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477-000-037

REV. JANUARY 21, 2020 NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAID ELIGIBILITY 477-000-037 – Medically Needy Standard Medically Needy Income Level The following figures are used for Medicaid or SIMP budgeting: (Figures listed are representative of dollar amounts) Number of Individuals One Month 1 392.00 2 392.00 Individual in long term care facility 60.00 Individual in Assisted Living with Waiver Services 783.00