New Hampshire State Guide for Medicaid Home Care Coverage Benefits
Learn how Medicaid supports in-home dementia care in New Hampshire, helping families ensure comfort, safety, and continuity for loved ones at home.
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Tendly Home Key Takeaways
Here's a quick summary of how Medicaid supports in-home dementia care in New Hampshire:
- 🏡 Medicaid in New Hampshire offers home and community-based services (HCBS) that allow individuals with dementia to receive care in their own homes.
- 📝 Eligibility for in-home care includes income and asset limits, along with needing a level of care similar to nursing home services.
- 🤝 Programs like Choices for Independence (CFI) help families by coordinating medical and non-medical care, including meal delivery and personal care assistance.
- 💰 Medicaid can reduce financial burden by covering many home care expenses, preventing out-of-pocket costs for long-term dementia support.
- 📞 Local Area Agencies on Aging and ServiceLink offer guidance and help navigate the application and care coordination process.
When a loved one begins to need daily assistance due to age, illness, or disability, families can experience a whirlwind of emotions—worry, confusion, and a deep desire to find compassionate care while managing the high costs. If you live in New Hampshire, you may wonder if Medicaid can help cover the cost of home care. The good news? It can, but understanding how it works—and qualifying for it—can feel like solving a complex puzzle.
This guide is designed to make that process easier for you. Whether you're a family caregiver, an adult child stepping into a helper role, or someone planning their own long-term care journey, we’ll break down how Medicaid home care works in New Hampshire. From eligibility requirements to services covered and how to apply, consider this your go-to resource for making informed, confident decisions about home care and financial support.
Medicaid is a state and federally funded program that provides health coverage for people with limited income and resources. In New Hampshire, Medicaid plays a critical role in supporting access to home- and community-based care, especially for elderly or disabled individuals who want to remain in their homes rather than move to a care facility.
Home care, in the context of Medicaid, often includes personal care assistance, nursing care, therapy services, and help with activities of daily living (ADLs), such as bathing, dressing, and meal preparation. This kind of support isn’t just medical—it’s about dignity, independence, and quality of life.
New Hampshire administers its Medicaid home care services through several programs, most notably the Choices for Independence (CFI) Waiver. This program helps eligible adults avoid institutional care by providing needed services in the home or a community setting. Unlike standard Medicaid, which automatically covers institutional nursing homes, the CFI Waiver specifically targets people who prefer aging in place.
It’s worth noting that Medicaid is a payer of last resort—meaning other insurance or family resources may be considered first. However, for many families struggling with the increasing cost of at-home care, Medicaid coverage can be a lifeline.
Navigating these programs may seem daunting, but understanding their structure is key. New Hampshire’s Department of Health and Human Services (DHHS) is responsible for administering these benefits, and their caseworkers can help applicants move through the process.
Realistically, applying for Medicaid home care involves more than just forms. It’s a holistic process that takes financial documentation, functional assessment, and often a bit of advocacy on behalf of the care recipient. But taking that first step can unlock a path to compassionate, cost-effective care right at home.
Qualifying for New Hampshire Medicaid home care services is determined by both financial need and medical necessity. This two-prong eligibility means that meeting income thresholds alone isn’t enough—you must also demonstrate a need for assistance that would typically require institutional care.
Financial Eligibility:
For 2024, the income limits for Medicaid’s long-term care programs in New Hampshire generally adhere to federal guidelines. For an individual, the monthly income cap is around $2,829, and for married couples—when only one spouse is applying—the non-applicant spouse may be allowed to keep a portion of their income to avoid impoverishment.
In addition to income, asset limits apply. Generally, the applicant must have countable assets under $2,000. Countable assets include cash, most investment accounts, and non-primary real estate. However, exemptions exist for a primary home (under certain equity limits), personal belongings, one vehicle, and some prepaid funeral arrangements.
Many families worry they’ll be forced to "spend down" assets or that applying for Medicaid means giving everything up. In reality, experienced elder law attorneys or Medicaid planners can help navigate these concerns, often with strategies to protect assets legally while gaining benefits.
Medical and Functional Eligibility:
Meeting the income and asset limits isn’t enough—you must also show a significant level of physical or cognitive impairment. This is established through a functional needs assessment conducted by the Bureau of Elderly and Adult Services (BEAS).
