New Hampshire is home to around 1.3 million people and just over 18% are classified as senior citizens. The state’s Bureau of Elderly and Adult Services has a variety of social and long-term supports available to older adults throughout New Hampshire, helping seniors remain independent and at home as they age. People wishing to age in place are protected by a comprehensive set of regulations that govern in-home care providers in the state. The average cost of in-home care in New Hampshire is $5,243 a month, which is significantly higher than the national average.

Read on for more information about the cost of in-home care in New Hampshire, financial assistance options provided by the state and other free and low-cost resources for seniors.

The Cost of In-Home Care in New Hampshire

In-Home Care Costs in Nearby States

Genworth Financial’s Cost of Care 2019 Survey puts the average cost of in-home care in New Hampshire at $5,243 per month. This is almost $1,000 higher than the national average of $4,290. It’s also high compared to other states in New England. Connecticut has the lowest cost of in-home care in the area at $4,195, while in Maine seniors pay $5,117 each month. The cost in Massachusetts and Vermont is closer to New Hampshire at $5,186 and $5,196, respectively.

$5243

New Hampshire

$4290

United States Average

$4195

Connecticut

$5117

Maine

$5186

Massachusetts

$5196

Vermont

Cost of Other Types of Care in New Hampshire

In-home care is one of the more affordable types of senior care in New Hampshire. Adult day care has the lowest cost, both state and nationally, with seniors in New Hampshire paying $1,777 per month. In-home care is the next most affordable at $5,243, and home health care has a slightly higher monthly average cost of $5,386. Seniors in assisted living facilities pay an average of $7,021 each month, while those in nursing home care pay $9,581.

$5243

In-Home Care

$5386

Home Health Care

$1777

Adult Day Care

$7021

Assisted Living Facility

$9581

Nursing Home Care

The Cost of In-Home Care in New Hampshire Top Cities

In-home care in New Hampshire’s major city of Manchester is $5,291 per month, slightly higher than the state average. The cost in other cities close to New Hampshire varies widely. In Worcester, Massachusetts, seniors pay $4,767 per month, $524 less than those in Manchester. In Maine, seniors in Lewiston pay $5,148, while those in Portland pay an average of $5,339 per month. Boston is less affordable with an average monthly cost of $5,434.

$5291

Manchester

$4767

Worcester, MA

$5148

Lewiston, ME

$5339

Portland, ME

$5434

Boston, MA

Financial Assistance for In-Home Care in New Hampshire

Personal Care Attendant Services

The Personal Care Attendant Services program is part of New Hampshire’s Medicaid program. It provides personal care services to people with severe physical disabilities. The services can be provided in the participant’s home or the home of a relative and are designed to prevent or delay placement in a nursing home. Beneficiaries can receive assistance with activities of daily living, such as bathing or grooming, as well as instrumental activities of daily living that include housekeeping and meal preparation.

People receiving help through the program are able to self-direct their own care, meaning that they hire and manage their personal care attendants. Relatives cannot be hired through the program; however, seniors can choose to hire a friend to provide care. All personal care attendants are also under the supervision of a registered nurse.

Who is Eligible?
Applicants must meet the income and asset limits to qualify for Medicaid. New Hampshire residents with a higher income may be able to qualify through the medically needy pathway. The functional requirements are more complex. The program is designed for people who are wheelchair-bound, and applicants must require a wheelchair 80% of the time. They must also require assistance with at least two ADLs and need at least two hours of daily care. In addition, applicants must be legally responsible for themselves and able to direct their own care.

How to Apply
Applicants must first enroll in Medicaid through their local New Hampshire Department of Health and Human Services office. From here, applications for PCAS can be made through Granite State Independent Living at 800-826-3700.

Choices for Independence Program

New Hampshire’s Choices for Independence Program is a Medicaid Waiver that helps seniors and adults with chronic illnesses remain living in their homes. A wide range of services is available to program beneficiaries, including homemaker services, meal delivery, personal care and home health services. The program can also fund medical alert services, specialized medical equipment and accessibility for homes and vehicles.

There is some degree of self-direction available in the program, meaning participants can choose some of their care providers, particularly for unskilled or custodial care. However, the program does not allow seniors to hire family members as caregivers.

Who is Eligible?
Applicants who are aged 65 and older must need a nursing home level of care, while adults younger than age 65 must be disabled. There are also financial eligibility requirements based on income and asset limits; however, people who exceed these limits may be able to qualify through a medically needy pathway.

How to Apply
Seniors can apply using an online form, by contacting their local ServiceLink office or phoning 1-866-634-9412.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they won’t cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance, and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in New Hampshire

There’s a range of services available to New Hampshire residents for independent aging. These include assistance with transportation, prescriptions and assistive technology.

