Government, Financial & Legal

An Area Agency on Aging (AAA) is a public or private non-profit agency, designated by the state to address the needs and concerns of all older persons at the regional and local levels. “Area Agency on Aging” is a generic term — specific names of local AAAs may vary.

AAAs coordinate and offer services that help older adults remain in their homes. By making a range of options available, AAAs make it possible for older individuals to choose the services and living arrangements that suit them best.

• Medicaid / Medicaid Waiver – food and financial assistance eligibility
• Long-Term Care Ombudsman – education, consultation, referral and advocacy for those in a long-term care facility
• Developmental Disability Services – service coordination for those with disabilities
• Social Services Block Grant Program – assistance for persons aged 60+ or disabled to remain in their own home
• Adult Protective Services (APS) – investigates and helps remedy abusive situations. Anyone can report suspected abuse to the Hotline.

Nebraska Elder Abuse/Neglect Hotline: 800-652-1999  |  Iowa Elder Abuse/Neglect: 800-362-2178

Social Security is a retirement program for Americans who have paid for coverage through payroll deductions or self-employment taxes.

Some services may be extended to the spouse or dependent of an eligible Veteran.

Hospitals and Hospice Programs often have Foundations established to help those in need. Many Pharmaceutical Companies offer Discounted Prescription Programs.

Many banks offer Trust and Wealth Management Services.

A reverse mortgage lets individuals aged 62+ convert home equity into cash. The Home Equity Conversion Mortgage (HECM) is FHA’s reverse mortgage program. You must meet with an HECM counselor first to discuss eligibility and requirements. Call HUD to find an FHA reverse mortgage lender or counselor.

Medicare is federal health insurance for people aged 65+, people under 65 with certain disabilities, and people with end-stage renal disease. Medicare is divided into four parts:

• Part A – Hospital Insurance
• Part B – Medical Insurance
• Part C (Medicare Advantage) – Choose from different health care plans
• Part D – Prescription drug plan options

There are 2 main ways to get Medicare coverage — Original Medicare or a Medicare Advantage Plan. With Original Medicare, you decide if you need Part D and/or a Medigap policy. Medicare Advantage (Part C) combines Part A and Part B, and most include or offer Part D. “Medicare & You” is a booklet revised yearly covering benefits, rights, protections, and plans. Available in English and Spanish from Medicare.gov or by calling 800-633-4227.

Part A helps pay for care in hospitals and nursing facilities, hospice care and some home health. Premium-free for most people because of Medicare taxes paid while working.

Part B helps pay for medically necessary doctor’s services, outpatient care, home health, durable medical equipment and some preventive services. Standard 2026 premium: $202.90/month. Annual deductible: $283 (2026). After deductible, you typically pay 20% of approved amounts.

Medicare Advantage plans are offered by private, Medicare-approved insurance companies. They cover all Part A and Part B services and often add vision, hearing, dental and wellness. Most include Part D prescription drug coverage. Compare plans at Medicare.gov/find-a-plan. You may change plans October 15–December 7 each year. Call SHIP at 877-564-7323 (Nebraska) or 800-351-4664 (Iowa) for help.

Voluntary prescription drug insurance through private companies. Enrollment window: 3 months before through 3 months after your 65th birthday. Change plans October 15–December 7 each year. Compare at Medicare.gov/find-a-plan.

Medigap policies are sold by private companies to fill the gaps in Part A and Part B coverage — copayments, coinsurance and deductibles. Ten standardized plans to choose from. You must have both Part A & B; cannot use Medigap with Medicare Advantage. Enroll starting when you enroll in Part B (6-month open enrollment window). Compare at Medicare.gov/find-a-plan or call SHIP.

Medicaid is financed by individual states and the federal government to pay some health care costs for people with limited incomes and resources. Available to low-income persons 65+, blind, disabled, children 18 or younger, and others who meet eligibility requirements.

Medicaid generally pays Medicare copayments and deductibles. It may also cover hospital care, doctor visits, dental, eye care, speech/hearing/physical therapy, lab and x-ray services, nursing home care, home health, prescriptions, medical equipment, health aids, transportation and institutional care.

