Medicaid eligibility and enrollment in Nebraska
Nebraska’s Medicaid expansion work requirement is in effect
Who is eligible for Medicaid in Nebraska?
Nebraska Medicaid (Heritage Health for most enrollees) coverage is available for the following populations:
- Adults under age 65 with income up to 138% of the federal poverty level (FPL), due to Medicaid expansion that took effect in Nebraska in 2020. Starting May 1, 2026, this population is subject to a work requirement.1
- Pregnant women with household income up to 199% of FPL.2 (Coverage for the mother continues for 12 months after the baby is born.)3
- Children with household income up to 218% of FPL. (Coverage will either be Medicaid or CHIP, depending on age and household income.)4
- Nebraska Medicaid is also available for people who are 65 or older, or disabled, but these populations are subject to asset limits as well as income limits to qualify for Medicaid.
for 2026 coverage
0.0%
of Federal Poverty Level
Apply for Medicaid in Nebraska
You can enroll online at HealthCare.gov or use the call center at 1-800-318-2596. You can also enroll online at ACCESSNebraska, or print a paper application from their website.
Eligibility: Parents with dependent children are eligible with household income up to 57% of poverty. Pregnant women with income up to 194% of poverty, and children with income up to 213% of poverty.
Enrollment in expanded Medicaid took effect in 2020
Medicaid expansion – dubbed the Heritage Health Adult Program – took effect in Nebraska as of October 2020, under the terms of the ballot initiative that was approved by the state’s voters in the 2018 election (details below).
Under the newly expanded eligibility rules, adults with income up to 138% of the poverty level are eligible for Medicaid in Nebraska. As of mid-2025, there were just under 70,000 Nebraska residents covered by Medicaid expansion.5
Learn how states that expanded Medicaid might reduce spending on Medicaid.
Nebraska Medicaid work requirement starts May 1, 2026
Under H.R.1 (the “One Big Beautiful Bill Act”), Medicaid expansion enrollees must comply with a work requirement starting in January 2027. But Nebraska chose to implement this several months early, on May 1, 2026.1
The work requirement applies to the roughly 70,000 adults who are covered under Nebraska’s Medicaid expansion (Heritage Health Adult). Nebraska officials have said that they already have work or exemption data for many of those enrollees, from information that the state has on file. But up to 28,000 enrollees will need to provide information to the state to prove their compliance with the work requirement.6
- 332,216 – Number of Nebraskans covered by Medicaid/CHIP as of October 20257
- 69,678 – Number of Nebraskans covered by ACA Medicaid expansion as of June 20258
- 36% – Increase in total Medicaid/CHIP enrollment in Nebraska since late 20139
Explore our other comprehensive guides to coverage in Nebraska
The ACA Marketplace allows individuals and families to shop for and enroll in ACA-compliant health insurance plans. Subsidies may be available based on household income to help lower costs.
Hoping to improve your smile? Dental insurance may be a smart addition to your health coverage. Our guide explores dental coverage options in Nebraska.
Use our guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in Nebraska as well as the state’s Medicare supplement (Medigap) regulations.
Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage.
Frequently asked questions about Nebraska Medicaid
How do I enroll in Nebraska Medicaid?
You can submit an application for Medicaid at any time during the year. Applications can be made online or by phone.
If you are under 65 and don’t have Medicare:
- You can begin the process online at HealthCare.gov or by phone via the HealthCare.gov call center at 800-318-2596. If it looks like you’re eligible for Medicaid, HealthCare.gov will send your information to Nebraska Medicaid and they will contact you to complete the enrollment.
- You can also enroll online at ACCESSNebraska at any time.
- The Do I Qualify screening tool at ACCESSNebraska can help you determine which public programs you’re eligible for. You may be able to enroll in other benefits beyond Medicaid.
If you’re 65 or older or have Medicare:
- You can apply online using this website.
- You can apply by calling (855) 632-7633.
- You can apply by visiting a local Public Assistance office.
How does Medicaid provide financial assistance to Medicare beneficiaries in Nebraska?
Many Medicare beneficiaries receive Medicaid financial assistance that can help them with Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare – including long-term care.
Our guide to financial assistance for Medicare enrollees in Nebraska includes overviews of these programs, including Medicaid long-term care benefits, Extra Help, and eligibility guidelines for assistance.
How many people were disenrolled from Medicaid in Nebraska after the pandemic?
Medicaid disenrollments were paused nationwide for three years during the pandemic, but resumed in the spring/summer of 2023. Under federal rules, all Medicaid enrollees’ eligibility had to be redetermined at some point in a year-long “unwinding” period that began in the spring of 2023.
During the “unwinding” process in Nebraska:10
- Coverage was renewed for 237,109 people
- 122,389 people were disenrolled from Medicaid.
Of the people who were disenrolled, nearly half were disenrolled for procedural reasons, meaning the state didn’t have enough information to determine whether they were still eligible.
At the end of the unwinding process, CMS reported that 23,735 of the people who were disenrolled from Nebraska Medicaid found replacement coverage through the Nebraska health insurance Marketplace (HealthCare.gov).11
Nebraska Medicaid history and details
Medicaid expansion: Voters said yes in 2018, but implementation was delayed until late 2020
After GOP lawmakers in Nebraska continually rejected Medicaid expansion for six years, proponents of Medicaid expansion took the issue to the state’s voters in the 2018 election.
