New Hampshire
What Is New Hampshire Medicaid Long-Term Care?
New Hampshire Medicaid (also known as Medical Assistance) offers health coverage to low-income individuals. For seniors aged 65 and older, it includes support in nursing homes, assisted living, adult family care homes, and even in their own homes through long-term care services.
What Are the Main Medicaid Long-Term Care Options for Seniors?
1) What Is Institutional / Nursing Home Medicaid?
This is an entitlement program—anyone who meets eligibility requirements is guaranteed assistance. Care is provided only in nursing homes.
2) What Are Medicaid Waivers / Home and Community Based Services (HCBS)?
HCBS Waivers are not entitlements—there are enrollment caps and waiting lists. Services aim to delay or prevent nursing home placement and are delivered at home, in adult day care, adult foster care, or assisted living facilities.
3) What Does Regular Medicaid / Old Age Assistance (OAA) Provide?
Also an entitlement, OAA offers long-term care services like personal care and adult day care to those who qualify based on age, income, and medical needs.
What Are the 2025 Financial Eligibility Limits for Medicaid Long-Term Care?
The table below outlines eligibility criteria for different Medicaid programs based on marital status:
| Type of Medicaid | Single | Married (Both Apply) | Married (One Applies) |
|---|---|---|---|
| Institutional / Nursing Home Medicaid | $2,901 income / $2,500 assets* | $5,802 income / $5,000 assets* | $2,901 income (applicant) $2,500 assets (applicant) $157,920 assets (non-applicant)* |
| HCBS Waivers | $2,901 income / $2,500 assets* | $5,802 income / $5,000 assets* | $2,901 income (applicant) $2,500 assets (applicant)* |
| Regular Medicaid / OAA | $981 income / $1,500 assets | $1,451 income / $1,500 assets | $1,451 income / $1,500 assets |
* Most income must go toward care, with exceptions like a $90 Personal Needs Allowance. Asset disregard may allow up to $7,500.
How Does Medicaid Treat Income?
What Counts as Income?
Income from wages, Social Security, pensions, IRAs, and investments counts. Exceptions include Holocaust restitution and VA Aid & Attendance benefits.
How Is Income Counted for Married Couples?
When only one spouse applies, only the applicant’s income is counted. The non-applicant may receive up to $2,644/month (or $3,948 with excess shelter costs) through the MMMNA provision.
Is Income Counted Differently for OAA?
Yes. Both spouses’ income is considered, and there is no spousal allowance for the non-applicant spouse.
What Are Countable and Exempt Assets?
Which Assets Are Counted?
Countable: cash, stocks, bonds, IRAs, bank accounts, and non-residential property.
Exempt: primary home, one vehicle, personal belongings, burial funds (up to $1,500), and household goods.
How Are Assets Evaluated for Married Couples?
For nursing home Medicaid, both spouses’ assets are counted. The non-applicant spouse may keep up to 50% of assets (max $157,920 or min $31,584). For HCBS, assets are considered separately.
What Is the Medicaid Look-Back Rule?
New Hampshire has a 5-year look-back period. If assets are gifted or sold under market value during this time, a penalty period of ineligibility applies. The federal gift tax exemption ($19,000 in 2025) does not override this rule.
Can a Home Be Exempt from Medicaid?
Yes, if the applicant or their spouse lives in it. If not, the home equity must be below $730,000 (2025). Even exempt homes may be subject to Medicaid Estate Recovery after death.
What Are the Medical or Functional Criteria?
Nursing Home Medicaid and HCBS Waivers require a Nursing Facility Level of Care (NFLOC). For OAA, help with Activities of Daily Living (ADLs) is enough—NFLOC is not required.
What If Someone Exceeds the Financial Limits?
Can You Qualify Under the Medically Needy Pathway?
Yes. Through a Spend-Down program, excess income can be used on medical expenses. In 2025, the protected income level is $916/month (individual) or $1,066/month (couple). Asset limits: $2,500 (individual) or $4,000 (couple).
What Is an Asset Spend-Down?
Excess assets can be spent on exempt items like home improvements, funeral prepayment, or debt. Keep receipts to avoid violating the Look-Back Rule.
What Is Medicaid Planning?
Professional planners can help seniors become eligible through legal strategies and protect assets like the home from Medicaid Estate Recovery.
What Other Medicaid Programs Help Seniors in New Hampshire?
What Is the Choices for Independence Program?
This HCBS Waiver helps those needing nursing home care live in community settings. Benefits include adult day care, medical equipment, and personal care.
Personal Care Attendant Services (PCAS)
Part of Regular Medicaid, this program helps seniors with physical disabilities (e.g., stroke survivors) who need daily assistance. Participants may hire relatives as caregivers.
Money Follows the Person Program
This federal program helps Medicaid recipients transition from institutional settings back into the community.
How Do You Apply for Long-Term Care Medicaid in New Hampshire?
Apply online at NH EASY Gateway or by mailing Form 800 to a local DHHS office. For questions, call DHHS at 844-275-3447 (844-ASK-DHHS).
Because Medicaid eligibility rules are complex, applicants are strongly encouraged to verify all requirements or seek help from a Certified Medicaid Planner.
