Get Paid to Care for Your Elderly Parent in Nebraska
Nebraska lets you be paid to care for an aging parent through the Aged and Disabled (A&D) Waiver, which allows participant-directed personal care and hiring of certain family members. After a 2026 review, DHHS chose not to cap weekly paid hours for live-in family caregivers.
This guide covers what Nebraska family caregivers need to know: the program structure, pay rates, who can be paid, eligibility, how to apply, and other programs that may supplement your income.
Nebraska pays family caregivers $15–$22 per hour through the Aged and Disabled Waiver (self-directed personal care) option within the Aged and Disabled (AD) Medicaid HCBS Waiver. Your parent must meet a nursing-facility level of care but prefer to remain at home.
Nebraska's Main Program: Aged and Disabled Waiver (self-directed personal care)
Aged and Disabled Waiver (self-directed personal care) is a self-directed option within Nebraska's Aged and Disabled (AD) Medicaid HCBS Waiver, which provides home and community-based care for seniors and adults with disabilities who meet a nursing-facility level of need. Under self-direction, your parent (or you as their authorized representative) can hire, train, schedule, and supervise the personal-care attendant — and that attendant can be you, an adult child.
What the Program Pays For
Authorized self-directed services typically include:
- Personal care: bathing, grooming, dressing, oral hygiene
- Toileting assistance and incontinence care
- Mobility help: transferring, positioning, ambulation support
- Meal preparation and feeding assistance
- Light housekeeping directly related to health and safety
- Medication reminders (not administration, which requires a nurse)
- Supervision for individuals with cognitive impairment, including dementia
Pay Rates Across Nebraska
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Omaha Metro (Eastern Nebraska) | $17–$22/hr | ENOA serves as service coordinator; live-in family caregivers may bill up to authorized hours |
| Lincoln / Southeast Nebraska | $16–$20/hr | Personal care assistance paid near the state average of about $17/hr |
| Rural / Western Nebraska | $15–$18/hr | Minimum wage is $15/hr (2026); rural caregiver pay often near that floor |
Rates are set within the participant's approved plan-of-care budget and the state's limits; the figures above are typical ranges, not guarantees.
Who Can Be Paid
Certain family members may be hired and paid as the personal care provider under the AD Waiver, including adult children and live-in family caregivers; spouses and legally responsible relatives are generally excluded. Always confirm the current rules with Nebraska Department of Health and Human Services, Division of Medicaid & Long-Term Care before you count on a specific arrangement.
Eligibility Requirements
Your Parent Must:
- Be enrolled in full Nebraska Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing-facility level of care
- Be enrolled in the Aged and Disabled (AD) Medicaid HCBS Waiver (or its self-directed option)
- Live in Nebraska in a community setting (not a nursing home)
- Be able to direct their own care, or have a legal/authorized representative who can
You (the Caregiver) Must:
- Be 18 years of age or older
- Meet the program's relationship rules (see above)
- Pass a criminal background check and registry search
- Complete any required caregiver orientation and training
- Be legally authorized to work in the United States
- Submit timesheets through a financial management service
How to Apply: Step-by-Step
- Apply for Nebraska Medicaid. Apply online at iserve.nebraska.gov or call 1-855-632-7633. Your parent must meet income and asset limits.
- Request a long-term-services assessment. Contact your local Medicaid or aging office to request a comprehensive functional assessment that determines whether your parent qualifies for the Aged and Disabled (AD) Medicaid HCBS Waiver.
- Enroll in the waiver. Once deemed eligible, your parent is enrolled in the Aged and Disabled (AD) Medicaid HCBS Waiver and assigned a case manager or care coordinator.
- Request the self-directed (A&D Waiver) option. During care planning, ask specifically for the consumer/self-directed service model and state that you, the adult child, want to be the hired caregiver.
- Enroll with a financial management service. Complete enrollment paperwork — W-4, I-9, and background authorization — so payroll, tax withholding, and timesheets are handled for you.
- Complete orientation. Finish any state-required caregiver orientation covering personal-care techniques, emergency procedures, and reporting.
- Begin care and submit timesheets. Provide care per the authorized plan and submit electronic timesheets; payroll is processed on a regular cycle with taxes withheld.
Check Your Parent's Eligibility
Our free Benefits Checker helps identify whether your parent qualifies for Nebraska's caregiver-pay programs and other benefits.
