Heritage Health (Nebraska Medicaid) Income Limits 2026

Heritage Health is Nebraska's Medicaid managed care program, operated by the Nebraska Department of Health and Human Services (DHHS). Nebraska adopted the Affordable Care Act's Medicaid expansion on October 1, 2020, after voters approved Initiative 427 in November 2018 with 53% of the vote. The expansion arm of the program, called Heritage Health Adult, extended coverage to adults ages 19 to 64 with household income at or below 138% of the Federal Poverty Level, the standard expansion threshold. Prior to October 2020, Nebraska covered children and pregnant women through Medicaid but left most non-disabled, non-elderly adults without Medicaid coverage regardless of income. The 2026 Federal Poverty Level is $15,960 for a single person in the 48 contiguous states, with each additional household member adding $5,680, making the 2026 Heritage Health Adult income ceiling $22,025 for an individual and $45,540 for a family of four.

Heritage Health eligibility in Nebraska divides into four main population groups. Heritage Health Adult covers non-pregnant, non-Medicare-eligible adults ages 19 to 64 up to 138% FPL, with work requirements effective May 1, 2026 for able-bodied enrollees. Children under age 19 qualify up to 218% FPL through Heritage Health or the Nebraska CHIP program (NU CHIP), a combined Medicaid-CHIP continuum that does not require a separate application. Pregnant women qualify up to 199% FPL with 12 months of postpartum coverage guaranteed after delivery. Aged, blind, and disabled Nebraskans who do not qualify via Heritage Health may qualify under SSI-related rules with an asset test (resources limited to $4,000 for an individual, $6,000 for a couple). Nebraskans with Medicare and limited income may qualify for a Medicare Savings Program through DHHS, which can cover Medicare Part B premiums and cost-sharing. Heritage Health benefits are delivered through managed care organizations, combining physical health, behavioral health, and pharmacy coverage in one plan.

Nebraska's launch of Medicaid work requirements on May 1, 2026, makes the state a national first and adds an important eligibility layer for Heritage Health Adult enrollees. Able-bodied adults ages 19 to 64 must document 80 hours per month of qualifying work, job training, education, or community service to maintain Heritage Health Adult coverage. Exemptions apply to individuals who are medically frail, pregnant or within 12 months postpartum, enrolled in Medicare, caregiving for a dependent, or enrolled at least half-time in an accredited educational program. Existing enrollees with renewal dates in May or June 2026 will not face work-requirement checks until their 2027 renewal; DHHS began reviewing compliance for members with coverage periods ending July 31, 2026 or later. If your income is above the Heritage Health threshold but below 400% FPL, Nebraska's ACA marketplace plans at healthcare.gov offer premium tax credits since the enhanced subsidies from the American Rescue Plan Act expired January 1, 2026.

Heritage Health (Nebraska Medicaid) income limits by household size (2026)

The 2026 Heritage Health (Nebraska Medicaid) income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = Heritage Health Adult expansion threshold (138% FPL, ages 19 to 64). Children column = combined Heritage Health and Nebraska CHIP ceiling (218% FPL, under age 19). Pregnancy column = Heritage Health for Pregnant Women (199% FPL, with 12 months postpartum coverage). Add roughly $5,680 of annual income per additional household member.

Heritage Health (Nebraska Medicaid) eligibility requirements (non-income)

Heritage Health eligibility requires meeting both income and non-income criteria. Income limits vary by population category as shown in the table above. The non-income requirements below apply across all MAGI-based Heritage Health categories (Heritage Health Adult, children, and pregnant women). Aged, blind, and disabled Nebraskans follow SSI-related rules with an additional asset test.

