Nebraska Medicaid

Updated August 2026

Nebraska Medicaid is the state-federal health coverage program administered by the Nebraska Department of Health and Human Services (DHHS). For most enrollees, coverage is delivered through Heritage Health — Nebraska's managed care program — which contracts with health plans to coordinate services for members. Nebraska DHHS sets the eligibility rules and oversees the program; Heritage Health handles day-to-day care coordination.

Medicaid work requirements are already in effect in Nebraska — the first state in the country

H.R. 1 (signed July 4, 2025) requires states to implement Medicaid work requirements by January 1, 2027, but Nebraska began enforcing them starting May 1, 2026 — making it the first state to do so. Heritage Health Adult (expansion) members generally must complete 80 hours per month of work, school, volunteering, or a work program unless exempt, checked at each member's renewal. Members with renewal dates in May or June 2026 are not affected until their 2027 renewal; phased implementation continues through June 2027. Details and exemptions are at dhhs.ne.gov/WorkRequirements or by logging in to iServe Nebraska at iserve.nebraska.gov.

What is Nebraska Medicaid?

Nebraska expanded Medicaid coverage through Initiative 427, a ballot measure passed by voters in November 2018. Expansion took effect on October 1, 2020, extending eligibility to most adults ages 19–64 earning up to 138% of the Federal Poverty Level. Before Initiative 427, Nebraska was one of the last states without adult expansion. As of 2025, approximately 390,000 Nebraskans are enrolled in Medicaid — a figure that grew significantly after expansion took effect.

Heritage Health managed care covers the majority of Nebraska Medicaid members. Three contracted health plans serve Nebraska: United Healthcare Community Plan, Nebraska Total Care, and Molina Healthcare of Nebraska. Members choose a plan at enrollment, and that plan becomes responsible for coordinating covered services within its network.

How Heritage Health managed care works

Under Heritage Health, each member selects one of the three contracted health plans. The plan assigns a primary care provider, coordinates referrals to specialists, and manages the member's covered benefits. All three plans cover the same core Nebraska Medicaid benefits — doctor visits, hospital care, prescriptions, behavioral health, and dental — but each operates its own provider network. Check that your current doctors participate in a plan's network before selecting it.

DHHS manages eligibility through the iServe Nebraska portal at iserve.nebraska.gov, which replaced the former ACCESSNebraska system. Members can apply, view benefits, report changes, and submit renewals through iServe Nebraska. The legacy ACCESSNebraska phone line at 855-632-7633 still connects to customer service.

Who qualifies for Nebraska Medicaid?

Nebraska Medicaid covers multiple eligibility groups. Income limits vary by group and are based on Modified Adjusted Gross Income (MAGI) for most categories. The following are the main groups and approximate thresholds — verify current figures at dhhs.ne.gov or by calling 855-632-7633.

Adults ages 19–64 (Heritage Health Adult/expansion): at or below 138% FPL — approximately $1,732/month for a single person (2025 FPL); subject to work requirements starting at each member's 2026 or 2027 renewal, unless exempt
Children under 19: up to 205% FPL through Medicaid and Kids Connection CHIP combined
Pregnant women: up to 185% FPL during pregnancy and for 60 days postpartum
Parents and caretaker relatives: income limit varies by household size
Individuals with disabilities receiving SSI: automatically eligible
Elderly individuals ages 65+ with limited income and assets
Former foster care youth up to age 26 who were in foster care at age 18

Source: Nebraska DHHS Medicaid eligibility information; CMS Medicaid expansion data. Income figures are approximate — verify current monthly limits at dhhs.ne.gov or by calling 855-632-7633.

A late expansion — and why it matters

Nebraska was one of only 14 states that had not expanded Medicaid by 2018, leaving a substantial coverage gap for low-income adults without dependent children. The Initiative 427 ballot campaign bypassed the state legislature, which had blocked expansion bills for years. Nebraska's expansion date of October 1, 2020 came over six years after most states had expanded under the ACA's 2014 effective date.

The practical consequence: many adult Nebraskans who spent years uninsured in the coverage gap became eligible for the first time when Heritage Health Adult launched. If you were denied Nebraska Medicaid before 2020 as an adult without dependent children, you may now qualify. Income rules changed, and the eligibility categories now cover a much broader population.