ContactServices Provided
ServiceLink1-866-634-9412ServiceLink is New Hampshire’s aging and disability resource center and it works in partnership with the Bureau of Elderly and Adult Services. There are local offices throughout the state that provide a range of services, including options counseling, information and referral, meal delivery and health insurance assistance. ServiceLink also runs the Senior Medicare Patrol program, which helps protect seniors from Medicare fraud.
Assistive Technology in New Hampshire603-862-4320The Assistive Technology in New Hampshire program promotes the use of assistive technology throughout the state. It runs training classes and outreach programs concerning assistive technologies, has an equipment loan program and also refurbishes used equipment to provide low-cost options for people.
Home Care, Hospice & Palliative Care Alliance of New Hampshire800-639-1949The Alliance is a membership organization for home care provider agencies in New Hampshire. It provides information and resources for seniors and families and advocates for patients in the state.
Office of the Long-Term Care Ombudsman800-442-5640The Office of the Long-Term Care Ombudsman investigates and resolves complaints relating to long-term care. It also advocates for seniors and educates people regarding their rights.
Non-Emergency Transportation Program603-271-4344This program is offered by NH Medicaid and provides transportation to Medicaid-covered services. It’s available to Medicaid recipients and in most cases provides reimbursement for the costs involved in driving to treatment. Family and friends who provide transport can also be reimbursed. The program can also arrange rides for those who don’t have access to transportation options.
NH Medication Bridge Program603-225-0900The NH Medication Bridge Program connects low-income residents with the Patient Assistance Programs of pharmaceutical companies. It helps eligible uninsured and underinsured people access long-term medications.

In-Home Care Laws and Regulations in New Hampshire

The New Hampshire Department of Health and Human Services, Health Facilities Administration oversees the licensing and regulation of home care providers in the state. The HFA inspects and enforces standards that ensure people receive safe and appropriate care.

Scope of CareHome health care providers can accommodate personal care services, transfer and mobility assistance, assistance with personal appliances, such as hearing aids and dentures, and assistance with nutrition, hydration and meal preparation. In addition, agencies can provide homemaker services, nursing services and some therapeutic services, such as occupational therapy.
Care Plan RequirementsBefore initiating care, providers must assess patients and develop a care plan that outlines any relevant diagnoses, equipment required, goals of the service and the frequency and duration of the service. The assessment must be repeated at least every 90 days or when there’s a significant change in the patient’s condition. People only receiving homemaker services don’t require a care plan. For those only receiving personal care services, assessments need to be performed every six months.
Medication Management RequirementsMedications can be administered by licensed practitioners or those under the supervision of nurses. Unlicensed caregivers can also assist patients with self-administration by performing limited tasks, such as reading labels or giving reminders.
Staff Screening RequirementsAll staff must undergo a criminal background check. Those who will have direct contact with patients must also be screened for tuberculosis.
Staff Training RequirementsCaregivers providing home health care services must be licensed professionals. Unlicensed caregivers must complete training in the performance of their duties that’s conducted by a licensed professional.
Medicaid CoveragePersonal Care Attendant Services and the Choices for Independence programs cover some or all of the cost of in-home care for eligible residents.
Reporting AbuseAbuse should be reported to the office of the long-term care ombudsman at 800-442-5640 or OLTCO@dhhs.nh.gov.

Frequently Asked Questions

How much does in-home care cost in New Hampshire?

In New Hampshire, in-home care, also known as homemaker services, has an average cost of $5,243 per month, according to Genworth Financial’s Cost of Care 2019 Survey. Home health care includes skilled nursing services and has a slightly higher cost of $5,386 each month.

Does New Hampshire Medicaid pay for in-home care?

New Hampshire’s Personal Care Attendant Services and Choices for Independence programs cover some or all of the costs for in-home care for eligible residents. Each program has different requirements regarding the care needs of applicants, and seniors must also meet financial eligibility requirements.

Are there transportation assistance programs in New Hampshire?

There’s a range of transportation programs that can help seniors remain mobile as they age. Public transport providers throughout the state have paratransit options that may be beneficial to seniors. In addition, the Non-Emergency Transportation Program provides assistance to individuals who need to travel to a Medicaid-covered service. This may be done by reimbursing the cost of gas to the senior, their friends and family or by organizing a ride.

What are “Activities of Daily Living”?

Activities of daily living, or ADLs, are a set of self-care activities that are often used to assess a person’s functional ability. These basic tasks must be accomplished daily for an individual to thrive and can be broken down into five categories: personal hygiene, continence management, dressing, feeding and ambulating. Instrumental activities of daily living are more complex tasks that are required to live independently, such as shopping, preparing meals and housekeeping.

What is the difference between in-home care and home health care?

In-home care refers to non-clinical help that can assist with both activities of daily living and instrumental activities of daily living. Common services provided by in-home care include meal preparation, housekeeping and help bathing or grooming. Home health care provides professional medical assistance, such as occupational therapy, wound care and health monitoring.

Home Care Services in New Hampshire (245)