What is Changing in Medicaid?
Since the beginning of the public health emergency, waiver participants kept both waiver and Medicaid coverage even if they were no longer eligible because of the continuous coverage requirement.
The continuous coverage requirement expired March 31, 2023.
This impacts all Medicaid members, including all participants on the following waivers:
- Aged and Disabled (AD) Waiver
- Developmental Disabilities Comprehensive (CDD) Waiver
- Developmental Disabilities Adult Day (DDAD) Waiver
- Traumatic Brain Injury (TBI) Waiver
Starting March 1, 2023, the Division of Developmental Disabilities (DDD) and the Division of Medicaid and Long-Term Care (MLTC) resumed regular reviews of Medicaid eligibility. It will take approximately twelve months to review each member's Medicaid eligibility. For more information, visit the Medicaid renewal page.
It is very important that Medicaid members make sure their contact information is up to date with Nebraska Medicaid. If Nebraska Medicaid is not able to reach a member, they could unnecessarily lose Medicaid coverage.
Check your contact information on ACCESSNebraska
Waiver Renewals
DHHS reviews all HCBS waiver eligibility once per year to determine if participants still qualify for HCBS waiver services. However, because of the public health emergency, DHHS kept everyone's Medicaid HCBS waiver cases active since March 2020 regardless of eligibility determination.
Beginning March 1, 2023, DHHS is reviewing all Medicaid HCBS waiver eligibility determinations to make sure participants still qualify for HCBS waiver services.
To remain on a Medicaid HCBS waiver after March 31, 2023, a person must meet waiver specific requirements:
- Participants need to meet level of care requirements for their waiver:
- Participants on the Aged and Disabled (AD) or Traumatic Brain Injury (TBI) waivers are required to meet a Nursing Facility (NF) level of care.
- Participants on the Developmental Disabilities Comprehensive (CDD) or Developmental Disabilities Adult Day (DDAD) waivers are required to meet an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care.
- Participants need to utilize a waiver service on a regular basis after April 1, 2023:
- Participants on the CDD/DDAD waivers need to use a waiver service at least once between April 1, 2023, and June 30, 2023, and at least once every 90 days thereafter to maintain eligibility.
- Participants on the AD/TBI waivers need to use a waiver service at least once between April 1, 2023, and May 31, 2023, and at least once every 60 days thereafter to maintain eligibility.
- Participants and/or guardians needed to complete any requested consents, assessments or other plan requirements as requested from Service Coordinators by April 1, 2023.
- If a participant or guardian does not respond to requests from the Service Coordinator by April 15, 2023, after giving adequate and timely notice, the waiver case will be closed.
- As of July 1, 2023, all reviews for Medicaid HCBS waiver eligibility determinations have been completed.
- Renewal reviews will occur every year.
Information for Members
Completing your Level of Care Assessment
When your 2023 level of care is completed will depend on the results of your last assessment:
- Participants who did NOT meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed before May 31, 2023. A DDD teammate will be in touch after April 1, 2023, to schedule a time to complete a new level of care assessment.
- Participants who did meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed at their next annual reassessment.
To prevent an unnecessary interruption in Medicaid or waiver coverage, make sure your information is up to date.
Make sure your contact information is up to date and report any changes. You can make updates in any of the following ways:
You should check your mail regularly. DHHS may send you important information that you need to respond to so you do not unnecessarily lose your Medicaid or Waiver coverage. If you have provided your email address and phone number, DHHS may also send you texts and emails when your level of care assessment or Medicaid renewal is coming up.
Returned mail
If DHHS cannot contact you due to returned mail, we will contact you to ask for up-to-date contact information.
Frequently Asked Questions
Make sure DHHS has the best contact information for you. This includes your mailing address, phone number, and email address.
To make sure your contact information is up to date, you can:
DHHS must complete a renewal for all members starting March 1, 2023. When your level of care is completed will depend on the results of your last assessment.
Participants who did NOT meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed prior to May 31, 2023. A DDD teammate will be in touch after April 1, 2023, to schedule a time to complete a new level of care assessment.
Participants who did meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed at their next annual reassessment.
When your level of care is completed will depend on the results of your last assessment.
Participants who did NOT meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed before May 31, 2023. A DDD teammate will be in touch after April 1, 2023, to schedule a time to complete a new level of care assessment.
Participants who did meet level of care requirements during the Public Health Emergency (PHE) will be re-assessed at their next annual reassessment.
If you are not sure whether you met your last level of care, you can call your Service Coordinator.
Yes. It is required that all waiver participants also be eligible for Medicaid. MLTC is conducting its own process for ensuring all Medicaid members are still eligible for Medicaid coverage after March 31, 2023.
For information, visit the Medicaid MOE Unwind page.
If you are no longer eligible for your Medicaid HCBS Waiver, DHHS will send you a notice of decision to terminate your waiver services. The notice includes information about your right to appeal the decision.