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Nebraska Medicaid Program

Nebraska Medicaid Reform

Eligibility

For most purposes we can talk about PDF four categories of Medicaid eligibility in Nebraska:

  • Children through age 18. This includes the children’s health insurance program, which is an expansion of Medicaid; it also includes women who are covered by Medicaid solely because they are pregnant. They are covered basically to protect their unborn child.

  • Low income adults (Aid to Dependent Children adults, parents or caretakers of children).

  • Blind and Disabled population.

  • Aged, persons 65 and over.

Every eligibility category is listed on PDF this chart, with notes on whether it's mandatory, optional or mandatory/limited coverage.


PDF Four Categories of Eligibilty

PDF NE Eligibility Categories

PDF Medicaid Eligibility

PDF NE Eligibles

PDF NE Eibility Groups NOT Federally Required

PDF Major Medicaid Program Changes FY89 - Present

An adult in Nebraska who receives an ADC cash benefit is eligible under the mandatory rules at about 33% of the federal poverty level.   The "medically needy spend down" option lets people who spend a large portion of their income for medical care (such as a nursing home or any medical care that is uninsured) qualify for some Medicaid services through "spending down" their income into this range.  They pay part of their income for those services that Medicaid picks up the rest.  All people in nursing homes are going to be either aged, blind or disabled (ABD). Most of the medically needy spend down occurs related to nursing home coverage.

PDF This chart shows there are mandatory coverages for different ages of children but we have taken it optionally to 185% of poverty.  Anything that’s pink was an optional choice, and anything in blue was mandated by the federal government. 

PDF This chart shows how eligibility has worked out over time, starting back in 1987 with about 90,000 people on Medicaid.  As of the end of June, 2005, there were 199,632 people on Medicaid. The milestones are marked showing various changes made in eligibility. Cumulatively, those changes together with population changes, economic cycles, etc., have created the current level of the Medicaid population.  The area labeled LB 8 shows when our state was in fiscal crisis and a number of people were taken off of Medicaid during a special session of the Legislature.

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