To qualify for the CFI Waiver, for example, a person typically must require assistance with at least two or more ADLs, such as bathing, dressing, eating, toileting, or transferring from a bed or chair. Mental health conditions like dementia, Alzheimer's, or developmental disabilities may also qualify if they substantially limit functioning.
Age Requirements and Residency:
Applicants must be New Hampshire residents and either:
- Age 65 or older, or
- Age 18 and older with a permanent disability.
It’s important to note that the CFI Waiver is not an entitlement program—there may be a waiting list even if you’re eligible. Therefore, applying as soon as possible is always in your best interest.
While the application process can be time-consuming, the outcome—receiving support to live safely and with dignity at home—makes the effort well worth it.
Once approved for Medicaid home care under New Hampshire programs like the CFI Waiver, individuals can access a broad menu of services tailored to support both medical and non-medical needs in the home environment.
In-Home Personal Care Services:
This includes assistance with daily activities that may be difficult or unsafe to perform alone—things like bathing, dressing, grooming, using the toilet, and eating. These services are typically provided by trained home health aides or certified nursing assistants.
Nursing and Medical Services:
For individuals who require skilled care at home, Medicaid may cover services from registered nurses or licensed practical nurses. These services can include medication administration, dressing changes, catheter care, and ongoing health monitoring to avoid hospital admissions.
Therapy Services:
Physical therapy, occupational therapy, and speech-language pathology may be covered if they’re prescribed and considered medically necessary. These therapies help individuals regain function and maintain independence after illness, surgery, or injury.
Homemaker and Companion Services:
Some Medicaid home care programs offer light housekeeping, laundry assistance, help with grocery shopping, meal preparation, and running errands. Though these may seem simple, they make an immense difference in ensuring a clean and safe living environment for seniors.
Respite Care for Family Caregivers:
Family caregivers are the backbone of home care, but they need rest, too. Medicaid-funded respite care gives unpaid caregivers a break while a professional takes over care duties temporarily—helping to prevent burnout and maintain family well-being.
Emergency Response and Assistive Technologies:
In some cases, Medicaid may fund personal emergency response systems (like medical alert devices), home modifications for safety, and durable medical equipment (DME) such as hospital beds, walkers, or grab bars.
Case Management and Care Coordination:
Approved Medicaid home care patients in New Hampshire typically have a case manager who helps coordinate their care, ensures they receive needed services, and serves as a point of contact for the family. This can bring immense peace of mind.
It’s important to note: services are tailored to the individual’s assessed needs. You or your loved one won’t receive everything on this list—but rather those services deemed necessary for daily safety, health, and well-being by your Medicaid assessment and care team.
Legal guardianship provides the authority to make vital healthcare and placement decisions for adults who can no longer make those choices themselves. This legal status ensures that home care arrangements, medical treatments, and financial matters can be managed in the best interest of the individual. Without guardianship, family members may face legal barriers when trying to secure care or services, even when acting with good intentions. For aging adults or those with cognitive decline, establishing guardianship proactively can help avoid delays in receiving necessary care at home.
Applying for Medicaid home care in New Hampshire is a detailed process, but with the right preparation and knowledge, families can navigate it successfully. Here’s what you need to know to begin the process with clarity and confidence.
Step 1: Gather Financial and Personal Documentation
Start by collecting the necessary documents. This includes proof of income (Social Security statements, pension, wages), bank account and investment records, medical records, Social Security numbers, proof of New Hampshire residency, and any documentation related to health insurance or living expenses. Having these ready can help shorten processing times.
Step 2: Contact the NH Department of Health and Human Services (DHHS)
Applications can be submitted online through NH EASY, via mail, or in person at your local DHHS office. Calling DHHS at 1-800-852-3345 can connect you with someone who can help you understand the latest application forms and requirements.
Step 3: Request a Functional Assessment from BEAS
For programs like the Choices for Independence Waiver, a functional needs assessment will be done by the Bureau of Elderly and Adult Services. This evaluation will determine your level of need based on mobility, cognitive challenges, and ability to complete ADLs. A nurse or social worker will conduct this assessment at your home or facility.
Step 4: Monitor the Application Status and Respond to Requests
Keep in contact with your caseworker throughout the process. If additional information is needed, respond promptly to avoid delays. If your application is approved, you’ll receive a notice indicating eligibility and the services you qualify for.
