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

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Nebraska program

Nurses and aides at home through Medicaid

Medicaid-paid nurses and aides who help with your child’s care at home.

What it is

Medicaid-paid nurses and aides who help with your child’s care at home.

Going home can leave you managing a line, feeding tube or other skilled care. The treating team describes the tasks and hours and asks the Heritage Health plan to approve them. Approval of hours and finding an agency with staff are separate steps.

Eligibility rules
  • Your child must have Nebraska Medicaid. The care must meet medical-need and approval rules.
  • Health Check applies through age 20. It requires covered, medically necessary state-plan services within Medicaid benefit categories.
What you get
  • No premium or child copay for approved Medicaid home care.
  • Nursing, personal care and home health visits matched to assessed needs.
What the help covers
  • Private-duty nursing, personal care and home health are different services. The clinical request needs to identify the kind and amount of care.
  • There are three kinds of help: shift nursing, an aide for daily tasks beyond what a child that age normally needs, and occasional nurse visits. The health plan approves most of them; a few go through the state instead. Ask the care manager which office handles your child's request.
  • Your care manager can identify whether the request is home health, private-duty nursing, children’s personal care, state-plan Personal Assistance Services or a waiver service, and which office authorizes it. The requested tasks, hours and medical need require separate review. The care manager confirms your plan’s service limits and approval route.
If you decide to apply
  1. Ask the oncology team or discharge planner to send your child’s home-care request to the Heritage Health plan.
  2. Have the discharge plan and a daily list of medical and personal-care tasks ready.

Heritage Health member services: Molina 844-782-2018 · Nebraska Total Care 844-385-2192 · UnitedHealthcare 800-641-1902 · Official page ↗

After you apply
  • A written approval names the hours and services. A staffed home-care agency is a separate practical requirement.
  • For a 2026 Heritage Health request for nursing or another non-drug medical service, the standard authorization decision limit is seven calendar days and the urgent limit is 72 hours, subject to legally permitted extensions. Approval and finding staff are separate. If an approved agency cannot staff the hours, your social worker can ask the plan’s care manager about other agencies or an authorized out-of-network arrangement, and a written notice for any denial or reduction.
  • The 2026 non-drug decision standard took effect January 1, 2026. An extension of up to 14 calendar days requires the applicable conditions. UnitedHealthcare describes five working days after required records, never beyond seven calendar days from the request without a permitted extension. Staffing has a separate care-management and network-access review.
Good to know

For a child under 21, care covered by the regular Medicaid benefit should not depend on joining a waiver.

Other details
  • The waiver team can check whether a legally responsible parent could be approved for extraordinary personal care, including any DD-26 requirements. Ordinary parenting is not paid care; an assessment alone does not establish wages.
Official sources
Ask your social worker

“Could we have nursing or aide help at home? Which tasks and hours would qualify, what would we still handle ourselves, and could you help the team request an assessment?”

Why I’m asking: I want to know what help can be in place for safe care at home.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for it before discharge and keep a written note of the decision date.

Your social worker

The discharge planner and the oncology team write the request.

The care team

The team documents the hours and tasks needed at home.

Who decides
The Heritage Health plan authorises the hours.
Ask your social worker
“Can we request private-duty nursing hours before discharge, and can you tell me the plan’s decision timeframe in writing?”

How to apply

First step: Your social worker or discharge planner can help the treating team send the home-care request to the responsible plan or office.

  1. Ask the discharge planner to request nursing hours before discharge, not after.
  2. Ask the plan in writing how long it has to decide.
  3. If told a waiver is needed first, quote the Health Check requirement.

Official application / program page ↗

Where it starts: The oncology or discharge team helps identify and submit the requested home service to the responsible plan or office. The separate waiver/DD contact is 877-667-6266.

What to gather

  • The discharge plan
  • The list of tasks needed at home each day

How long: From January 1, 2026, Medicaid managed-care non-drug authorization decisions have a seven-calendar-day ordinary limit and a 72-hour expedited limit, subject to legally permitted extensions. Approval does not guarantee immediately available staff.

What a yes looks like

An authorisation naming hours per day or week, and an agency assigned.

What a no looks like, and the next move

Ask whether it was refused on medical necessity or on staffing, and appeal the first.

Watch out

  • Approval and staffed hours are separate. The care manager can review other agencies or an approved out-of-network arrangement when approved hours cannot be staffed.
  • From January 1, 2026, Medicaid managed-care non-drug authorization decisions have a seven-calendar-day ordinary limit and a 72-hour expedited limit, subject to legally permitted extensions. Approval does not guarantee immediately available staff.
  • If told a waiver is needed first, quote Health Check: state-plan care must come through it for a child under 21.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Nursing and personal care hours at home through the Medicaid plan, with a parent payable for assessed extraordinary care on the Aged and Disabled waiver.

Covers: Private-duty nursing hours at home · Personal care and aide hours · Home health visits · Legally responsible individual personal care on the Aged and Disabled waiver, for assessed extraordinary care

Legal protection: Under 21, state-plan-coverable personal care must be furnished through Health Check rather than requiring a waiver

What it costs the family: No premium or copay for a child on Medicaid.

The eligibility facts, as published

Age
through 20 for Health Check
Other
the child must be on Nebraska Medicaid and the plan must authorise the hours
Residency
Nebraska
Processing standard
From January 1, 2026, Medicaid managed-care non-drug authorization decisions have a seven-calendar-day ordinary limit and a 72-hour expedited limit, subject to legally permitted extensions. Approval does not guarantee immediately available staff.

Decisions this site cannot make: Prior authorisation by the Heritage Health plan

Expect friction on: From January 1, 2026, Medicaid managed-care non-drug authorization decisions have a seven-calendar-day ordinary limit and a 72-hour expedited limit, subject to legally permitted extensions. Approval does not guarantee immediately available staff.

The trap: Under 21, personal care that the state plan can cover has to be furnished through Health Check, Nebraska’s name for the federal child screening and treatment rule. Quote that if anyone tells you a waiver is needed first.

Where I read this

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