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What is the Medicaid Spend Down Required to Enter a Nursing Home in Nebraska?

What is Medicaid Spend Down??

“To be eligible for Medicaid long term care, an applicant must have income and assets under a specified amount. If the applicant’s income or countable assets exceed Medicaid’s financial limits in their state, an applicant can become eligible by ‘spending down’ one’s income or assets to the point where they become financially eligible.” See

What is the Current Spend Down Requirement for Nebraska?

  • Institutional/Nursing Home Medicaid
    • Single Person
      • Income limit: $1,215/month
      • Asset limit: $4,000
    • Married (both spouses applying)
      • Income limit: $1,644/month
      • Asset limit: $6,000
  • Medicaid Waivers/Home and Community Based Services Medicaid (HCBS)
    • Single Person
      • Income limit: $1,215/month
      • Asset limit: $4,000
    • Married (both spouses applying)
      • Income limit: $1,644/month
      • Asset limit: $6,000
  • See:

 What are the Assets an Applicant is Allowed to Keep?

Medicaid divides assets into two categories: Exempt and Available:

  • Available assets are all non-exempt assets of both spouses that can be used as payment for long-term care expenses. If an asset is not listed as exempt, then it needs to be liquidated and applied toward the costs of nursing home care before the applicant can receive Medicaid benefits. The state has a look back period of 5 years with a penalty for people who sell assets below fair market price, transfer assets to others, or give money and property away.
  • Exempt assets are specifically designated under the rules, and ownership of an exempt asset by the applicant will not result in a denial of benefits.

The following are some of the most common items that are excluded in making a determination of eligibility for Medicaid under 477 NAC 23 003.06:

  1. Real Property the individual owns and occupies as a home;
  2. Household goods and personal effects;
  3. A specified maximum in proceeds from an insurance policy irrevocably assigned for the purpose of burial of the client;
  4. Burial spaces;
  5. Up to $1,500 set aside for burial arrangements;
  6. One motor vehicle;
  7. Certain life estates in real property;
  8. The unspent portion of any Retirement, Survivors, and Disability Insurance (RSDI) or Supplemental Security Income (SSI) retroactive payments (excluded for six months following the month of receipt);
  9. Savings bonds, which are excluded for the initial 12 month mandatory retention period; and,
  10. Resources used in a trade or business.

See the full list at:

Please contact the estate planning lawyers at Berkshire & Burmeister for your estate planning needs.

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