Step 5: Begin Receiving Services
Once eligibility is confirmed, a care plan will be developed with input from the case manager, the Medicaid recipient, and their family. You can choose from a list of approved home care providers or—in some cases—even opt for consumer-directed care, where a family member may be paid to provide services.
Helpful Resources:
- ServiceLink Aging and Disability Resource Centers offer free support in navigating long-term care services.
- Medicaid Planning attorneys or eldercare consultants can offer guidance on complex financial situations or spend-down strategies.
Applying doesn’t guarantee immediate coverage—so don’t delay if you suspect a need is approaching. Start conversations early and ask professionals for help when needed. It’s always better to be prepared than to feel overwhelmed during a crisis.
Caring for a loved one is a beautiful, selfless act—but without support, it can become an unsustainable burden. Thankfully, New Hampshire’s Medicaid home care programs offer families a lifeline—a way to ensure their loved one receives professional, dignified care in the place they know best: home.
Understanding your eligibility, the services provided, and how to apply can be the difference between stress and peace of mind. While the application process can be complex, it's navigable, especially if you use trusted resources and start conversations early.
If you’re reading this, chances are you're already doing the courageous work of planning a better future for someone you love. Now is the time to take action—reach out to DHHS, schedule that assessment, gather your documents. Whether you need help today or are simply planning ahead, exploring Medicaid home care in New Hampshire is a wise, compassionate step toward preserving both quality of life and family peace.
You’re not alone, and with the right information and support, help is closer than you think.
Frequently Asked Questions
To be eligible for Medicaid home care services in New Hampshire, you must meet income and asset limits set by the state, and you must require a level of care that would typically be provided in a nursing home. If you're 65 or older, blind, or disabled, the state uses financial criteria, including an income limit (based on monthly income) and asset caps. In some cases, a Medicaid waiver program may be used to provide services at home instead of in a facility. It's recommended to contact DHHS or a local Medicaid office for help assessing your specific situation.
New Hampshire Medicaid covers a variety of home and community-based services for those who qualify, including help with daily activities like bathing and dressing, skilled nursing services, physical therapy, and case management. Depending on the individual's care plan and Medicaid waiver program, services may also include homemaker assistance, meal preparation, transportation, and personal emergency response systems. These services are aimed at helping people stay safely in their homes instead of moving to a nursing facility.
You can apply for Medicaid home care in New Hampshire by contacting the Department of Health and Human Services (DHHS) or completing an application online through the NH Easy Gateway to Services. You'll need to provide personal and financial information to determine eligibility, and you may be asked for medical documentation that outlines your care needs. After applying, an assessment will be scheduled to evaluate your functional requirements and determine if you qualify for in-home services under Medicaid.
Yes, New Hampshire offers Medicaid waiver programs that support home care services for eligible residents who would otherwise need to live in a facility. The most common is the Choices for Independence (CFI) Waiver, which provides in-home care for seniors and adults with disabilities. These waivers allow you to receive customized services at home rather than institutional care, and may include non-medical supports such as adult day services, home-delivered meals, and personal assistance.
In some situations, a family member can be paid to provide in-home care under the New Hampshire Medicaid program, particularly under the Choices for Independence waiver. This program may allow spouses, adult children, or other relatives to be compensated as personal caregivers if the person needing care qualifies for the waiver. However, there are rules about who can be paid, and the caregiver may need to meet certain training or documentation requirements. Always consult with a Medicaid case manager for the most accurate guidance.
Dr. Alan Lee is a board-certified geriatrician specializing in neurodegenerative conditions including Alzheimer’s disease, Parkinson’s, and Lewy Body dementia. With more than two decades in clinical practice and research, Dr. Lee is a trusted authority in personalized care planning for aging adults. He serves as a medical reviewer for several national caregiving organizations and frequently lectures on aging in place and ethical dementia care.
Emily Sanders is a Dementia Practitioner and educator who trains in-home caregivers and family members in person-centered dementia care. With a background in occupational therapy and caregiver training, Emily creates practical tools and care plans that improve everyday life for people living with Alzheimer’s and related conditions. She is passionate about preserving identity, dignity, and connection in home-based settings.
Maria Torres is a social worker with a focus on elder care, family systems, and caregiver mental health. She has worked in both hospice and community health settings and currently supports family caregivers navigating long-term care decisions. Maria brings an empathetic lens to her writing and advocates for proactive planning, emotional resilience, and equitable access to home care resources.