• Nebraska residency: You must live in Nebraska with the intent to remain. Nebraska does not require a minimum residency period, but you must be physically present in the state and not have a permanent home elsewhere. Individuals experiencing homelessness may use a shelter address or a statement of residency.
• Citizenship and immigration status: U.S. citizens and qualifying immigrants are eligible. Qualifying immigration statuses include lawful permanent residents (green card holders), refugees, asylees, Cuban/Haitian entrants, and certain other qualified aliens. A 5-year bar applies to most newly-arrived lawful permanent residents for full Medicaid, though emergency Medicaid is available regardless of status. Children and pregnant women may have broader access under emergency coverage provisions.
• Social Security Number: All applicants must provide a Social Security Number (SSN) or proof of having applied for one. Children applying for the first time and immigrants without SSNs may still be screened for emergency Medicaid. Nebraska DHHS uses SSNs to verify income through employer wage data, Social Security Administration records, and IRS data matches.
• Age requirements by category: Heritage Health Adult covers adults ages 19 to 64 who are not eligible for Medicare. Children must be under age 19. There is no minimum age for the children's category (newborns are covered from birth if the mother had Heritage Health at delivery). Pregnant women of any age may qualify under the pregnancy category. Adults 65 or older may qualify under the aged/blind/disabled category with SSI-related income and asset rules.
• Work requirements for Heritage Health Adult: Starting May 1, 2026, able-bodied adults enrolled in Heritage Health Adult (ages 19 to 64) must complete and report 80 hours per month of qualifying activity (employment, self-employment, job training, apprenticeship, education at least half-time, or community service). Exemptions include being medically frail, pregnant or within 12 months postpartum, caring for a dependent child under age 6, being enrolled in Medicare, or being a primary caregiver for a disabled family member. Members with renewal dates in May or June 2026 will not face compliance checks until their 2027 renewal.
• Asset test: MAGI-based Heritage Health categories (Heritage Health Adult, children, pregnant women) have no asset test. Aged, blind, and disabled adults and long-term care applicants face a resource limit of $4,000 for an individual and $6,000 for a couple. Exempt resources include the primary home, one vehicle, household goods, personal items, and certain life insurance policies. A 60-month lookback period applies to asset transfers for nursing home Medicaid applicants.
• No other comprehensive health coverage: Heritage Health Adult generally requires that the applicant not have access to employer-sponsored insurance that meets minimum value standards. If employer coverage is available but unaffordable (exceeding roughly 9.02% of household income in 2026), Heritage Health eligibility is not automatically blocked, but Nebraska DHHS may review cost-effectiveness before approving. Children and pregnant women are not subject to the employer-coverage exclusion.

What income counts for Heritage Health (Nebraska Medicaid)

Heritage Health uses Modified Adjusted Gross Income (MAGI) methodology to calculate income for Heritage Health Adult, children, and pregnant women. MAGI follows federal income tax rules: the household income counted is the sum of all household members' MAGI income, compared against the threshold for the household size. Nebraska does not apply the optional federal 5% income disregard for Heritage Health Adult but does apply it to some children's categories; verify the current disregard status with Nebraska DHHS at (855) 632-7633 or at dhhs.ne.gov.

Income sources included

• Wages, salaries, and tips (W-2 income): All gross employment earnings before payroll taxes are counted. If you have multiple jobs, all W-2 wages are added together.
• Self-employment net income (1099): Net earnings from self-employment, freelance work, and gig economy work after deducting ordinary and necessary business expenses. Losses from self-employment may offset other MAGI income.
• Social Security benefits (taxable portion): Social Security retirement and survivor benefits are counted at the taxable portion calculated under IRS rules. Social Security Disability Insurance (SSDI) benefits are counted; SSI (Supplemental Security Income) benefits are NOT counted (see excluded list).
• Interest, dividends, and capital gains: All taxable interest income, dividends, and net capital gains from the sale of investments or property are counted. Long-term and short-term capital gains are both included in MAGI.
• Pension and retirement distributions: Taxable distributions from 401(k), 403(b), IRA, and other qualified retirement accounts are counted. Roth IRA distributions that are federally tax-free are generally excluded; traditional pre-tax distributions are counted.
• Unemployment compensation: All unemployment insurance benefits received from any state are counted as MAGI income in the year received.
• Alimony received under pre-2019 divorce agreements: Alimony and separate maintenance payments received under divorce decrees finalized before January 1, 2019, are counted. Alimony from divorces finalized after December 31, 2018, is not included in the recipient's taxable income under the Tax Cuts and Jobs Act and thus not counted in MAGI.
• Foreign earned income: Even if excluded from federal taxable income under the foreign earned income exclusion (Form 2555), income earned abroad is added back for MAGI purposes and counted toward Heritage Health income limits.
• Rental income (net): Net rental income after deducting allowable rental expenses is counted. Rental losses may offset other MAGI income up to IRS passive activity loss limits.

