In short
- Medicare has no income or asset test. Nebraska Medicaid for people 65 and older does: in 2026, $1,330 a month in income and $4,000 in resources for one person.
- Medicare Savings Programs have higher limits. In Nebraska, QI-1 covers incomes up to $1,796 a month for one person, with resources up to $9,950 (2026).
- If you have both, Medicare pays first. You also qualify automatically for Extra Help with drug costs.
- Medicare does not pay for long-term custodial nursing home care. Medicaid can, for people who qualify.
- Apply for Nebraska Medicaid and Medicare Savings Programs through iServe Nebraska or (855) 632-7633.
Medicare vs Nebraska Medicaid at a glance
| Feature | Medicare | Nebraska Medicaid |
|---|---|---|
| Who runs it | The federal government (CMS), with sign-up through Social Security | Nebraska DHHS, with federal and state funding |
| Who qualifies | People 65 and older, and younger people with certain disabilities or ESRD | People with limited income and resources who meet other rules |
| Income test | None; higher incomes pay an IRMAA surcharge | Yes; $1,330 a month for one person 65+ (aged, blind and disabled limit, 2026) |
| Asset test | None | $4,000 single, $6,000 couple for aged, blind and disabled coverage (2026) |
| Monthly premium | Part B $202.90 in 2026; Part A has no premium for most people | Generally none for full Medicaid |
| Long-term nursing home care | Not covered; skilled nursing only, up to 100 days per benefit period | Covered for people who qualify |
| Dental | Not covered by Original Medicare | Included in Heritage Health plans since 2024 |
| How you get care | Original Medicare or a Medicare Advantage plan | Heritage Health plans from Molina, Nebraska Total Care or UnitedHealthcare Community Plan |
| If you have both | Pays first | Pays second and can cover costs Medicare leaves |
| Where to apply | Social Security, at SSA.gov or by phone | iServe Nebraska online, or (855) 632-7633 |
The short answer
Everyone eligible should have Medicare; it is not a choice between the two. If your income and savings are limited, apply for Nebraska Medicaid or a Medicare Savings Program too, because having both can cover most of what Medicare leaves you to pay.
The names sound alike, and both pay for health care, but Medicare and Medicaid answer different questions. Medicare asks how old you are or whether you have a qualifying disability. Medicaid asks how much income and savings you have. Plenty of Nebraskans qualify for both, and those people often have the most help available and the least idea it exists.
What is the difference between Medicare and Medicaid?
Medicare is federal health insurance for people 65 and older, and for younger people with certain disabilities or end-stage renal disease. There is no income test. You pay premiums, deductibles and coinsurance, such as the $202.90 monthly Part B premium in 2026.
Medicaid is a joint federal and state program for people with limited income and resources. In Nebraska, it is run by the Department of Health and Human Services (DHHS). Most members get care through Heritage Health, which combines medical, behavioral health, dental and pharmacy coverage in one of three plans: Molina Healthcare of Nebraska, Nebraska Total Care or UnitedHealthcare Community Plan.
It is not a choice between the two. If you are eligible for Medicare, you should have it. The question is whether you also qualify for some form of Medicaid help.
Who qualifies for Medicaid help in Nebraska in 2026?
There are several levels of help, each with its own limits. These are DHHS's 2026 monthly income limits and resource limits.
| Program | What it helps with | Income, 1 person | Income, couple | Resources, 1 / couple |
|---|---|---|---|---|
| Aged, blind and disabled Medicaid | Full Medicaid coverage | $1,330 | $1,804 | $4,000 / $6,000 |
| QMB | Part A and B premiums, deductibles and coinsurance | $1,330 | $1,804 | $9,950 / $14,910 |
| SLMB | Part B premium | $1,596 | $2,164 | $9,950 / $14,910 |
| QI-1 | Part B premium | $1,796 | $2,435 | $9,950 / $14,910 |
Extra Help with drug costs is a separate federal program run by Social Security, with 2026 limits of $23,940 a year in income and $18,090 in resources for one person. Anyone on Medicaid or a Medicare Savings Program qualifies for it automatically. See Medicare Savings Programs in Nebraska and Extra Help.
Medicare's handbook gives good advice here: even if you don't think you qualify, apply. Some income and assets do not count.
What happens when you qualify for both?
Medicare pays first, and Medicaid pays second. With full Medicaid, Medicare's handbook says most of your health care costs are covered, and Medicaid may cover things Medicare does not, like long-term nursing home care, personal care, transportation to medical visits, and dental, vision and hearing services.
Being dual eligible also brings Medicare protections:
- Extra Help automatically. In 2027, that means drug copays of no more than $5.80 for generics and $14.40 for brand names.
- No billing for Medicare cost sharing under QMB. If you are in the QMB program, Medicare providers are not allowed to bill you for Medicare deductibles, coinsurance or copays. Show your Medicare and Medicaid cards every visit.
- More chances to change plans. People with Medicaid or Extra Help can change drug coverage once a month, effective the first of the next month.
- Special plans. Dual Eligible Special Needs Plans coordinate Medicare and Medicaid. See D-SNP vs regular Medicare Advantage.
Does Medicare or Medicaid pay for a nursing home in Nebraska?
