New Hampshire Medicaid is administered by the New Hampshire Department of Health and Human Services (DHHS) and funded by federal and state dollars, providing health coverage to low-income New Hampshire residents including children, pregnant women, parents, seniors, and people with disabilities.
New Hampshire’s Medicaid program has a politically distinctive character. The state is the only state in New England to expand Medicaid later than 2014 — it expanded in 2014 but only through a unique private option model called the Granite Advantage Health Care Program, named after the state’s iconic “Live Free or Die” granite state identity. Granite Advantage routes expansion coverage through commercial managed care plans with cost-sharing elements — a conservative expansion approach similar to Indiana’s HIP.
New Hampshire is the ninth no-QIT state in this series — joining Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, and Nevada — using a medically needy pathway with a $591/month income standard for long-term care. This $591 floor is higher than Maine’s and Maryland’s $350 floors but below Massachusetts’s $522 and well below Michigan’s and Minnesota’s $967 — placing New Hampshire in the middle of the no-QIT state range.
Notable features: New Hampshire has one of the most generous children’s Medicaid thresholds in this series — 319% FPL ($4,147/month), matching D.C., Maryland, Iowa, and Hawaii at the high end. The Choices for Independence (CFI) Waiver is the state’s primary HCBS program. The asset limit is $2,500 for a single applicant — slightly above the $2,000 standard. And New Hampshire previously implemented work requirements under a waiver before federal courts blocked them — the 2027 federal mandate revisits familiar policy ground.
New Hampshire’s geography — bordered by Massachusetts to the south, Vermont to the west, Maine to the east, and Canada to the north — creates a real estate market shaped by proximity to the Boston metro and vacation property culture in the Lakes Region and White Mountains.
This guide covers every major New Hampshire Medicaid program, 2026 income and asset limits, the 60-month look-back rule, and how to apply through NH EASY. For a quick eligibility check, use our Medicaid Eligibility Calculator before applying.
New Hampshire Medicaid Programs
Institutional / Nursing Home Medicaid
An entitlement program with no waiting list — everyone who qualifies is guaranteed coverage. It funds care in nursing facilities, hospitals, and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
Applicants must demonstrate a Nursing Facility Level of Care (NFLOC). New Hampshire’s nursing home industry is concentrated in Manchester, Concord, Nashua, and the Seacoast region. Rural north-central and far northern New Hampshire — the North Country and the White Mountains region — have very limited local nursing facility options.
Choices for Independence (CFI) Waiver — HCBS
New Hampshire’s primary HCBS waiver for seniors and disabled individuals is the Choices for Independence (CFI) Waiver — the name deliberately reflecting New Hampshire’s “Live Free or Die” cultural emphasis on individual autonomy. The CFI Waiver covers in-home personal care, adult day services, delivered meals, home modifications, and other community-based supports.
The CFI Waiver is a non-entitlement program with limited slots and waiting lists. Demand is high statewide — but particularly in the Lakes Region and White Mountains communities where an aging seasonal population has settled permanently and prefers to age in place.
Apply as early as possible. While waiting, many New Hampshire residents also qualify for food assistance — see our New Hampshire SNAP benefits page.
Regular Medicaid (Aged, Blind, and Disabled)
Covers elderly, blind, or disabled New Hampshire residents with lower income and assets, without requiring nursing-level medical need. No look-back period applies.
New Hampshire offers a medically needy spend-down pathway — if income exceeds $967/month, qualifying medical expenses can be deducted to reach the eligibility threshold. SSI recipients are categorically eligible.
For seniors on Social Security who also need food assistance, see our guide on whether seniors on Social Security can get food stamps.
Children’s Medicaid and CHIP
New Hampshire covers children up to age 19 at income limits up to 319% FPL ($4,147/month for a single-person household) — matching D.C., Maryland, Iowa, and Hawaii at the highest children’s Medicaid threshold in this series. No asset test applies.
Pregnant women qualify separately at 194% FPL ($2,596/month), with coverage extending 12 months postpartum. Families who qualify may also be eligible for WIC — see New Hampshire WIC income guidelines or use our WIC Eligibility Calculator.
Granite Advantage Health Care Program — ACA Expansion (2014)
The Granite Advantage Health Care Program is New Hampshire’s ACA Medicaid expansion, launched in 2014. It covers adults aged 19–64 without dependent children earning up to 138% FPL ($1,799/month for a single person) with no asset test.
Unlike standard Medicaid expansion in most states, Granite Advantage routes coverage through commercial managed care plans with cost-sharing elements — a conservative expansion model that built private-sector participation into the framework. New Hampshire’s manufacturing, tourism, technology, and service economy workers in the Manchester–Nashua corridor and the Seacoast rely on this coverage.
