New immigration-related eligibility rules have been in effect since Oct. 1. Refugees, asylees, parolees and other groups may lose full Medicaid, while lawfully present pregnant women and children under 19 remain exempt.
By Hola Nebraska
Updated Oct. 1, 2026
New rules limiting which noncitizens can receive full Medicaid coverage are now in effect in Nebraska as of Oct. 1, 2026.
The change applies both to new applicants and to people who already had Medicaid coverage. Some refugees, asylees, parolees, trafficking survivors and people in other immigration categories may no longer qualify for full Medicaid even if their regular annual renewal is scheduled for a later date.
That does not mean everyone in one of those groups automatically lost coverage. Nebraska Medicaid will review each member’s eligibility using the information it already has and will send a notice if additional documents are needed or if a person is determined to no longer be eligible.
DHHS says members should not assume they are no longer eligible unless they receive an official notice from Nebraska Medicaid. Members can also review notices and correspondence through iServe Nebraska.
Refugees, asylees and parolees may lose full Medicaid coverage
People who do not have lawful permanent resident status may no longer qualify for full Medicaid if they fall into certain immigration categories.
Potentially affected groups include:
- refugees;
- asylees;
- parolees;
- certain survivors of domestic violence who qualify under the Violence Against Women Act, or VAWA;
- trafficking survivors and certain family members;
- people granted conditional entry;
- people whose deportation or removal is being withheld;
- certain veterans, active-duty service members and family members who also have a qualified noncitizen status;
- Native Americans born outside the United States.
The list is not exhaustive, and other immigration categories may also be affected.
Immigration status is only one part of Medicaid eligibility. A person must also meet the program’s other requirements, including applicable income and coverage-category rules.
A refugee or asylee who later became a lawful permanent resident, commonly known as a green card holder, may remain eligible if they meet the rules that apply to permanent residents.
Permanent residents and several other groups can still qualify
People who meet Medicaid’s other eligibility requirements may continue to receive full coverage if they fall into certain immigration categories.
- Lawful permanent residents, or green card holders, who have met the five-year waiting period, can be credited with 40 qualifying quarters of work or qualify for an exemption;
- Cuban and Haitian entrants;
- migrants covered under the Compact of Free Association, or COFA, from Micronesia, the Marshall Islands and Palau;
- lawfully present pregnant women;
- lawfully present children under age 19.
The pregnancy and children’s exceptions also apply to people who otherwise fall into some of the immigration categories affected by the new restrictions, as long as they meet the program’s other eligibility requirements.
Some refugees, asylees, certified trafficking survivors and other groups are also exempt from the five-year waiting period after becoming lawful permanent residents.
Nebraska Medicaid will send a notice if it needs more information
DHHS will first review eligibility using information already available in its systems.
If the agency needs to confirm immigration status or another eligibility factor, it will send a notice explaining which documents or information are needed and how to submit them.
An outdated mailing address or phone number could prevent a member from receiving a request for information or an eligibility decision on time.
Members can update information, report changes and review correspondence through iServe Nebraska.
Documents and changes can also be sent by mail to:
Nebraska DHHS Document Imaging Center
P.O. Box 2992
Omaha, NE 68103-2992
The Medicaid Eligibility fax number is 402-742-2351.
A request for documents does not mean Medicaid coverage has already ended
A letter asking for additional information is different from a final eligibility decision.
The notice will identify what information DHHS needs and how the member can respond. This may be especially important if someone recently received a green card, became a U.S. citizen or has updated immigration information that is not yet reflected in the Medicaid case.
DHHS accepts eligibility updates through iServe, by phone, by fax, by mail or at a local DHHS office.
An eligibility decision should explain the reason and effective date
People who no longer qualify for full Medicaid because of their immigration status will receive an official eligibility notice from Nebraska Medicaid.
The notice should identify the reason for the decision, the effective date and instructions that apply to the member’s case.
If the immigration status, address, household information or another fact used in the decision appears outdated or incorrect, the Medicaid Eligibility Customer Service Center can explain what information is currently on file and how to submit an update.
Current Medicaid eligibility phone numbers are:
- Medicaid Eligibility Customer Service Center: 855-632-7633
- Lincoln: 402-473-7000
- Omaha: 402-595-1178
- TTY: 402-471-7256
Live customer service is available Monday through Friday from 8 a.m. to 5 p.m.
Nebraska also provides 800-642-6092 for Medicaid eligibility verification.
Some eligibility decisions can be appealed through a fair hearing
Nebraska DHHS has a fair hearing process for people who disagree with certain benefit decisions.
General state rules allow an applicant or participant to request a fair hearing in writing within 90 days of an action or decision. However, Nebraska regulations also state that an appeal may not be available when state or federal law requires an automatic change affecting an entire class of applicants or participants.
Someone who believes DHHS used an incorrect immigration status, outdated information or other inaccurate facts can review the appeal rights and deadlines included in their individual eligibility notice.
DHHS provides a Request for Fair Hearing form for decisions that are eligible for appeal.
599 CHIP and emergency medical assistance may still be available
Losing full Medicaid because of immigration status does not necessarily mean a person is ineligible for every medical assistance program administered by Nebraska.
599 CHIP may cover prenatal and pregnancy-related services, labor and delivery for an unborn child when the pregnant person does not have a Medicaid-eligible immigration status, has no other health coverage and meets the program’s other requirements.
The Refugee Resettlement Program may also provide medical assistance to certain people with eligible immigration statuses who have been in the United States for less than eight months.
Emergency Medical Services Assistance, or EMSA, may help pay for emergency medical care when a person meets Medicaid’s other eligibility requirements but does not meet the citizenship or immigration requirement.
EMSA covers emergency services only and does not replace full Medicaid coverage.
The immigration change is separate from Nebraska Medicaid work requirements
The new immigration-status restrictions are separate from the Medicaid work requirements Nebraska began applying May 1 to certain adults covered through Medicaid expansion.
A person may face separate eligibility rules involving income, coverage category, qualifying activities and immigration status.
Hola Nebraska previously explained how Nebraska Medicaid work requirements affect adults covered through expansion.
Some people who lose Medicaid may have other health coverage options
When someone is found ineligible for Medicaid, information may be transferred to the Federal Marketplace to determine whether the person qualifies for private health insurance coverage or financial assistance.
Marketplace eligibility and any available subsidies depend on the person’s individual circumstances.
Current information about the immigration categories affected by the Oct. 1 rules is available through the Nebraska Medicaid eligibility guide for noncitizens.
Members can review notices, update information and manage benefits through iServe Nebraska or call 855-632-7633.
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