Omaha Senior AdvisorWhat is Nebraska's Aged and Disabled Waiver?
The Medicaid HCBS Aged and Disabled (AD) Waiver lets Nebraska Medicaid pay for services that help older adults and people with disabilities who need nursing home level care to live at home or in assisted living instead; to qualify, a person must have Nebraska Medicaid, be 65 or older or have a disability, meet Nursing Facility Level of Care and need waiver services.
Services include personal care, chore, companion, respite, adult day health, home-delivered meals, personal emergency response systems, home and vehicle modifications, assistive technology, non-medical transportation, independence skills building, the Home Again transition service for nursing home residents, and Supported Residential Living in an assisted-living facility. A services coordinator builds a person-centered plan and monitors it at least monthly. For people 65 and older in Omaha, that coordinator is usually from the Eastern Nebraska Office on Aging, the Area Agency on Aging, unless the person chooses a DHHS coordinator.
What does the AD Waiver pay for in an Omaha assisted living facility?
In a waiver-certified ALF, the AD Waiver pays for Supported Residential Living, the service formerly called Assisted Living: personal care, help with daily activities, health maintenance, medication assistance, housekeeping, laundry, activities, essential shopping and escort, plus at least five round-trip medical appointments a year and three meals a day prepared as part of room and board.
DHHS sets the waiver's daily rate, and the provider may not bill personal care separately. The waiver also has housing standards: each waiver participant must have a private room with a bathroom with at least a toilet and sink, unless DHHS approves a semi-private room, plus lockable doors, a lease within the service agreement, and basic furniture and hygiene items when the resident has none. Nursing and skilled therapy are incidental to the service, not part of it, and the waiver does not pay for 24-hour skilled care.
Does the AD Waiver pay room and board in assisted living?
No. The waiver's payment explicitly excludes housing, food, comfort items and facility upkeep, which are covered by a room-and-board fee the resident pays to the facility from his or her own income, usually Social Security and any pension.
DHHS's 2025 Aged, Blind and Disabled Standard of Need lists $967 a month for the Assisted Living Waiver living arrangement, the figure Medicaid uses when it budgets a waiver resident's income.
| Nebraska Medicaid figure | Amount |
|---|---|
| Resource limit, one person | $4,000 |
| Resource limit, two-person household | $6,000 |
| Medically Needy Income Level, household of one or two | $392 a month |
| Personal needs allowance, nursing home | $75 a month |
| Standard of need, Assisted Living Waiver arrangement (2025) | $967 a month |
| Standard of need, licensed ALF not on the waiver (2025) | $1,420 a month |
Sources: Nebraska DHHS Medicaid Eligibility and Share of Cost pages; DHHS guidance document “Aged, Blind, and Disabled (ABD) Standard of Need” (2025 figures, the latest it lists).
Ask each certified facility what it actually charges a waiver resident for room and board and whether family can supplement it. A resident whose income is above Medicaid's limits may still qualify through the Medically Needy program and pay a monthly share of cost toward the services.How many Omaha-area assisted living facilities accept the AD Waiver?
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.
Certification means the facility can bill the waiver, not that it has an opening for a waiver resident today, and some certified buildings limit how many waiver apartments they offer. The waiver flag on each facility's page in our directory comes straight from the DHHS roster. If a parent will likely spend down savings, choose a certified building from the start and ask in writing whether a private-pay resident can convert to the waiver and stay in the same apartment.
How do Omaha families apply for the AD Waiver?
Apply for Nebraska Medicaid first if your parent does not already have it, online at iServe Nebraska or by calling (855) 632-7633 (Omaha (402) 595-1178), and apply for the waiver itself through iServe, by requesting a paper application at (877) 667-6266, or by emailing or mailing the DD-10 form to HCBS Waiver Eligibility.
After the application, DHHS schedules a Nursing Facility Level of Care assessment. Once eligible, the participant chooses a services coordination provider; ENOA's services coordinators in Omaha do the comprehensive assessment, care planning and ongoing case management. ENOA's Information and Assistance line, (402) 444-6444, can explain the steps and the documents needed. Start early: the Medicaid application, the level of care assessment and finding a waiver-certified apartment all take time.
At a glance
| The AD Waiver pays for | The AD Waiver does not pay for | |
|---|---|---|
| In assisted living | Supported Residential Living services | Room and board |
| At home | Personal care, chore, respite, meals, PERS | 24-hour skilled nursing |
| Where | Certified ALFs and private homes | Facilities without waiver certification |
| Who | Medicaid-eligible adults at nursing facility level of care | People who do not need that level of care |
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.