New Hampshire previously implemented work requirements under the Granite Advantage program before federal courts blocked them in 2019 — giving DHHS administrative experience with the infrastructure the 2027 federal mandate will require.
General Eligibility Requirements
- New Hampshire Residency: You must currently reside in New Hampshire.
- Citizenship / Immigration Status: U.S. citizens, nationals, and qualifying immigrants — including permanent residents with 5+ years in the U.S., refugees, and asylees — are eligible. Undocumented immigrants are generally not eligible for full Medicaid, though emergency services may be covered.
- Income: Varies by program — see limits below.
- Assets: Limits apply for long-term care and aged/blind/disabled programs only.
- Medical / Functional Need: Nursing home Medicaid and the CFI Waiver require documented NFLOC.
2026 Income Limits for New Hampshire Medicaid
New Hampshire uses the standard 48-state FPL figures. Note the high children’s threshold (319% FPL) versus the more moderate pregnancy threshold (194% FPL). Income limits below are expressed as monthly amounts.
| Program / Eligibility Category | Single / Applicant | Married (Both Applying) |
|---|---|---|
| Nursing Home / CFI Waiver (Seniors & Disabled) | $2,901/month (300% FBR) | $5,802/month (300% FBR) |
| Regular Medicaid (Aged, Blind, Disabled) | $967/month (single); $1,450/month (couple) | $1,450/month |
| Granite Advantage — ACA Expansion (19–64) | $1,799/month (138% FPL) | $2,432/month (138% FPL) |
| Children / CHIP | Up to $4,147/month (319% FPL) | |
| Pregnant Women | $2,596/month (194% FPL) | |
Important Notes on Income
No QIT in New Hampshire — Medically Needy Pathway Instead: New Hampshire does not use a Qualified Income Trust (QIT) for nursing home or CFI Waiver applicants with income above $2,901/month. New Hampshire is the ninth no-QIT state in this series.
New Hampshire’s medically needy income standard is $591/month for a single person. Medical expenses — including nursing home costs — are applied against income to reduce it to this threshold. This $591 floor sits between Maryland’s/Maine’s $350 and Massachusetts’s $522 — making it a mid-range no-QIT state. Work with a New Hampshire-licensed Certified Medicaid Planner.
New Hampshire’s Personal Needs Allowance for nursing home residents is $71/month — above average for the series, reflecting New Hampshire’s New England cost of living.
Married couples, one spouse applying: Only the applicant’s income counts toward the $2,901 limit. The community spouse may retain income up to a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $3,948/month, provided housing and utility costs exceed $793.13/month (effective July 1, 2025 through June 30, 2026). In the Seacoast region and southern New Hampshire communities near the Massachusetts border, virtually all community spouses will meet the housing cost threshold.
Use our FPL Calculator to check where your household falls, or see our New Hampshire Medicaid income eligibility page for the full breakdown.
2026 Federal Poverty Level Reference (48 States & D.C.)
| Household Size | 100% FPL (monthly) | 138% FPL (monthly) | 194% FPL (monthly) | 319% FPL (monthly) |
|---|---|---|---|---|
| 1 | $1,304 | $1,799 | $2,596 | $4,147 |
| 2 | $1,762 | $2,432 | $3,508 | $5,622 |
| 3 | $2,221 | $3,064 | $4,420 | $7,084 |
| 4 | $2,679 | $3,697 | $5,332 | $8,547 |
Asset Rules for New Hampshire Medicaid
Asset tests apply only to long-term care (Nursing Home / CFI Waiver) and Regular Medicaid (aged, blind, and disabled). Granite Advantage adults, CHIP children, and pregnant women face no asset test.
Long-Term Care Medicaid (Nursing Home and CFI Waiver)
Countable asset limits:
- Single applicant: $2,500 — modestly above the $2,000 standard, matching Maryland
- Married, both applying: $3,000 total
- Married, one applying: $2,500 for the applicant; up to $157,920 for the non-applicant spouse (CSRA)
Home equity limit: $730,000. The primary home is exempt if the applicant or their spouse lives there or intends to return, provided equity stays under $730,000.
New Hampshire’s real estate market creates significant home equity cap exposure. Southern New Hampshire communities in Hillsborough and Rockingham counties — Bedford, Windham, Londonderry, Exeter, and the Seacoast towns of Portsmouth, Hampton, and Rye — have seen dramatic appreciation driven by Boston metro spillover. Properties in these communities routinely approach or exceed $730,000. Lakes Region properties on Lake Winnipesaukee and Squam Lake, and White Mountains vacation homes, are also frequently in the range. Applicants in these markets should verify equity carefully before applying.