Nebraska State Senator Adam Morfeld (D-Lincoln) introduced Legislative Resolution 281CA during the 2018 session, calling for a constitutional amendment to be on the ballot, declaring health care a right and expanding Medicaid in Nebraska. But that measure did not advance in the Health and Human Services Committee.
Instead, supporters began working on a ballot initiative that would propose a Medicaid expansion law, instead of a constitutional amendment. (In Nebraska, 7% of voters must sign a petition to get a proposed law on the ballot, as opposed to 10% for a constitutional amendment.)
Medicaid expansion proponents began collecting signatures in March 2018, and successfully gathered enough signatures. The Nebraska Secretary of State confirmed in late August that Medicaid expansion would be on the ballot in Nebraska in November 2018. A judge rejected efforts by Nebraska GOP Senators who tried to block the ballot initiative based on “procedural, statutory and constitutional flaws.”
Nebraska Initiative 427 passed with 53% of the vote. It required the state to expand Medicaid as called for in the ACA (i.e. to people earning up to 138% of the federal poverty level). According to the terms of the initiative, the state had to submit an expansion plan to the federal government by April 1, 2019.
On April 1, the Nebraska Department of Health and Human Services announced the details of their Medicaid expansion proposal, and also submitted their state plan amendments to the federal government. The state has also maintained a web page with a variety of information about the Medicaid expansion process. But then-Governor Pete Ricketts had long opposed Medicaid expansion, and while his administration did implement the voter-approved Medicaid expansion, they did so on a very delayed timeline, with coverage taking effect in October 2020.12 (For perspective, voters in Utah and Idaho approved Medicaid expansion at the same time, and expanded coverage in those states took effect in January 2020.)
The Ricketts administration also initially rolled out a two-tiered system, with enhanced benefits (dental, vision, and over-the-counter medication coverage) available for enrollees who participated in care management and, starting in the second year of the program, fulfilled a community engagement/work requirement that was approved by the Trump administration in October 2020. But that program was terminated by the state in 2021, after the Biden administration made it clear that work requirements would not be allowed. So as of October 2021, all Medicaid expansion enrollees in Nebraska have the enhanced benefits package.
Nebraska Medicaid enrollment numbers
From the fall of 2013 through July 2016, total net enrollment in Nebraska’s Medicaid program actually declined by 9,764 people, which amounted to a decrease of 4%.
By January 2026, more than five years after Medicaid expansion took effect, enrollment in Nebraska Medicaid was 36% higher than it had been in the fall of 2013.13
Heritage Health uses three managed care organizations
As of 2024, all of Nebraska’s Medicaid enrollees were in managed care programs.14
Nebraska’s Medicaid managed care program is called Heritage Health, and it combines coverage (for Medicaid and CHIP) of physical health, behavioral health, and pharmacy care into one coordinated system. The new system took effect January 1, 2017.
As of 2026, the managed care entities in Nebraska are:15
- Nebraska Total Care
- Molina Healthcare
- UnitedHealthcare Community Plan
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Footnotes
- “Work Requirements” Nebraska Department of Health & Human Services. Accessed Apr. 28, 2026 ⤶ ⤶
- “Eligibility Groups – Mandatory Coverage, Pregnant Women” Nebraska Department of Health & Human Services. Apr. 28, 2026 ⤶
- “Maternal Health Resources for Medicaid” Nebraska Department of Health & Human Services. Accessed Apr. 28, 2026 ⤶
- “Income Limits for MAGI Based Programs and Transitional Medical Assistance” Nebraska Department of Health & Human Services. Feb. 12, 2026 ⤶
- “Medicaid Expansion Enrollment” KFF.org. June 2025. Accessed Apr. 28, 2026 ⤶
- “Nebraska to become first state to implement Medicaid work requirement signed by Trump” KOAT Action 7 News. Apr. 28, 2026 ⤶
- “January 2026 Medicaid & CHIP Enrollment Data Highlights” Medicaid.gov, Accessed Apr. 28, 2026 ⤶
- “Medicaid Enrollment – New Adult Group” Medicaid.gov, Accessed February 2026 ⤶
- “Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment” KFF.org, Accessed Apr. 28, 2026 ⤶
- “Medicaid Enrollment and Unwinding Tracker” (State Data, Nebraska). KFF.org. Apr. 24, 2026 ⤶
- “HealthCare.gov Marketplace Medicaid Unwinding Report” Medicaid.gov. Updated Aug. 30, 2024 ⤶
- “Nebraska Medicaid Issues Expansion Update” Nebraska Department of Health & Human Services. Apr. 10, 2020 ⤶
- “Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment” KFF.org. Jan. 2026. Accessed Apr. 28, 2026 ⤶
- “Total Medicaid MCO Enrollment, 2024” KFF.org. Accessed Apr. 28, 2026 ⤶
- “Heritage Health” Nebraska Department of Health & Human Services. Accessed Apr. 28, 2026 ⤶
