New Hampshire Nursing Home Medicaid pays for a nursing home once Medicare’s short rehabilitation benefit runs out — but only after the family clears an income test, an asset test and a level-of-care assessment. This New Hampshire nursing home medicaid guide gives the 2026 figures, what the spouse at home is allowed to keep, how the five-year look-back works, and where in New Hampshire the application actually goes.
Every dollar figure below comes from the state Medicaid agency, CMS or the statute cited, and each resets on its own calendar. Where New Hampshire has not published a current figure we say so instead of guessing.
In This New Hampshire Nursing Home Medicaid Guide:
New Hampshire Nursing Home Medicaid at a Glance (2026)
| Program | New Hampshire calls this coverage NH Medicaid for Long Term Care, often written as Medicaid Long Term Care or Long Term Care Medicaid in the state’s own materials. When the care is delivered in a licensed nursing home, the Department of Health and Human Services describes it as Medicaid-funded nursing facility care, and eligibility is discussed under Nursing Facility Level of Care. The same eligibility gateway also leads to the Choices for Independence (CFI) Waiver, which is New Hampshire’s alternative for people who qualify medically but want to stay at home. |
| 2026 income limit (single applicant) | $2,982 |
| 2026 asset limit (single applicant) | $2,500 |
| Spouse at home may keep (assets) | $32,532 to $162,660 |
| Spouse at home income floor | $2,705 to $4,066.50 per month |
| Look-back period | 60 months |
| Penalty divisor | not published here yet — confirm with Two DHHS bureaus split the work. The Bureau of Family Assistance (BFA), through the DHHS District Offices, takes and decides the financial side of the long-term-care application. The Bureau of Adult and Aging Services (BAAS) handles the medical side. Families usually begin at a regional Aging and Disability Resource Center, known in New Hampshire as ServiceLink, which offers Options Counseling and helps walk people through the application; ServiceLink can be reached at 1-866-634-9412. The DHHS Customer Service Center is 1-844-ASK-DHHS (1-844-275-3447), TDD Relay 1-800-735-2964. |
| Home equity limit (no spouse at home) | $752,000 (confirm with Two DHHS bureaus split the work. The Bureau of Family Assistance (BFA), through the DHHS District Offices, takes and decides the financial side of the long-term-care application. The Bureau of Adult and Aging Services (BAAS) handles the medical side. Families usually begin at a regional Aging and Disability Resource Center, known in New Hampshire as ServiceLink, which offers Options Counseling and helps walk people through the application; ServiceLink can be reached at 1-866-634-9412. The DHHS Customer Service Center is 1-844-ASK-DHHS (1-844-275-3447), TDD Relay 1-800-735-2964.) |
| Over the income limit? | Medically-needy spend-down — no Miller trust |
New Hampshire Nursing Home Medicaid Income and Asset Limits
Two tests, both applied to the person entering the facility. The income test looks at gross monthly income from every source — Social Security, pensions, IRA withdrawals, annuities, rent. The asset test counts what can be turned into cash: bank accounts, investments, retirement accounts in most states, and any property other than the home.
New Hampshire is a medically-needy state. Being over the New Hampshire nursing home medicaid income figure does not end the application: the excess is spent down on the cost of care each month, and the nursing home bill itself usually absorbs it. No Miller trust is needed.
New Hampshire does not count everything a family owns. The primary home is generally excluded while the applicant intends to return to it, or while a spouse, a minor child, or a disabled or blind child lives there, subject to a home equity ceiling this file does not state. One motor vehicle used by the applicant or the spouse is excluded.
Household goods, furnishings, clothing and ordinary personal effects are not counted. Burial spaces for the applicant and immediate family are excluded, and irrevocable prepaid funeral arrangements and designated burial funds are generally excluded within limits set by rule.
New Hampshire does not require a Qualified Income Trust, Miller Trust, or income-cap trust for nursing home applicants whose income is above the standard, so families do not need to create that kind of account.
Instead the state runs a Medically Needy spend-down: medical bills, the nursing home bill itself, and health insurance premiums such as Medicare Part B are applied against income to bring it down to the medically needy standard over a set budget period. Once approved and living in a Medicaid bed, the resident pays most monthly income to the facility as patient liability.