Non-countable (exempt) assets include:
- Primary home (subject to the $730,000 equity cap)
- One vehicle
- Household goods and personal effects
- Pre-paid funeral contracts (irrevocable, up to reasonable limits) — confirm current dollar cap with a Certified Medicaid Planner
- Medicaid Compliant Annuities
- Life insurance with a face value of $1,500 or less
New Hampshire’s 60-Month Look-Back Rule
New Hampshire enforces a standard 60-month (5-year) look-back period for Nursing Home Medicaid and the CFI Waiver. All asset transfers within that window are reviewed.
Gifts or transfers below fair market value — including transfers of New Hampshire real estate, lake property, vacation homes, or investment accounts — can trigger a penalty period of Medicaid ineligibility.
New Hampshire’s vacation and lake property culture creates specific look-back risks. Lake Winnipesaukee — New Hampshire’s largest and most famous lake — has some of the most valuable lakefront property in the Northeast. A camp or cottage on Winnipesaukee or Squam Lake that was transferred to children within 5 years of a nursing home application can create a penalty period of many months or years. White Mountains ski properties and Seacoast beach cottages present similar risks.
New Hampshire’s proximity to Massachusetts also creates a unique pattern — families that own property in both states, or retirees who moved from Massachusetts to New Hampshire, may have complex asset histories that require careful look-back review. There is no look-back period for Regular Medicaid.
New Hampshire’s Medicaid Estate Recovery Program
After a New Hampshire Medicaid long-term care beneficiary passes away, New Hampshire’s Estate Recovery Program seeks reimbursement from the estate. Lake and vacation properties passing through the probate estate are common recovery targets given their high values. Consult a New Hampshire-licensed Certified Medicaid Planner for protective strategies.
Regular Medicaid (Aged, Blind, and Disabled)
Asset limit is $2,500 for individuals and $3,000 for couples — matching Maryland’s $2,500 single limit. No home equity cap and no look-back period apply. New Hampshire’s medically needy spend-down pathway is available here when income exceeds the limit.
Medical and Functional Requirements
For Nursing Home Medicaid and the CFI Waiver, applicants must demonstrate a Nursing Facility Level of Care (NFLOC) through a formal evaluation of:
- Activities of Daily Living (ADLs): bathing, dressing, eating, toileting, mobility
- Instrumental Activities of Daily Living (IADLs): cooking, shopping, managing finances, taking medications
- Cognitive or behavioral issues — including Alzheimer’s disease and dementia. A diagnosis alone does not satisfy NFLOC; documented functional limitations are required.
For Regular Medicaid (aged, blind, and disabled), applicants must document disability or blindness per Social Security Administration (SSA) criteria. NFLOC is not required.
New Hampshire’s ServiceLink Aging and Disability Resource Center (1-866-634-9412) is the state’s primary elder navigation resource — providing CFI Waiver information, NFLOC assessment coordination, and long-term care planning assistance across all ten counties. ServiceLink is well-regarded as one of New England’s better-organized elder resource networks.
What Federal Policy Changes Mean for New Hampshire Medicaid
The One Big Beautiful Bill Act, signed July 4, 2025, introduces Medicaid changes phasing in through 2028. New Hampshire’s prior work requirement implementation gives the state specific administrative context.
Work Requirements (Starting January 2027): Federal work requirements will apply to Granite Advantage adults aged 19–64. New Hampshire previously implemented work requirements under its Granite Advantage program in 2019 before a federal court blocked them — meaning DHHS has real administrative infrastructure from that prior effort. This makes New Hampshire better positioned than most states to quickly implement 2027 federal requirements.
New Hampshire’s manufacturing workers in the Manchester–Nashua corridor, service employees on the Seacoast, and seasonal tourism and ski resort workers in the White Mountains and Lakes Region will need to document qualifying activity during off-seasons. Seniors, disabled individuals, pregnant women, and children are exempt.
Reduced Retroactive Coverage (Starting January 2027): Coverage will only extend back 2 months from application, down from 90 days. New Hampshire residents who delay applying after a health event will face more uncovered medical debt — particularly significant given New Hampshire’s high cost of healthcare relative to national averages.
More Frequent Eligibility Renewals (Starting December 2026): Renewals every 6 months instead of annually. New Hampshire’s highly employed, mobile population in the southern tier — many commuting to Boston-area jobs — may face renewal lapse risks during periods of income or employment transitions.
