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REV. MAY 8, 2026 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY HEALTH AND HUMAN SERVICES 477-000-012

Medically Needy, ABD/OMB, MSP/QMB and ABD/QMB Income Limits

FPL - 100% HH SIZE MNIL MA ABD/OMB MSP/QMB 1 392 1,330 2 392 1,804 3 492 2,277 4 584 2,750 5 675 3,224 6 775 3,697 7 867 4,170 8 967 4,644 9 1,059 5,117 10 1,150 5,590

+91

SLMB and QI-1 Income Limits

FPL 120% 135% HH SLMB QI-1 1 1,596 1,796 2 2,164 2,435

Eligibility for the payment of the Part B by the State for QMB is effective the first of the month following the month that initial eligibility determination is processed. For example, if you determine an individual meets all eligibility requirements for QMB status on August 15th, the effective date of eligibility for payment of premiums, deductibles, and co-insurance is September 1. However, in no case are benefits effective prior to January 1, 1989, which is the effective date of this provision. Retroactive eligibility is precluded under this provision.

QI’s cannot be otherwise eligible for any other Nebraska Medicaid category. The individual must choose either medically needy/SOC or QI. Retroactive eligibility (up to 3 months prior to application) applies if: 1. The individual met all QI eligibility criteria in the retroactive period; and 2. The retroactive period is no earlier than January 1 of that calendar year.

QIs are eligible if their incomes are at least 120% of the FPL, but less than 135% of the FPL