If you are living in Nebraska and rely on Medicaid for your health insurance, there is a big change coming soon that you need to know about. At African Immigrant Family Services (AIFS), we know how hard you work to build a life for your family. Navigating health insurance is already tricky, and new rules can feel overwhelming.
Starting May 1, 2026, the state of Nebraska is introducing "community engagement" or work requirements for some adults on Medicaid. If you’ve seen a yellow letter in your mailbox from the Nebraska Department of Health and Human Services (DHHS), please don't set it aside! That letter contains important information about your coverage.
We want to make sure no one in our community loses their doctor or their prescriptions because of a paperwork mix-up. Let’s break down exactly what is happening, who it affects, and how you can stay covered.
What is Changing?
For a long time, having Medicaid in Nebraska mostly depended on your income. But starting this May, some adults will also have to show that they are "active" in the community to keep their insurance.
Nebraska Medicaid (often called Heritage Health) will now require certain people to complete at least 80 hours of approved activities every month. If this applies to you and you don't meet the hours (or qualify for an exemption), you could lose your health insurance.
Who Must Meet the New Work Rules?
Not everyone on Medicaid has to follow these new rules. This change specifically targets the "Adult Expansion Group." You likely fall into this group if:
- You are between the ages of 19 and 64.
- You are not currently pregnant.
- You do not have a documented disability.
- You qualified for Medicaid because your income is at a certain level (Expansion group).
If you are over 65, or if you are a child, these rules do not apply to you. However, if you are a healthy adult working to get your feet under you in Omaha, Lincoln, or anywhere else in Nebraska, you need to pay close attention.
Who is Exempt? (You Might Not Have to Do Anything!)
The good news is that many people in our community will be "exempt," which means the work rules don't apply to them. But even if you are exempt, you might need to send in proof to DHHS so they know.
You are likely exempt if you:
- Are Pregnant: This includes the duration of the pregnancy and up to 12 months afterward.
- Care for a Child: If you are the main caregiver for a child aged 13 or younger, you usually don't have to meet the 80-hour work rule.
- Have a Disability: This includes physical disabilities, blindness, or serious health conditions that prevent you from working.
- Have Special Needs: This can include being "medically frail," having a substance use disorder, or a developmental disability.
- Are a Student: If you are in college or a trade school at least half-time, that counts!
- Are a Member of a Federally Recognized Tribe: Native American tribe members are exempt.
- Aged out of Foster Care: If you are under 26 and were in the foster system.
If you think you should be exempt, you should visit the DHHS Work Requirements page to see the full list and find out what documents you need to send.
What Counts as "Work"?
The state is using a broad definition of work. You don't necessarily need a 9-to-5 office job to meet the 80-hour monthly requirement. You can mix and match these activities:
- Paid Employment: Full-time or part-time jobs.
- Self-Employment: If you run your own small business or do freelance work, this counts. Keep good records of your hours!
- Job Training: Programs that help you learn new skills for a career.
- Apprenticeships: Learning a trade while you work.
- School: Attending a university, community college, or trade school.
- Volunteering/Community Service: Helping out at a local nonprofit, your church, or a community center.
The Income Shortcut
There is another way to meet the requirement. If you earn enough money in a month, the state assumes you’ve met your hours. As of late 2025/early 2026, if you earn at least $580 in a single month (which is the equivalent of 80 hours at federal minimum wage), you are considered compliant.
How Does Nebraska Check Your Hours?
You might be wondering, "Do I have to call the government every single month?"
Not necessarily. DHHS will first check the information they already have. For example, if you are already reporting your income for SNAP (food stamps) or other programs, they might see that you are working enough hours.
However, if they cannot find proof that you are working or that you are exempt, they will contact you.
- Watch for the Yellow Letter: This is the most important piece of mail you will receive.
- Check Your Portal: If you use the online DHHS system, log in regularly to check for notifications.
- Report Changes: If you lose your job or your hours decrease, tell DHHS immediately. Don't wait until your insurance is canceled.
We Are Here to Help
At AIFS, we understand that for many of our brothers and sisters who have recently arrived in the U.S., these systems feel like a maze. If English is not your first language, or if you are confused by the legal wording in the letters you receive, please reach out.
We are a welcoming community dedicated to helping African immigrant families thrive. Whether you need help understanding the 80-hour rule, finding a place to volunteer to meet your hours, or finding a French, Swahili, or Arabic speaker to help you call DHHS, we can point you in the right direction.
How to Get Free Professional Help
If your case is complicated, you can also talk to a Certified Assister or a Navigator. These are people whose job is to help you with health insurance for free.
- You can find a local navigator by visiting HowToGetCare.org.
Why This Matters for Our Community
Health is wealth. When our community members have access to doctors, they can stay healthy enough to work, take care of their children, and contribute to Nebraska. We don't want anyone to lose their "Heritage Health" coverage because they didn't know about the May 1st deadline.
If you have friends or family members who are on Medicaid, please share this information with them. Sometimes the mail gets lost, or people move and forget to update their address with the state. A simple conversation could save someone’s health coverage.
Quick Checklist for You:
- Update your address: Make sure DHHS has your current mailing address.
- Read your mail: Look for any letters (especially yellow ones) from "Nebraska DHHS" or "Heritage Health."
- Determine if you are exempt: If you are caring for a young child or have a health condition, get your proof ready.
- Track your hours: If you are working or volunteering, keep a simple log of your hours just in case.
- Ask for help: Don't wait until May 1st!
If you want to support our mission in helping families navigate these tough transitions, consider visiting our donations page to see how you can get involved. Every bit of support helps us keep our doors open for those who need guidance the most.
Stay healthy, stay informed, and let's make sure our community stays covered!
For more official details, you can also read the DHHS FAQ PDF here.
