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REV. MAY 8, 2026 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY

HEALTH AND HUMAN SERVICES 477-000-012

FAMILY SIZE 7 FAMILY SIZE 8+

ADJUSTED

ADJUSTED

MONTHLY

MONTHLY

EARNED

EARNED

INCOME

Fee INCOME

Fee

4170 - 4378.99 114 4644 - 4875.99 126 4379 - 4586.99 119 4876 - 5107.99 133 4587 - 4795.99 125 5108 - 5339.99 139 4796 - 5003.99 131 5340 - 5571.99 145 5004 - 5212.99 136 5572 - 5803.99 152 5213 - 5420.99 142 5804 - 6035.99 158 5421 - 5629.99 148 6036 - 6268.99 164 5630 - 5837.99 153 6269 - 6500.99 171 5838 - 6046.99 159 6501 - 6732.99 177 6047 - 6254.99 165 6733 - 6964.99 183 6255 - 6463.99 170 6965 - 7196.99 190 6464 - 6671.99 176 7197 - 7428.99 196 6672 - 6880.99 182 7429 - 7661.99 202 6881 - 7088.99 187 7662 - 7893.99 209 7089 - 7297.99 193 7894 - 8125.99 215 7298 - 7505.99 199 8126 - 8357.99 221 7506 - 7715.00 204 8358 - 8591.00 228