Medicaid for nursing home and home care in New Hampshire

Who qualifies

You must live in New Hampshire, be 65 or older (or blind or disabled), and need the level of care a nursing home gives. CFI is open to adults 18 and older who meet these rules.

Income

For nursing home care and CFI, New Hampshire uses a gross income cap: your income before deductions must be at or below $2,982 a month.

For nursing home care, your net income (after allowed deductions) must also be no more than the nursing home's monthly Medicaid rate. The home must be licensed and Medicaid-certified.

Over the limits? DHHS then checks whether you can get In and Out Medical Assistance, New Hampshire's spenddown program. It works like a deductible: once your medical bills reach a set amount, Medicaid helps pay the rest. Ask DHHS to check this for you.

Assets

If you meet the income cap, DHHS ignores part of your savings, so the effective asset limit is about $7,500.

• Not counted: your home (within the equity limit), your vehicles, and a burial plot for yourself.
• Counted: cash, bank accounts, stocks, bonds and some life insurance.
• Home equity: If your home equity is very high (at least $752,000 in 2026), long-term care may not be covered unless your spouse or certain relatives live there.
• Gifts and transfers: Giving away money or property to qualify can cause a waiting period. Talk to DHHS before you do it.

If you are married

When one spouse needs long-term care and the other stays home, part of the couple's money is protected for the spouse at home.

• Savings: Federal rules for 2026 let the spouse at home keep between $32,532 and $162,660.
• Income: If the spouse at home has low income, part of your income can go to them. The most they can be brought up to is $4,066.50 a month.

DHHS works out your exact amounts.

What Medicaid pays for

Nursing home care

Medicaid pays the nursing home's Medicaid rate after the part of your income you must pay. It also covers your doctor visits, prescriptions and other Medicaid services.

Choices for Independence (CFI)

CFI is a Medicaid waiver run by the Bureau of Elderly and Adult Services (BEAS). It helps you stay at home or in a community setting instead of a nursing home. It can pay for:

• help with eating, bathing, dressing and other personal care,
• household tasks and meals,
• adult day services,
• medical equipment and supplies,
• changes to your home,
• respite care for family caregivers.

A case manager you choose helps plan and arrange your care.

How to apply

1. Call ServiceLink at 1-866-634-9412 (NH Relay 7-1-1). An Options Counselor explains the rules, does a basic check of your Medicaid financial eligibility, and gives you the Medicaid application.
2. Apply for Medicaid. Apply online at NH EASY, or call DHHS at 1-844-ASK-DHHS (1-844-275-3447), Monday to Friday, 8 a.m. to 4 p.m. (TDD 1-800-735-2964). You can also visit your local DHHS District Office, or mail your application to Division of Medicaid Services, 129 Pleasant Street, Concord, NH 03301.
3. Have your DHHS interview. Your counselor schedules a meeting with the DHHS Bureau of Family Assistance. Return any papers they ask for within 10 days.
4. Have a care assessment. A community nurse, often at your home, asks about your daily activities. It takes one to two hours and there is no physical exam.
5. Choose a CFI case manager once you are approved. Together you make your service plan.

If you are 18 to 64, you must also apply for Social Security disability benefits.

If nobody contacts you within 10 business days of your Medicaid interview, call ServiceLink.

Gather proof of income, bank and investment accounts, life insurance, vehicles and any property you own.

After you apply

• Report changes to DHHS, such as a change in income, assets or where you live.
• Appeals: If you are denied or disagree with a decision, you can ask DHHS for a fair hearing. Follow the deadline on your notice.
• Estate recovery: After death, DHHS can seek repayment from your estate for Medicaid paid from age 55 on. This usually applies only when there is no surviving spouse and no child under 21 or disabled child. Jointly owned property and living trusts can count. Families can ask for a hardship waiver.

Things people miss

• Income over the limit is not always the end. Ask DHHS about In and Out Medical Assistance (spenddown).
• CFI and Medicaid are linked. You need both the care assessment and the Medicaid financial approval.
• Follow up. If you hear nothing within 10 business days of the Medicaid interview, call ServiceLink.

Free help

• ServiceLink Resource Center: 1-866-634-9412. ServiceLink is New Hampshire's network of Aging and Disability Resource Centers and its free Medicare counseling program (SHIP).
• Bureau of Elderly and Adult Services (BEAS): 105 Pleasant Street, Main Building, Concord, NH 03301.

See also paying for a nursing home, Medicare and all benefits in New Hampshire.

Phone numbers: Free help lines for New Hampshire agencies

Check what you may qualify for