Official Nebraska Government Website
Do I Qualify?
Confirmation
Are you sure you want to exit?
05/16/2024
EXIT
Household Information
Your Information
First Name
*
Last Name
*
Date Of Birth
Age
*
Sex
*
Male
Female
Health Insurance Coverage
*
Yes
No
How many people live in your home (include yourself)?
*
Adults Age 19 and Over
Children Age 18 and Under
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