Income sources excluded

• Supplemental Security Income (SSI): SSI payments are not counted as MAGI income. SSI recipients often qualify for full Nebraska Medicaid (not Heritage Health Adult) under the aged/blind/disabled category, but the SSI payment itself does not count toward the income limit calculation.
• Child support received: Child support payments received are not counted as MAGI income for the recipient household. Child support paid by a non-custodial parent does not reduce the payer's MAGI income either.
• Veterans' benefits: VA disability compensation, VA pension, and GI Bill education benefits are not counted as MAGI income. Veterans receiving VA benefits may still qualify for Heritage Health if their household income from other sources is below the relevant threshold.
• Workers' compensation: Workers' compensation benefits received for a workplace injury are not counted as MAGI income.
• Gifts, inheritances, and loan proceeds: Money received as a gift, inheritance, or loan is not counted as MAGI income. Lottery or gambling winnings may be counted if they appear on a federal tax return as taxable income.
• TANF cash assistance: Temporary Assistance for Needy Families (TANF) cash payments and most other means-tested public benefit cash payments are not counted as MAGI income.

How to apply for Heritage Health (Nebraska Medicaid) in Nebraska

Heritage Health applications in Nebraska go through ACCESSNebraska, the state's online benefits portal operated by Nebraska DHHS. The same application captures Heritage Health Medicaid, Nebraska CHIP, SNAP, cash assistance, and child care assistance. Applications can be submitted online at accessnebraska.ne.gov, by calling (855) 632-7633, by visiting any Nebraska DHHS local office, or by mailing or faxing a paper application. The iServe Nebraska portal at iserve.nebraska.gov is the current online intake gateway and routes directly to ACCESSNebraska. Heritage Health does not have an open-enrollment window; applications are accepted year-round and coverage is retroactive to the first day of the application month in most cases.

1. 1. Gather your documents before starting: photo ID for adults in the household, Social Security Numbers for each person applying, proof of Nebraska residency (utility bill, lease, or bank statement with a Nebraska address), proof of income for the past 30 days (pay stubs, employer letter, or 12 months of self-employment records), and proof of immigration status if applicable.
2. 2. Go to iserve.nebraska.gov or accessnebraska.ne.gov to create an online account. If you need help, call (855) 632-7633 (TTY: 711) or visit your nearest Nebraska DHHS office to start an application in person. A paper application is also available on the DHHS website if you prefer to apply by mail or fax.
3. 3. Complete the application: list every person in your household, report all income sources for the past 30 days (or best monthly estimate if income varies), and answer all required questions about citizenship, immigration status, and other health coverage. The system will automatically screen your household for all Heritage Health categories plus CHIP, SNAP, and other benefits.
4. 4. Submit the application and save your confirmation number. Nebraska DHHS will contact you if additional documentation is needed; respond within 10 days to avoid processing delays. You can check your application status online through ACCESSNebraska using your confirmation number.
5. 5. Receive your eligibility determination notice. If approved, Heritage Health coverage is managed by a contracted managed care organization; you will receive information about choosing a health plan. If you do not choose a plan, Nebraska DHHS will auto-assign you to one. If denied, the notice will include the reason and instructions for requesting a fair hearing within 90 days.
6. 6. If you are a Heritage Health Adult enrollee, report qualifying work-requirement activity (80 hours per month) through your Nebraska DHHS account starting July 31, 2026 (for members with renewal dates on or after that date). Keep records of pay stubs, school enrollment letters, or volunteer logs to document compliance at renewal.