What the Spouse at Home Keeps Under New Hampshire Nursing Home Medicaid
Federal spousal impoverishment rules stop New Hampshire nursing home medicaid from bankrupting the husband or wife who stays home. The at-home spouse keeps a protected share of the couple’s assets — between $32,532 and $162,660 in 2026 — and is guaranteed a monthly income floor of at least $2,705, rising to $4,066.50 when housing costs are high. The house is fully exempt while the spouse lives in it.
New Hampshire applies the federal spousal impoverishment protections rather than a homegrown system, and DHHS is explicit that only the applicant’s own income is counted, so the at-home spouse’s income does not disqualify the person entering the nursing home.
The community spouse may keep a share of the couple’s countable resources, called the Community Spouse Resource Allowance, and may receive part of the institutionalized spouse’s monthly income as a Minimum Monthly Maintenance Needs Allowance. DHHS calculates these using its own worksheets, BFA Forms 798A and 799A. Figures are UNVERIFIED here.
The asset snapshot is taken on the first day of the continuous stay, not the application date. Families who spend down before asking for a resource assessment often spend money the spouse was entitled to keep.
The Look-Back Rule and Transfer Penalties
New Hampshire reviews every transfer made in the 60 months before the application. Money or property given away, or sold for less than it was worth, is added up and divided by the state’s penalty divisor — its average private-pay nursing home cost — to produce a period during which New Hampshire nursing home medicaid will not pay. The divisor in New Hampshire is not published here yet — confirm with Two DHHS bureaus split the work.
The Bureau of Family Assistance (BFA), through the DHHS District Offices, takes and decides the financial side of the long-term-care application. The Bureau of Adult and Aging Services (BAAS) handles the medical side. Families usually begin at a regional Aging and Disability Resource Center, known in New Hampshire as ServiceLink, which offers Options Counseling and helps walk people through the application; ServiceLink can be reached at 1-866-634-9412. The DHHS Customer Service Center is 1-844-ASK-DHHS (1-844-275-3447), TDD Relay 1-800-735-2964..
60 months, federal standard. The IRS annual gift exclusion has no bearing here: a gift that is tax-free can still trigger a Medicaid penalty. Transfers to a spouse, to a disabled child, or of the home to a child who lived there and provided care for two years are the main exceptions.
How to Apply for New Hampshire Nursing Home Medicaid
Where: Two DHHS bureaus split the work. The Bureau of Family Assistance (BFA), through the DHHS District Offices, takes and decides the financial side of the long-term-care application. The Bureau of Adult and Aging Services (BAAS) handles the medical side. Families usually begin at a regional Aging and Disability Resource Center, known in New Hampshire as ServiceLink, which offers Options Counseling and helps walk people through the application; ServiceLink can be reached at 1-866-634-9412. The DHHS Customer Service Center is 1-844-ASK-DHHS (1-844-275-3447), TDD Relay 1-800-735-2964. — start the application.
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Medical eligibility is decided by an in-person, face-to-face assessment performed by a registered nurse employed or designated by the Bureau of Adult and Aging Services. The nurse completes a standardized instrument called the Medical Eligibility Assessment, or MEA form, to determine whether the person meets Nursing Facility Level of Care.
The assessment looks at whether the person needs licensed nursing monitoring or care, restorative or rehabilitative services, medication administration such as injections or tube feeding, or hands-on help with activities of daily living like bathing, dressing, toileting, eating, transferring and mobility.
Bring five years of bank statements, deeds, vehicle titles, insurance policies, the Medicare and Social Security cards, and any trust or power of attorney documents. Missing paperwork is the most common reason a New Hampshire nursing home medicaid decision is delayed.
While the Application Is Pending
While the application is pending, the nursing home ordinarily continues providing care and bills the resident privately or carries the balance, then adjusts the account once Medicaid is approved; the facility itself is not paid by Medicaid until the eligibility decision is issued.
New Hampshire allows a request for retroactive coverage for a period before the application month, so bills already incurred can sometimes be picked up, though the exact retroactive window is UNVERIFIED. The financial determination by BFA and the nurse’s MEA assessment run in parallel. Typical decision time in weeks: UNVERIFIED.
After approval, nearly all of the resident’s income goes to the facility each month as the patient share, minus a small personal needs allowance, health insurance premiums and the spouse’s allowance.