New Out-of-Pocket Costs (Starting October 2028): Non-exempt beneficiaries may owe up to $35 per specialist visit. Primary care and preventive services remain free.
Funding Cuts: Projected federal Medicaid cuts of approximately $1 trillion over 10 years may affect New Hampshire’s rural North Country hospitals — Androscoggin Valley Hospital, Coos County nursing facilities, and Weeks Medical Center — where Medicaid is a dominant payer and no alternative facilities exist for many miles.
For how these changes affect SNAP benefits alongside Medicaid, see our article on Big Beautiful Bill SNAP changes.
Options If Your Income or Assets Exceed the Limit
Medically Needy Pathway (No QIT Required): New Hampshire uses a medically needy pathway rather than a QIT. The income standard is $591/month for a single person. Medical expenses — including nursing home costs — are applied against income to reduce it to this level.
Work with a New Hampshire-licensed attorney or Certified Medicaid Planner who understands New Hampshire’s medically needy rules. The $591 floor is distinct from both Maine’s $350 and Massachusetts’s $522 — New Hampshire’s system requires New Hampshire-specific expertise.
Irrevocable Funeral Trusts (IFTs): Pre-paid funeral and burial expenses placed in an irrevocable contract are exempt from asset limits. Confirm New Hampshire’s current IFT dollar cap with a Certified Medicaid Planner.
Asset Spend-Down: Converting countable assets into exempt ones — home improvements (particularly valuable given New Hampshire’s high-appreciation real estate), vehicle purchase, paying off debt — can reduce countable assets below $2,500. Must be structured carefully to avoid look-back violations.
Medicaid Compliant Annuities: In spousal situations, converting excess assets into a compliant annuity can reduce the applicant’s countable assets while generating protected income for the community spouse.
Certified Medicaid Planners: New Hampshire’s $591 medically needy floor, lake and vacation property look-back complexity, proximity-to-Massachusetts cross-state asset patterns, and estate recovery exposure on high-value lakefront property make professional planning valuable. Seek a planner with New Hampshire-specific experience.
While addressing a Medicaid income or asset issue, check whether SNAP food assistance is available in parallel — see SNAP income limits for New Hampshire.
How to Apply for New Hampshire Medicaid
New Hampshire uses the NH EASY Portal as the primary online application entry point for Medicaid and other DHHS programs.
Application Methods
Online via NH EASY (Recommended): Apply at nheasy.nh.gov or through the federal marketplace at healthcare.gov for plan comparison. Before applying, use our Medicaid Eligibility Calculator to confirm which program applies. For step-by-step guidance, see our New Hampshire Medicaid application guide.
Phone: Call the DHHS Customer Service Center at 1-844-275-3447 for assistance.
In-Person or Mail: Download a paper application from dhhs.nh.gov and submit to a local DHHS District Office. New Hampshire has DHHS District Offices in Manchester, Concord, Nashua, Laconia, Keene, Claremont, Conway, and other locations — covering all ten counties.
Long-Term Care Support: Contact the ServiceLink Aging and Disability Resource Center at 1-866-634-9412 for help with CFI Waiver applications, NFLOC assessment coordination, and long-term care planning across the state.
Documents You’ll Need
- Proof of New Hampshire residency
- Social Security number
- Proof of income (pay stubs, Social Security award letters, tax returns)
- Proof of assets (bank statements, investment accounts, property records, lake/vacation property deeds) — for long-term care and ABD applications
- Medical expense documentation — for medically needy spend-down applications
- Proof of citizenship or qualifying immigration status
- Medical records documenting functional limitations (for Nursing Home / CFI Waiver applications)
- Disability documentation per SSA criteria (for Regular Medicaid aged/blind/disabled)
Processing Times
Standard applications: Up to 45 days
Disability-based applications: Up to 90 days
Pregnant women: May qualify for presumptive eligibility for outpatient care while the full application processes.
Starting January 2027, retroactive coverage drops to 2 months before application. Apply promptly after any health event that generates significant medical bills.
New Hampshire Medicaid and Other Benefit Programs
SNAP (Food Stamps): Many New Hampshire Medicaid recipients also qualify for SNAP. See our New Hampshire SNAP page or New Hampshire SNAP application guide.
If you already receive benefits, see how to check your SNAP balance in New Hampshire.
WIC: Pregnant women and young children qualifying for Medicaid typically also qualify for WIC. See New Hampshire WIC income guidelines.
Medicare: Many New Hampshire seniors use both Medicare and Medicaid simultaneously. Understanding the difference between Medicare and Medicaid is essential — particularly for long-term care coordination in a state where nursing facility access in the North Country is limited.