• Single person: Less than $1,799/month income. May retain up to $4,000 in resources. Home, one car, business property, up to $1,500 life insurance face value, and up to $6,122 irrevocable burial trust are exempt.
• Married couple: Less than $1,305/month income. May retain up to $8,000 ($4,000/spouse) in resources. Same exemptions per spouse.
• Couple with one spouse in nursing home: Spousal impoverishment rules apply. Combined resources split 50/50 if between $31,584–$157,920. Community spouse keeps all income; nursing home spouse keeps $60/month personal allowance.

Income and resource guidelines adjust yearly. Numbers above based on 2023 figures. Contact DHHS or AccessNebraska.NE.gov for current eligibility.

Long-Term Care Insurance (LTCI) covers personal and custodial care in a nursing facility, assisted living, or at home. It reimburses policyholders a daily amount for help with activities of daily living such as dressing and eating.

Without LTCI, many pay privately. Medicaid only applies after spending down most personal resources. Medicare covers only certain medical expenses for a limited time. It is often beneficial to begin researching LTCI between ages 45–60.

Key questions when shopping for a policy:

• What services are covered (home health, assisted living, nursing homes)?
• What are the daily benefit amounts and waiting period before benefits begin?
• What is the benefit period (2 years, 4 years, lifetime)? Is there an inflation clause?
• Has the company had complaints filed with the Dept. of Insurance?

Consult an online directory for additional listings.

Advance Medical Directives are written guidelines directing future care when an individual cannot make or communicate a medical decision. In Nebraska and Iowa, you must fill out both a Living Will and a Healthcare Power of Attorney for a complete Advance Directive.

Living Will is a legal document indicating wishes regarding end of life decisions (CPR, ventilators, feeding tubes). It only becomes active after the individual is determined unable to make or communicate a medical decision.

Five Wishes is a Living Will document meeting legal requirements in Nebraska and Iowa. The five wishes address: (1) who makes healthcare decisions, (2) what medical treatment you want, (3) how comfortable you want to be, (4) how you want to be treated, and (5) what you want loved ones to know. Call 1-888-594-7437 or visit AgingWithDignity.org.

Code/No Code – Do Not Resuscitate (DNR) Order is a medical order stating whether attempts should be made to restart the heart and lungs if they stop. Hospitals and facilities often ask terminally ill patients to establish a DNR for their medical record.

Powers of Attorney (POAs) are legal documents appointing trusted persons to assist with medical or financial management. A durable POA continues in effect after incapacity. A springing POA becomes effective upon incapacity.

Healthcare Power of Attorney (HCPOA) appoints a trusted agent to make medical decisions for an individual who cannot. The agent may accept/reject treatments, authorize medical records access, admit to facilities, and relay wishes regarding hospice, organ donation and funeral instructions. Must be written, signed, and either witnessed by two adults or notarized. An HCPOA from another state is honored in Nebraska and Iowa.

Financial Power of Attorney (FPOA) appoints a trusted agent to manage finances and property — checking/savings accounts, safety deposit boxes, securities, investments and more. Must be written, signed, and either witnessed by two adults or notarized.

The HCPOA and FPOA may be the same person or two different people. Contact an elder law attorney or the Nebraska/Iowa State Bar Association for assistance.

Guardianships & Conservatorships

• Guardianship: An interested party may petition the court to appoint a Guardian to assist an individual unable to manage their health or daily needs when no durable HCPOA is in place. The Guardian must report annually to the court.
• Conservatorship: An interested party may petition the court to appoint a Conservator to assist an individual unable to manage property and finances. The Conservator files a detailed annual accounting report for court review.

Call the Office of Public Guardian at 402-889-3272 or contact an elder law attorney for more information.

Representative Payee: Appointed by the Social Security Administration to handle an individual’s Social Security affairs.

Protective Payee: Appointed by the Nebraska or Iowa Dept. of Social Services to handle the protected person’s state benefits.

Probate, Wills and Trusts: POAs, Guardianships and Conservatorships lose authority when the individual dies. After death, the estate often goes into probate.

• Probate: Legal process after death. Probate courts admit Wills, appoint personal representatives, oversee accounting and distribution of the estate.
• Will: Appoints a personal representative and says to whom assets should go. Must be written, signed and witnessed by at least two individuals per state law.
• Trust: A legal entity holding title to assets. When the individual dies, beneficiaries bypass the probate process. An attorney can advise when a Trust has advantages over a Will alone.

Many law firms offer mediation services.

Many firms have attorneys with experience in probate, wills and estate planning.