Updated September 4, 2026. Quick answer: yes, through Personal Assistance Services (PAS), Nebraska Medicaid’s self-directed state plan personal care option. Most adult family members can be hired and paid to provide the care. A spouse cannot be the paid caregiver; the federal rule against paying a “legally responsible relative” still applies here.
How Nebraska pays a family caregiver
| Program | Personal Assistance Services (PAS), Nebraska Medicaid’s self-directed state plan personal care option |
|---|---|
| Can a family member be paid? | Yes. “Yes, as long as the family member is not legally responsible for you.” |
| Can a spouse be paid? | No. “A spouse or the parent/guardian of a minor child cannot be paid providers.” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
Under PAS, an eligible Medicaid member has the right to choose their own provider and self-direct their care, working with a DHHS Service Coordinator to complete an assessment. A qualifying relative (other than a spouse or the parent/guardian of a minor) can then apply and be approved as an Independent Provider through DHHS’s iServe application system and be paid directly for personal assistance services.
What this doesn’t answer
The dollar rate for PAS Independent Providers could not be confirmed from a primary DHHS fee-schedule document this session; the DHHS fee-schedule index page was read, but the individual rate PDFs would not render as readable text, so any specific hourly figure is left unverified rather than guessed. The full PAS provider handbook also would not extract as text this session.
Sources
- Nebraska DHHS: Medicaid Home and Community-Based Programs page
- Nebraska DHHS: Personal Assistance Services Provider Handbook page
- Nebraska DHHS: Medicaid Provider Rates and Fee Schedules page
Read September 4, 2026.
Same question, other states: Nevada · New Hampshire.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.