Nebraska’s Department of Health and Human Services gives adults on Medicaid expansion 30 days from receipt to answer a work-rule notice, or they may be denied or lose coverage. The state, which calls the expansion group Heritage Health Adult, is checking the rule for members whose annual eligibility periods end on or after July 31, 2026. The requirement itself has applied since May 1, according to DHHS.
What a Heritage Health Adult notice asks for
DHHS says it looks at information it already holds before it asks a member for anything. Only when that falls short does the department send a notice, which describes what is missing and comes with a declaration form. If no request ever arrives, the member has no further work-requirement information to supply.
The clock starts on receipt. A member has 30 days from the day the notice is received to respond, and the department warns that a late or missing answer can lead to denial or loss of coverage. DHHS advises members to check mail, email and text messages regularly, since a notice sitting unread uses up days.
The group that can receive one is defined narrowly. It is adults enrolled through expansion who are 19 to 64, not pregnant, without a disability and not on Medicare, whose income is within 138% of the federal poverty level. DHHS puts that at about $22,025 a year for one person and $45,540 for a family of four.
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The July 31 trigger works through renewal dates, not through a single deadline for everyone. A member whose yearly eligibility period ends on or after that date is checked when that period comes up, so notices reach different households in different months. New applicants face the test too: those applying on or after May 1 must have met it in the month before they apply.
The proof DHHS accepts in a qualifying month
The standard is 80 hours in one qualifying month. Those hours can come from work, school or an apprenticeship at least half time, a work program or volunteering, and different activities can be added together to reach the total. One month at the threshold is what the state describes, not a run of consecutive months.
Earnings are an alternative to counting hours. A member who works and earns about $580 in a month, the pay for 80 hours at the federal minimum wage, meets the standard on income alone. For someone with irregular shifts, the dollar figure can be simpler to document than a stack of timesheets.
Members the notice should never catch
Several groups are exempt from the requirement altogether. They include people under 26 who aged out of foster care, members of federally recognized tribes and people who receive Indian Health Service care, parents or caretakers of a child 13 or younger, and anyone caring for a person with a disability. A veteran with a total disability rating is also exempt.
Others on the exempt list are the medically frail, people in a qualified drug or alcohol treatment program, members of households receiving SNAP or TANF who meet certain conditions, anyone incarcerated or released within 90 days, and women who are pregnant or up to 12 months postpartum. DHHS adds that other mandatory exceptions may apply.
Some pauses are temporary. A member who is hospitalized or in a nursing facility, or who traveled for serious medical care not available locally, can claim a hardship with a declaration form. Hardships tied to a county under a federal emergency or with high unemployment are handled differently, because the department verifies those itself and a member cannot file a form for them. Dawson County, where the state announced a blanket exemption in July, is one example.
Nebraska is ahead of the national calendar. Public Law 119-21, the 2025 budget law, requires states to run community engagement checks no later than January 1, 2027, the Federal Register shows, and the state began on May 1, 2026.
Reporting changes keeps the file current
Members must report changes that affect eligibility, such as income, address, work status and household size, including a marriage, divorce, pregnancy or adoption. An old address is a real risk when the 30-day clock runs from receipt of a mailed notice. DHHS takes reports by phone, online, by mail, by fax or in person at a local office.
The statewide number is (855) 632-7633, option 3. Lincoln callers can use (402) 473-7000, option 3, and Omaha callers (402) 595-1178, option 3. The TTY line is (402) 471-7256 and the fax number is (402) 742-2351. The department’s work requirements page also lists videos and community presentations for members who want the rules explained.
The open question for a Heritage Health Adult member is what is already on file at DHHS and what is not. A member whose hours, earnings or exemption are already in state records may never see a notice. One whose records are thin, or who has moved, is the one most likely to face the 30-day response.
Is a Heritage Health notice already in the mailbox?
A Heritage Health Adult member who lets the 30 days run, or sends the wrong proof for an exemption that actually applies, can lose coverage over paperwork. Once coverage is dropped, getting it back is a harder job than answering on time.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, so a member can match their own situation to the list before replying. It also includes a renewal and reporting calendar and the 90-day window after coverage is dropped, plus a renewal document checklist.
Check exemptions and set the 30-day date with the Medicaid work-rule guide →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
