New Hampshire Choices for Independence Waiver: New Hampshire 2026 Guide
New Hampshire’s Choices for Independence (CFI) waiver pays for long-term care at home or in community settings for older adults and adults with physical disabilities who would otherwise need a nursing facility. It is run by the Bureau of Elderly and Adult Services (BEAS) in the New Hampshire Department of Health and Human Services (DHHS).
This page explains, in plain language, who can get the Choices for Independence waiver in 2026, what it pays for, how to apply, what to expect if there is a waiting list, and how it fits with nursing home Medicaid. For the full statewide rules on income, assets, spouses and the look-back, see our New Hampshire Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What the Choices for Independence waiver is
CFI is a 1915(c) waiver. After financial and clinical eligibility are confirmed, the participant chooses a case management agency, and the case manager works with the person to develop a care plan. Services can be delivered in the person’s home, in an adult family care home, or in a residential care facility (assisted living). CFI also offers participant-directed and managed services, in which the participant chooses and directs their own workers.
A home and community-based services (HCBS) waiver is a Medicaid program a state runs with federal approval. “Waiver” means the state may set aside some normal Medicaid rules, such as the rule that long-term care is paid only in a nursing home, so it can pay for care at home or in a community setting instead. Since no state has to offer a waiver, each program’s services and size are set by the state and its federal agreement. Unlike regular Medicaid, a waiver is usually not an entitlement: qualifying does not guarantee an opening.
Who qualifies in 2026
New Hampshire looks at both how much help a person needs and what they own and earn. In general, to qualify for the Choices for Independence waiver an applicant must:
- be 18 or older;
- live in New Hampshire;
- meet the clinical standard for nursing facility care, for example needing help with two or more activities of daily living;
- meet Medicaid financial rules for long-term care;
- need at least one CFI service each month; and
- choose CFI instead of a nursing facility.
The money test. the Choices for Independence waiver uses New Hampshire’s long-term care Medicaid financial rules, which are usually the same income and asset limits used for nursing home Medicaid. Savings, investments and real estate other than the home count; the home, a car, belongings and some burial funds usually do not. The five-year look-back on gifts and below-value transfers applies here too, so large gifts in the past five years can delay services.
In 2026, New Hampshire’s income limit for nursing facility level care is $2,982 a month, with a medically needy route above that. The single-person asset limit is $2,500.
For reference, these are New Hampshire’s key 2026 long-term care Medicaid figures:
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | $2,982 a month (above this, medically needy rules apply) |
| Asset limit (single applicant) | $2,500 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Minimum $32,532 / maximum $162,660 |
| Spouse at home: monthly income allowance | Minimum $2,705 (from July 1, 2026) / maximum $4,066.50 |
| Personal needs allowance (nursing home) | $93 a month |
| Look-back period | 60 months (5 years) |
Married applicants. When one spouse applies and the other stays at home, spousal impoverishment protections generally apply, so the spouse at home can keep a share of the couple’s assets and may receive part of the applicant’s income. The spousal allowance pages explain how these amounts are figured.
Services the Choices for Independence waiver can cover
What a participant actually receives depends on the plan of care written after the assessment. The services available under the Choices for Independence waiver include:
- case management
- in-home care, personal care and homemaker services
- home health aide services
- adult day services
- home-delivered meals
- adult family care
- residential care facility services
- respite care
- skilled nursing
- personal emergency response systems
- medical equipment and home changes
- non-medical transportation
- participant-directed and managed services
Limits to keep in mind. the Choices for Independence waiver does not pay for rent, groceries or utilities; in residential settings, room and board is the resident’s responsibility. Plans of care are built around any unpaid help family already gives, and doctor, hospital and drug coverage continue separately.
How to apply for the Choices for Independence waiver
The usual sequence for the Choices for Independence waiver is below. Running the financial application and the care assessment in parallel can shorten the wait.
- Apply for New Hampshire Medicaid online through the state’s benefits website or through a DHHS district office, and say you are applying for CFI.
- Contact ServiceLink, the state’s Aging and Disability Resource Center network, for help with the forms and options counseling.
- BEAS arranges a clinical assessment by a nurse.
- After approval, choose a case management agency.
- The case manager writes the care plan with you, and services start.
Practical tips. Keep copies of everything you send and note the name of each person you speak with. During the assessment, describe a typical bad day rather than a good day, and have a family member present who knows how much help is really needed. Supervision needs, confusion and falls matter as much as hands-on help. A denial notice explains the fair hearing process and its deadline.
Waiting lists and timing
CFI has generally not used a long waiting list, but staffing shortages can delay the start of services in some regions. Start dates vary by region.
Starting the process early keeps options open if a wait develops. Stopgaps can include state plan home care, adult day centers, PACE where it operates and local aging services. The waiver waiting lists page explains common rules.
How it relates to nursing home Medicaid
the Choices for Independence waiver serves people who meet the same care-need standard as nursing home residents, so it is an alternative to a nursing home rather than a lower level of care. Nursing home Medicaid is an entitlement for people who qualify, so it has no waiting list, while a waiver may. Switching settings is possible in both directions: from home to a nursing home if needs grow, and back home with help from Money Follows the Person.
Tips for families
Start early, because the money test, the assessment and any wait can all take time. Pull together five years of financial statements and keep a short care log ahead of the assessment. Income over the limit can often be handled with a Miller trust or spend-down, and any recent gifts deserve review before filing. If needs change, request a reassessment rather than waiting for the yearly review.
Many families find it worthwhile to talk with a Certified Medicaid Planner before applying for the Choices for Independence waiver. A planner who knows New Hampshire’s rules can review income and assets, explain which program fits, map the timing against any waiting list, and help with the paperwork. Typical fees vary widely: help with an application alone often runs about $500 to $6,000, full planning about $2,500 to $15,000 or more, and hourly advice about $150 to $600.
Related pages
- New Hampshire Medicaid guide
- New Hampshire Personal Care Attendant Services
- HCBS waivers explained
- Applying for a waiver
- Nursing home level of care
- Waiver waiting lists
- The five-year look-back
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.