SNAP Work Requirements: Granite Advantage adults who also receive SNAP should know both programs will have federal work requirements starting in 2027. New Hampshire’s seasonal resort and manufacturing workers face particular off-season documentation challenges. Read our guide on SNAP work requirements.
Frequently Asked Questions About New Hampshire Medicaid
What is the Granite Advantage Health Care Program?
The Granite Advantage Health Care Program is New Hampshire’s ACA Medicaid expansion program for adults aged 19–64 earning up to 138% FPL ($1,799/month for a single person). Launched in 2014, it’s named after New Hampshire’s granite state identity.
Unlike standard Medicaid expansion in most states, Granite Advantage routes coverage through commercial managed care plans — a conservative expansion model similar to Indiana’s HIP — with cost-sharing elements for some participants. New Hampshire previously implemented work requirements under Granite Advantage before courts blocked them in 2019, meaning the state has real administrative infrastructure for the 2027 federal mandate.
Does New Hampshire Medicaid require a QIT (Miller Trust)?
No — New Hampshire is one of nine states in this series (with Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, and Nevada) that does not require a Qualified Income Trust for nursing home or CFI Waiver applicants with excess income. New Hampshire uses a medically needy pathway with a $591/month income standard.
This floor sits between Maine’s/Maryland’s $350 and Massachusetts’s $522 — placing New Hampshire in the middle of the no-QIT state range. Work with a New Hampshire-licensed Certified Medicaid Planner.
What is the CFI Waiver in New Hampshire?
The Choices for Independence (CFI) Waiver is New Hampshire’s primary HCBS program for seniors and disabled individuals who meet nursing facility level of care criteria but want to remain at home. The name reflects New Hampshire’s strong cultural emphasis on individual autonomy.
It covers personal care aides, adult day services, meal delivery, home modifications, and respite care. Slots are limited — waiting lists apply. Contact ServiceLink at 1-866-634-9412 for waiver enrollment guidance.
What is New Hampshire’s medically needy income standard?
New Hampshire’s medically needy income standard is $591/month for a single person. This is the income target after nursing home costs and other qualifying medical expenses are applied against countable income. It is higher than Maine’s and Maryland’s $350 floors but lower than Michigan’s and Minnesota’s $967 floors — placing New Hampshire in the middle of no-QIT states.
Do lake properties in New Hampshire count as assets for Medicaid?
Yes — Lake Winnipesaukee camp cottages, Squam Lake waterfront properties, White Mountains vacation homes, and Seacoast beach properties that are not the primary homestead are countable assets for long-term care Medicaid purposes.
New Hampshire lake and vacation properties are among the most valuable in New England — Winnipesaukee waterfront has sold for millions in some cases. Transfers of these properties within 5 years of a nursing home application can create substantial penalty periods. Consult a Certified Medicaid Planner before any lake or vacation property transfers.
Can I get New Hampshire Medicaid if I work in tourism or ski resorts?
Yes — if your income during and between seasons averages at or below 138% FPL ($1,799/month for a single person), you likely qualify for Granite Advantage. Ski resort workers, summer resort employees, and tourism service staff often qualify during off-seasons or during reduced-hour periods.
Starting 2027, work requirements apply — but seasonal resort employment clearly qualifies as work activity. The documentation challenge is the off-season gap. Keep records of employment start/end dates, seasonal layoff notices, and any unemployment documentation. Our guide on SNAP work requirements covers what documentation typically qualifies.
What makes New Hampshire’s children’s Medicaid threshold unique?
New Hampshire covers children at 319% FPL ($4,147/month for a single-person household) — one of the highest thresholds in the country, matching D.C., Maryland, Iowa, and Hawaii. Even families earning nearly $50,000/year may qualify their children for New Hampshire Medicaid.
This is a significant policy choice for a state known for fiscal conservatism — New Hampshire has prioritized children’s coverage generosity even within a generally lean state government. There is no asset test for children’s coverage.
Does New Hampshire Medicaid cover dental for adults?
New Hampshire Medicaid provides limited dental coverage for adults — primarily emergency extractions and some basic restorative care. Coverage levels can change with state budget priorities. Verify current adult dental coverage with DHHS or your Medicaid managed care plan.
See our full guide on what dental services Medicaid covers.
This guide reflects 2026 federal and New Hampshire Department of Health and Human Services guidelines. Rules change — verify current requirements with DHHS at dhhs.nh.gov or by calling 1-844-275-3447 before making eligibility decisions.