iServe Nebraska or (877) 667-6266 after or alongside a Nebraska Medicaid application, and contact Immanuel Pathways directly at (402) 512-6199 for PACE enrollment.
ENOA's Information and Assistance line, (402) 444-6444, can explain both options. A person cannot be enrolled in both at once, but can switch.
What should we have ready before calling ENOA or Immanuel Pathways?
A short list of the daily activities your parent needs help with, who helps now and how often, recent hospital stays, current medications and doctors, monthly income and approximate savings.
That information lets either organization tell you quickly which program fits and what the next step is.
At a glance
| AD Waiver | PACE (Immanuel Pathways) | |
|---|---|---|
| Age | 65+ or a disability | 55+ |
| Medicaid | Required | Not required (premium without it) |
| Doctors | Keep current providers | PACE team and contracted providers |
| Assisted living | Pays services in certified ALFs | Ask the program |
Sources include 175 NAC 4 (assisted-living facilities), the Nebraska Revised Statutes cited above, Nebraska DHHS program and licensure pages, CMS, CareScout and VA rate tables; see our editorial standards.
