Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Nebraska Department of Health and Human Services

AD Waiver Extra Care for Children

What you get

Specialized childcare while your usual caregiver works or attends approved education. Open now.

Who starts it
You, with a document from your doctor
How it’s sent
Email to dhhs.hcbswaiverapp@nebraska.gov, or by post
Your time
About 15 minutes, plus waiting for the document
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your child is 18 or under.
  • Parents pay the routine childcare cost.
  • Cancer alone may not satisfy disability, SSI, Medicaid, developmental, caregiver, or level-of-care requirements; individual authorization and capacity rules apply.

  1. Ask your doctor for the documentStart here. This is the part that takes the longest.

    Nebraska Department of Health and Human Services needs a note confirming the diagnosis from your doctor. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to Nebraska Department of Health and Human Services’s AD Waiver Extra Care for Children. They offer specialized childcare while our usual caregiver works or attends approved education, and they are taking applications now.

They need a note confirming the diagnosis from you. Their form and instructions are here: https://dhhs.ne.gov/Pages/Medicaid-Aged-and-Disabled-Waiver.aspx

Could you do that when you have a chance? I’ll bring the printed form to our next visit, or I can email it. Thank you for everything you do for us.

[your name] · [phone]
    Copying is the only thing this page does with your text. Nothing is saved.

  2. Fill in their formPrint it, or fill it in on screen if the PDF allows.

    Open the application PDF ↗ Checked Aug 27, 2026

    What the form asks for

    DD-10 published application questions
    HCBS waiver you are applying forApplicant name, birthdate, phone, gender, address, email, and preferred languageAuthorized representative, guardian/attorney in fact, or parent of a minorI am a legal resident of NebraskaIf there is any other information relevant to this application that you want us to know, note it here

    Have ready

    • Completed and signed DD-10 waiver application.
    • Authorization for disclosure of protected health information when DHHS must gather records.

  3. Email your application and the document togetherTo dhhs.hcbswaiverapp@nebraska.gov. Or post it to the address on the form.

    • Email to dhhs.hcbswaiverapp@nebraska.gov, fax to 402-328-6257, or mail to HCBS Waiver Eligibility, PO Box 98947, Lincoln, NE 68509-8947.

    Email: dhhs.hcbswaiverapp@nebraska.gov

    Fax: 402-328-6257

    Subject: AD Waiver Extra Care for Children application, [child’s name]

Hello,

Attached are our completed application and the document from [doctor’s name] at [hospital]. Please let me know that it arrived and if anything is missing.

Thank you,
[your name] · [phone]

After you send

Expect DHHS to call to schedule the level-of-care assessment after Medicaid eligibility is checked. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published