Denials, Appeals and What Comes After
The most common problems are paperwork rather than ineligibility: missing bank statements, life insurance values, deed or trust documents, or unexplained transfers and withdrawals that BFA asks about and the family does not answer by the date on the request notice. Applications also stall when the MEA assessment has not yet been completed or the nurse finds Nursing Facility Level of Care is not met.
A denial or a failure to act promptly can be appealed by requesting a fair hearing before the DHHS Administrative Appeals Unit, following the instructions and timeframe printed on the Notice of Decision.
One more thing families should know before they file: after the resident’s death, the state may seek repayment from the estate. That process — what it can reach and the exemptions — is covered in our guide to New Hampshire Medicaid estate recovery.
A Realistic New Hampshire Nursing Home Medicaid Timeline
Week one: the hospital or family calls the Medicaid office for the level-of-care assessment and starts gathering five years of statements. Weeks two to four: the assessment is done and the financial application is filed, usually with the facility’s admissions office helping. Weeks six to twelve: the caseworker verifies accounts and may ask for more documents; answer within the deadline on each request or the clock resets.
Approval, when it comes, is retroactive to the eligibility date, which is why filing early is the single most valuable thing a family can do.
Where to Get Help Free
Two free doors exist in every state: the New Hampshire SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For a New Hampshire nursing home medicaid question involving a house, a spouse at home or a recent gift, a local elder law attorney or legal aid office is the next call.
Key Takeaways: New Hampshire Nursing Home Medicaid
- Two tests, not one: New Hampshire nursing home medicaid checks income and assets separately, and passing one does not excuse the other.
- The spouse is protected: the at-home spouse keeps a share of assets and an income floor under New Hampshire nursing home medicaid before anything is spent down.
- The look-back is five years: any gift inside it is divided by the divisor and becomes months without New Hampshire nursing home medicaid coverage.
- The home usually does not count: while a spouse lives there, the house is exempt from the New Hampshire nursing home medicaid asset test.
- Apply as Medicaid pending: most facilities admit while New Hampshire nursing home medicaid is decided and the state pays back to the eligibility date.
- Assessment first: the level-of-care evaluation is what starts the New Hampshire nursing home medicaid clock, so request it on day one.
- Retirement accounts often count: IRAs and 401(k)s are countable in most states under New Hampshire nursing home medicaid unless in payout status.
- Income trust or spend-down: whether an over-income applicant needs a Miller trust is the first New Hampshire nursing home medicaid question to settle.
- The resource snapshot matters: New Hampshire nursing home medicaid measures the couple’s assets on the day the stay began, not the day you apply.
- Prepaid funerals are exempt: an irrevocable funeral trust is one of the few spend-downs New Hampshire nursing home medicaid always allows.
Official Sources
- New Hampshire calls this coverage NH Medicaid for Long Term Care, often written as Medicaid Long Term Care or Long Term Care Medicaid in the state’s own materials. When the care is delivered in a licensed nursing home, the Department of Health and Human Services describes it as Medicaid-funded nursing facility care, and eligibility is discussed under Nursing Facility Level of Care. The same eligibility gateway also leads to the Choices for Independence (CFI) Waiver, which is New Hampshire’s alternative for people who qualify medically but want to stay at home. — New Hampshire Medicaid: https://www.dhhs.nh.gov/programs-services/adult-aging-care/medicaid-medical-eligibility-determination-long-term-care
- Two DHHS bureaus split the work. The Bureau of Family Assistance (BFA), through the DHHS District Offices, takes and decides the financial side of the long-term-care application. The Bureau of Adult and Aging Services (BAAS) handles the medical side. Families usually begin at a regional Aging and Disability Resource Center, known in New Hampshire as ServiceLink, which offers Options Counseling and helps walk people through the application; ServiceLink can be reached at 1-866-634-9412. The DHHS Customer Service Center is 1-844-ASK-DHHS (1-844-275-3447), TDD Relay 1-800-735-2964.: https://nheasy.nh.gov — the NH EASY portal is where an online Application for Assistance is started. The paper Application for Assistance, BFA Form 800MA, is downloaded at https://nheasy.nh.gov/forms/E/800MA.pdf and mailed or delivered to a DHHS District Office. The ServiceLink office locator is at https://servicelink.nh.gov/locator/index.htm.
- Medicaid.gov spousal impoverishment standards: medicaid.gov
- Medicare.gov Medicare Savings Programs: medicare.gov
This New Hampshire nursing home medicaid guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.