Official portal: ACCESSNebraska (accessnebraska.ne.gov)

Documents needed

• Photo ID for the head of household (Nebraska driver's license, state ID, U.S. passport, or military ID)
• Social Security Numbers (or proof of application) for every person applying for Heritage Health coverage
• Proof of Nebraska residency: utility bill, bank statement, lease agreement, or mortgage statement showing a Nebraska address (must be dated within 90 days)
• Proof of U.S. citizenship or qualifying immigration status: birth certificate, U.S. passport, Certificate of Naturalization, permanent resident card (green card), or other CIS documentation
• Last 30 days of income documentation: pay stubs from all employers, a letter from your employer stating your pay rate and hours, or 12 months of business records if self-employed
• Most recent federal tax return or a signed statement that no return was filed, if self-employed or if income is from multiple sources
• Proof of pregnancy (for applicants applying under the pregnancy category): a letter from a healthcare provider, an ultrasound report, or other medical documentation confirming the pregnancy and estimated due date

Processing timeline: Standard Heritage Health applications are processed within 45 days of the date the application is submitted. Pregnancy applications are expedited and must be decided within 15 days under federal law. Disability-based applications may take up to 90 days because they require a medical determination by the Nebraska DHHS medical review team. Coverage, if approved, is generally retroactive to the first day of the month in which the application was submitted.

Common reasons applications get denied

• Income above the Heritage Health threshold: The most common denial reason. For Heritage Health Adult, income above 138% FPL ($22,025 for an individual or $45,540 for a family of four in 2026) results in denial. Review your MAGI income calculation carefully; excluded income types (SSI, child support, veterans' benefits) do not count.
• Failure to provide requested documentation within 10 days: Nebraska DHHS may request additional verification documents after you submit. If you do not respond within the 10-day window, DHHS will deny the application. You can usually reapply immediately if denied for this reason.
• Not a Nebraska resident: Applicants who cannot document Nebraska residency will be denied. Individuals who have recently moved to Nebraska should provide a lease, utility connection letter, or affidavit of residency. Individuals currently in another state's facility (such as a nursing home in another state) may not qualify for Nebraska Heritage Health.
• Failure to meet work requirements (Heritage Health Adult only, effective May 1, 2026): Heritage Health Adult enrollees who cannot document 80 hours per month of qualifying activity and do not qualify for an exemption will have coverage terminated at their renewal. The exemption categories are broad; if you believe you qualify for an exemption, contact Nebraska DHHS or a legal aid organization before your renewal date.
• Federal 5-year bar for certain immigrants: Lawful permanent residents who entered the United States within the past 5 years are generally barred from full Heritage Health Medicaid under federal law. Emergency Medicaid remains available for life-threatening conditions regardless of immigration status or the 5-year bar.

If your child's income is above the Heritage Health Medicaid limit

Nebraska's combined Medicaid and CHIP program covers children under age 19 with family incomes up to 218% of the Federal Poverty Level: $34,793 per year for a single-parent household of one child, or $71,940 per year for a family of four, in 2026. Children whose family income falls between the Heritage Health Medicaid threshold and 218% FPL receive coverage through NU CHIP (Nebraska's Children's Health Insurance Program), which provides the same benefits as Heritage Health Medicaid and uses the same ACCESSNebraska application. There is no gap between Medicaid and CHIP for Nebraska children; the programs are a seamless continuum. Children are also guaranteed 12-month continuous eligibility under the federal mandate effective January 2024, meaning that even if family income rises during the year, coverage will continue until the next annual renewal.

Compare Nebraska and all 50-state Medicaid and CHIP income limits

If you are 65 or older or have Medicare with limited income

Nebraska runs three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries, administered through Heritage Health and Nebraska DHHS. The Qualified Medicare Beneficiary (QMB) program covers Medicare Part A and Part B premiums, deductibles, and copayments for individuals with incomes at or below 100% FPL ($15,960/year in 2026) and resources below $9,430 for an individual. The Specified Low-Income Medicare Beneficiary (SLMB) program covers Part B premiums for individuals at 100-120% FPL. The Qualifying Individual (QI) program covers Part B premiums for individuals at 120-135% FPL. Dual-eligible Nebraskans (those who qualify for both Medicare and Heritage Health full Medicaid) may also enroll in a Dual Special Needs Plan (D-SNP) through a Heritage Health managed care organization. MSP applications go through ACCESSNebraska at (855) 632-7633 or accessnebraska.ne.gov.

Read the Medicare eligibility and savings programs guide

Frequently Asked Questions