New Hampshire Personal Care Attendant Services: New Hampshire 2026 Guide
New Hampshire Medicaid’s Personal Care Attendant Services (PCAS) program pays for help with daily activities for adults with severe physical disabilities who can direct their own care. It is a state plan Medicaid service that lets the participant hire, train and supervise their own attendant.
This page explains who can get Personal Care Attendant Services in 2026, what kind of help it pays for, how to request it, and how it compares with waivers and 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 Personal Care Attendant Services is
PCAS is designed for people who need hands-on help but want control over who helps them and when. The participant, sometimes with a representative, interviews and chooses the attendant and sets the schedule within the approved hours, while an agency acts as the employer of record and handles payroll and taxes. PCAS is sometimes used by people who do not want the full CFI waiver, or alongside other Medicaid services.
Personal Care Attendant Services pays for a worker to help with activities of daily living and the chores directly connected to them. When personal care is part of a state’s regular Medicaid program (the “state plan”), it is an entitlement: anyone who qualifies gets it, without waiver enrollment caps. Service lists are shorter than under a waiver, and an assessment decides the hours.
Who qualifies in 2026
New Hampshire’s basic requirements are that a person must:
- be enrolled in New Hampshire Medicaid and be 18 or older;
- have a severe, long-term physical disability (the program is designed for people who use a wheelchair long-term);
- be their own legal guardian and able to direct their own care, with help from an authorized representative if needed;
- need help with at least two of seven activities of daily living and at least two hours a day of medically oriented care; and
- live in the community, not in an institution.
Financial rules. Personal Care Attendant Services requires full New Hampshire Medicaid. For many older adults, the regular Medicaid income limit is lower than the long-term care limit used for nursing homes and waivers. As a result, some people qualify for nursing home Medicaid but not for state plan home care, or only with a spend-down.
New Hampshire’s 2026 long-term care Medicaid numbers, from our state guide:
| 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. For many state plan services, both spouses’ income and assets are counted together, and the spousal protections used for nursing homes and waivers may not apply the same way.
Services Personal Care Attendant Services can cover
Help is authorized in hours a week or month, based on the assessment. Depending on need, Personal Care Attendant Services can include:
- help with bathing, dressing and grooming
- eating and meal preparation
- transfers, positioning and mobility
- toileting and bowel and bladder routines
- household tasks tied to personal care
- help with community activities that support independence
Not included. Overnight supervision, rent and chores unrelated to care fall outside Personal Care Attendant Services. If more help is needed, a waiver or managed long-term care program may be the next step.
How to apply for Personal Care Attendant Services
Getting started usually looks like this:
- Make sure the person is on New Hampshire Medicaid.
- Contact ServiceLink to be referred for a PCAS assessment.
- A registered nurse assesses eligibility and writes the care plan; a physician’s authorization is needed, and managed care plans may require prior authorization.
- Recruit and hire an attendant, with the agency handling employment paperwork.
- Services start under the approved plan.
Practical tips. Keep copies of everything you send and note the name of each person you speak with. At the assessment, talk about the hardest days, not the best ones, and bring someone who sees the care needs firsthand. 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
PCAS is a state plan service without a formal enrollment cap, though recruiting an attendant can take time.
As an entitlement, Personal Care Attendant Services has no enrollment cap. Delays still happen: the Medicaid application, the assessment and finding a worker can each take weeks.
How it relates to nursing home Medicaid
Personal Care Attendant Services serves people at home, and many recipients would not meet a nursing home level of care. It is not designed for people who need care around the clock; for them, a waiver, managed care or a nursing home is the usual next step. Nursing home coverage uses different, often more generous income rules.
Planning around Personal Care Attendant Services
Most families come to Personal Care Attendant Services during a change: a fall, a hospital stay, or a caregiver who can no longer keep up. Planning a little ahead makes each step easier. A good first step is a short written picture of the day: which tasks need help, who does them now, and what the backup is. The same list helps at the assessment and makes it clear where paid help matters most.
On the financial side, gather recent bank statements, income letters such as Social Security and pension notices, health insurance cards, and proof of age and residence in New Hampshire. If long-term care Medicaid may be needed later, five years of records will matter, so it helps to keep them now. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.
Check in on how the arrangement is working every few months; a reassessment can adjust hours or services. A running log of health changes helps with every later review.
Tips for families
Write down each task, how often it happens and how long it takes before the assessor arrives. Programs differ on whether relatives can be paid and what training is needed. Low hours can be appealed through a fair hearing.
We encourage families to consult a Certified Medicaid Planner before filing for Personal Care Attendant Services. A planner can compare New Hampshire’s programs side by side, protect a spouse’s share where the rules allow, and prepare the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.
Related pages
- New Hampshire Medicaid guide
- New Hampshire Choices for Independence waiver
- In-home care and Medicaid
- Activities of daily living
- Consumer-directed care
- Paid family caregivers
- HCBS waivers explained
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.