Medicare pays only for short-term skilled care, and Medicaid pays for long-term care for people who qualify. That difference matters, because long-term care in Nebraska is expensive.
| Medicare | Nebraska Medicaid | |
|---|---|---|
| Type of care | Skilled nursing or rehab after a qualifying hospital stay | Long-term custodial care, plus home and community services through the Aged and Disabled Waiver |
| How long | Up to 100 days per benefit period | As long as you qualify |
| Your cost | Days 21 to 100: $217 a day in 2026 | Your income generally goes toward the cost of care, minus a $75 monthly personal needs allowance (2026) |
| Spouse at home | No protections needed | Can keep $32,532 to $162,660 in resources (2026), plus an income allowance |
CareScout's 2025 survey put Nebraska's median semi-private nursing home room at $275 a day, or $100,521 a year. Medicaid can pay for that care, but Nebraska's estate recovery rules may later seek repayment from the estate of a recipient 55 or older, after both spouses have died. Our page on Medicare and long-term care explains skilled versus custodial care.
How do you apply in Nebraska?
You apply for Medicare through Social Security. You apply for Medicaid and Medicare Savings Programs through Nebraska DHHS:
- Online at iServe Nebraska, which DHHS describes as replacing ACCESSNebraska
- By phone at (855) 632-7633, or (402) 473-7000 in Lincoln and (402) 595-1178 in Omaha
- By mail to DHHS, P.O. Box 2992, Omaha, NE 68103-2992
Lincoln-area residents 60 and older can also get help from Aging Partners' certified counselors at 402-441-7070. Nebraska SHIP (formerly SHIIP) offers unbiased Medicare counseling at 1-800-234-7119, and 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week (TTY 1-877-486-2048).
What mistakes do people make with Medicare and Medicaid?
The most common is never applying. People assume they earn too much, when a Medicare Savings Program could cover their Part B premium, which is $2,434.80 a year in 2026.
Other mistakes:
- Ignoring DHHS mail. Medicaid renews regularly. Missing a renewal notice can end coverage you still qualify for.
- Assuming expansion coverage continues. Heritage Health Adult covers ages 19 to 64 and is not available once you have Medicare. Expansion members also face work requirements that took effect May 1, 2026; see our work requirements update.
- Paying bills you don't owe. If you are in QMB and get a bill for Medicare cost sharing, tell the provider. If you already paid, you may be owed a refund.
- Staying in a plan that doesn't fit. Dual eligibles can change drug coverage monthly. Compare Nebraska's Heritage Health plans and your Medicare options.
If you have Medicaid or think you might qualify, and want help with the Medicare plan that works alongside it, talk to me. My help costs you nothing.
Frequently asked questions
Yes. People who qualify for both are called dual eligible, and Nebraska had 43,941 of them in June 2026, according to CMS. Medicare pays first and Medicaid pays second. With full Medicaid, most health costs are covered, you qualify automatically for Extra Help with drugs, and Medicaid can cover services Medicare does not, such as long-term nursing home care.
For aged, blind and disabled Medicaid, DHHS lists a monthly income limit of $1,330 for one person and $1,804 for a couple, with resource limits of $4,000 and $6,000. Medicare Savings Programs go higher: QMB to $1,330, SLMB to $1,596 and QI-1 to $1,796 a month for one person, with resources up to $9,950. Some income may not count, so apply if you are close.
Yes, for people who meet Medicaid's financial and medical rules. Medicare covers only short skilled nursing stays after a qualifying hospital stay, up to 100 days per benefit period, with a $217 daily coinsurance for days 21 to 100 in 2026. Medicaid can pay for long-term custodial care. Nebraska also protects a spouse at home, with a 2026 resource allowance of $32,532 to $162,660.
It can. Nebraska's estate recovery applies to people who got Medicaid at 55 or older, or who were permanently institutionalized. DHHS collects only after the recipient dies and after a surviving spouse dies, and not if a child is under 21, blind or permanently disabled. Nebraska's definition of an estate reaches some assets outside probate. A 2025 law added a protection for relatives who provided care at home.
Heritage Health Adult, Nebraska's Medicaid expansion for ages 19 to 64, is not available to people with Medicare. When you get Medicare, ask DHHS whether you qualify for another category, such as aged, blind and disabled Medicaid, or a Medicare Savings Program that helps pay your Part B premium. Respond to every DHHS notice so you do not lose help you still qualify for.
No. Medicaid applications in Nebraska go through DHHS, using iServe Nebraska online or by calling (855) 632-7633. Lincoln residents can also call (402) 473-7000. A licensed Medicare agent can explain how Medicare and Medicaid work together and help with Medicare plan choices once you are dual eligible, such as a Dual Eligible Special Needs Plan.
Sources
- Nebraska DHHS: Income levels and resources, 477-000-012 (rev. May 8, 2026) (opens in a new tab)
- Nebraska DHHS: iServe Nebraska and ACCESSNebraska (opens in a new tab)
- Medicare.gov: Medicare & You 2027 (CMS Product No. 10050) (opens in a new tab)
- Nebraska DHHS: Medicaid expansion (Heritage Health Adult) (opens in a new tab)
- Nebraska DHHS: Medicaid dental care (opens in a new tab)
- Nebraska Legislature: LB641 (2025), estate recovery changes (opens in a new tab)
- CareScout: Cost of Care Survey 2025, median cost tables (opens in a new tab)
- CMS: 2026 Medicare Parts A and B premiums and deductibles (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