Check Eligibility NowOther Programs That May Pay Nebraska Family Caregivers
VA Veteran-Directed Care & PCAFC
If your parent is a veteran enrolled in VA healthcare, the Veteran-Directed Care program provides a monthly budget that can pay family caregivers, and the Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for eligible primary caregivers. Contact the caregiver support coordinator at your parent's VA medical center or call 1-855-260-3274.
Personal Care Agreement (Private Pay)
If your parent does not qualify for Medicaid, a formal written Personal Care Agreement lets them pay you from their own funds at fair-market rates. Drafted with an elder-law attorney, it must be prospective and reasonable — and it keeps payments from being treated as "gifts" during the Medicaid 5-year look-back.
State Respite & Caregiver Support
Through the National Family Caregiver Support Program, Nebraska's Area Agencies on Aging fund respite, training, and counseling. These rarely pay ongoing wages but reduce your out-of-pocket costs. Find your local agency through the Eldercare Locator (1-800-677-1116) or 1-800-942-7830.
Tax Implications for Family Caregivers
- W-2 wages: The financial management agency issues you a W-2; federal income tax, Social Security, and Medicare are withheld.
- IRS Notice 2014-7: If you live in the same home as your parent (the Medicaid waiver participant), your self-directed wages may be excludable from federal gross income. Consult a CPA before filing — see IRS guidance on Medicaid waiver payments.
- Earned Income Tax Credit: These wages count as earned income and may qualify you for the EITC.
Maintain daily logs of services provided — date, time in, time out, and a brief description. Medicaid audits self-directed arrangements, and accurate records protect both you and your parent.
What Nebraska Caregivers Are Actually Earning
At 30 hours per week and about $18 per hour, you would earn roughly $2,340 per month. At 40 hours per week and $22 per hour, earnings reach about $3,813 per month — around $45,760 per year before taxes.
For comparison, a nursing home costs far more per year, and agency home care runs roughly $30–$40 per hour. A self-directed arrangement lets your parent receive care from someone they trust, while you earn income that partially replaces what you may have given up to provide care.
Contact Information
- Nebraska Department of Health and Human Services, Division of Medicaid & Long-Term Care: dhhs.ne.gov/Pages/Medicaid-Aged-and-Disabled-Waiver.aspx | 1-855-632-7633
- Apply for Medicaid: iserve.nebraska.gov
- State aging services: dhhs.ne.gov/Pages/Aging.aspx | 1-800-942-7830
- Eldercare Locator (find local help): eldercare.acl.gov | 1-800-677-1116
- Medicaid (federal): medicaid.gov
Frequently Asked Questions
Nebraska personal care attendants average about $17 per hour, with rates generally ranging from roughly $15 (the 2026 minimum wage) to about $22 per hour. Family caregivers can earn up to roughly $2,747 per month depending on authorized hours.
The Aged and Disabled (A&D) Waiver is a statewide Medicaid HCBS program for Nebraskans who are elderly or disabled and at risk of institutionalization. It covers personal care assistance, respite, adult day health, and meal delivery, and allows participants to direct their own care.
Spouses and other legally responsible relatives are generally excluded from being paid under the AD Waiver. Adult children and certain other family members, including live-in family caregivers, may be hired and paid as personal care providers.
The Aged and Disabled (A&D) Waiver allows certain family members to be hired and paid as the personal care provider. An adult child can typically be paid to care for an aging parent under this waiver.
Apply online at iServe Nebraska or call 1-877-667-6266 to request an HCBS Waiver application; you can also reach ACCESSNebraska at 1-855-632-7633. Your local Area Agency on Aging can serve as your service coordinator at 1-800-942-7830.
Yes. A parent with dementia who qualifies for the A&D Waiver and meets nursing-facility level of care can have an adult child or eligible family member hired for personal care assistance. As of 2026, DHHS will not cap weekly paid hours for live-in family caregivers.
Related Guides
- How to Get Paid to Care for Your Parent (National Overview)
- How to Apply for Medicaid for an Elderly Parent
- Caregiver Tax Deductions 2026
- VA Benefits for Elderly Parents
- Power of Attorney for an Elderly Parent
- Medicaid Spend-Down Rules
This guide is general information, not legal or financial advice. Program names, pay rates, and eligibility rules change and vary by county — confirm details with Nebraska Department of Health and Human Services, Division of Medicaid & Long-Term Care. Sources: dhhs.ne.gov · dhhs.ne.gov.