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The change affects certain adults covered through Medicaid expansion. If DHHS requests documentation during a renewal, beneficiaries will have 30 days to respond or could lose their health coverage.
By Hola Nebraska
Nebraska – The Nebraska Department of Health and Human Services (DHHS) will begin reviewing work requirements during Medicaid renewals for people whose coverage periods end on or after July 31, 2026.
The review applies to certain adults ages 19 to 64 enrolled through Medicaid expansion, also known as Heritage Health Adult. The process will roll out gradually as beneficiaries reach their regular renewal month.
New Medicaid expansion applicants have been subject to the requirements since May 1, 2026. People who renewed in May or June of this year will not have to demonstrate compliance until their 2027 renewal.
Current beneficiaries must meet the requirement for at least one month since their last renewal
People who already receive coverage through Medicaid expansion do not have to document 80 hours of qualifying activity every month of the year.
During the renewal process, DHHS will determine whether a person worked, attended school, participated in another approved activity, qualified for an exemption or experienced a temporary hardship during at least one month since their last renewal.
If the state can confirm that information using data it already has, the renewal will be approved without requiring additional documentation.
A person can meet the requirement by completing at least 80 hours of an approved activity during one month or by combining multiple qualifying activities.
The requirement can also be met by earning at least $580 in one month. Seasonal workers may qualify if their average monthly income over six months reaches at least that amount.
Related: Nebraska Medicaid work requirements began May 1
Work, education and volunteer service can count
Approved activities include paid employment, employment or training programs, volunteer work and community service.
Enrollment in a college, technical school or registered apprenticeship program also counts when the person attends at least half time.
Attending high school or a program leading to a high school equivalency credential, commonly known as a GED, may also satisfy the requirement.
Hours from different activities can be combined to reach the required 80 hours in one month.
An independent job search does not count on its own, although it may qualify when it is part of an approved employment program.
The requirements do not apply to everyone enrolled in Medicaid
Some beneficiaries may qualify for an exemption and will not need to complete work-related activities.
Exemptions may apply to parents or caregivers of a child age 13 or younger; people caring for someone with a disability; people who are pregnant; and those within 12 months after giving birth who received Medicaid during pregnancy.
People with a medical condition that prevents them from working, veterans with a total disability rating and people under age 26 who aged out of foster care may also qualify for an exemption.
The list also includes members of federally recognized tribes, people receiving care through the Indian Health Service and participants in certain alcohol or drug treatment programs.
Some people who meet SNAP or TANF work requirements may also qualify for an exemption from the separate Medicaid requirement.
DHHS may request a statement or additional documentation when it does not have enough information to confirm an exemption.
A hospitalization or emergency may qualify as a temporary hardship
Certain temporary circumstances may prevent a person from losing coverage for failing to complete the required activities.
These situations include hospitalization, a stay in a nursing facility or travel to receive treatment for a serious medical condition when the service is unavailable in the person’s community.
A federal emergency in the county where the person lives and certain periods of high unemployment may also qualify.
In some cases, the person will need to complete a form reporting the hardship. DHHS will automatically verify federal emergencies and unemployment levels when that information is available.
DHHS will allow 30 days to submit additional information
Nebraska Medicaid will first review the information it already has to determine whether the person met the requirement or qualifies for an exemption.
If the available information is insufficient, DHHS will send a letter explaining which details or documents are missing. People who agreed to receive electronic communications may also receive a text message or email.
The person will have 30 days from the date they receive the notice to respond. Failing to submit the requested information by the deadline could result in Medicaid denying the renewal or ending the person’s coverage.
Beneficiaries do not need to send new documents before receiving a request. If DHHS does not ask for additional information, there is no need to submit proof related to the work requirements.
How to respond to a DHHS request
- Online: through the QR code included in the letter or at iServe Nebraska
- Statewide phone number: (855) 632-7633, option 3
- Omaha phone number: (402) 595-1178, option 3
- Lincoln phone number: (402) 473-7000, option 3
- Mail: P.O. Box 2992, Omaha, NE 68103-2992
- In person: at a local DHHS office
An adult losing coverage does not automatically end coverage for their children
Work requirements are reviewed individually. If a parent loses Medicaid for failing to meet the requirement, their children’s coverage will not automatically end.
When an adult’s coverage ends for this reason, the person will need to meet the requirement and submit a new application to regain coverage through Medicaid expansion.
The iServe portal allows beneficiaries to check their renewal date and notices, submit documents and update information such as income, address, employment or household size.
DHHS provides a Spanish-language guide to Medicaid work requirements, approved activities, exemptions and the response process.
The first reviews apply to coverage periods ending July 31, 2026. Additional reviews will take place during each beneficiary’s regular renewal month.
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