New Hampshire pays for home health care through its Choices for Independence (CFI) Medicaid Waiver. CFI is a Home and Community-Based Services (HCBS) program that allows nursing facility eligible seniors to stay in the comforting and familiar environment of their own home. New Hampshire’s home health care can be expensive at an average of $6,197 per month, so CFI services are usually in high demand. 

Choices for Independence Services

In addition to their own home, seniors can also get care through CFI in a family member’s home or assisted living facility. Seniors can choose to self-manage their own services or have a care coordinator manage services on their behalf. Due to limited funding, CFI can only serve a certain number of people each year, which means seniors might need to join a wait-list before receiving care. CFI provides both medical and non-medical services, including:

  • Personal care assistance, such as help with mobility, eating, bathing and dressing
  • Help with housekeeping, laundry, shopping and meal preparation
  • Daytime supervision in a community setting
  • Transportation
  • Skilled nursing
  • Specialized medical equipment and supplies
  • Medication assistance and reminders
  • Personal emergency response system
  • Home and vehicle modifications
  • Community transition services, including home furnishings, utility set-up fees and security deposits

Eligibility Requirements

To qualify for CFI, seniors must first be eligible for New Hampshire’s Medicaid program. In 2023, the income limit for HCBS Medicaid is $2,742 per month. Nearly all types of income count toward the limit except Holocaust restitution payments and the Veterans Aid and Attendance allowance. Additionally, there is an asset limit of $2,500, which includes savings, investments and most real estate. Personal belongings, vehicle, burial funds and primary home are excluded from the limit.

CFI also requires seniors to need a Nursing Facility Level of Care (NFLOC). To determine NFLOC, seniors must undergo a face-to-face assessment as part of the CFI application process. They will be assessed on:

  • The ability to complete activities of daily living, such as feeding, bathing, dressing and getting into and out of bed
  • The severity of their medical needs and whether they are able to meet these needs on their own
  • Their level of cognitive functioning
  • Any behavioral issues they may exhibit that may impact their health and safety