Seniors looking for safe neighborhoods, generous tax savings and access to excellent medical care will find much to love about New Hampshire. The Granite State ranked number 10 on our 2022 Senior Living Report, making it one of the Northeast’s best locations for older adults.

New Hampshire’s monthly average cost of assisted living is $6,053, which is higher than average. However, it’s the only New England state with no general income tax, and taxes on interest and dividends will be completely phased out by 2027, so the state can still be budget-friendly for retirees. Very low crime rates are another perk of living in New Hampshire, which can help give residents peace of mind. When it comes to health care, seniors have many top-rated options to choose from. Several hospitals, such as Dartmouth-Hitchcock Medical Center, Alice Peck Day Memorial Hospital and Concord Hospital, are highly rated. The state also has the eighth-largest senior population in the nation, with almost 19% of residents aged 65 and up.

This guide compares the cost of assisted living in New Hampshire and nearby states and provides prices for other kinds of care, information about the state’s Medicaid waiver program and free resources that seniors may find helpful.

The Cost of Assisted Living in New Hampshire

According to Genworth’s 2021 Cost of Care Survey, assisted living in New Hampshire costs a monthly average of $6,053, or $1,553 more than the national average of $4,500. Still, prices are similar to several other Northeast states. Rates in Massachusetts are more expensive at $6,500. Seniors pay an average of $5,865 in Maine, $5,250 in Vermont and $4,580 in New York.

$6053

New Hampshire

$4500

The United States

$5865

Maine

$5250

Vermont

$6500

Massachusetts

$4580

New York

Assisted living costs an average of $8,061 in Manchester, which is about 20 miles south of New Hampshire’s capital city of Concord. Prices in cities from neighboring states are generally cheaper but still more than the U.S. average. Seniors in Portland, Maine, pay $6,525, and prices drop to $5,484 to the north in Lewiston. Care costs around $6,371 in Burlington, Vermont. In Massachusetts, Boston assisted living costs $6,819, and Springfield residents pay $5,048. Rates average $5,269 in Albany, New York.

$8061

Manchester

$6525

Portland, ME

$5484

Lewiston, ME

$6371

Burlington, VT

$6819

Boston, MA

$5048

Springfield, MA

$5269

Albany, NY

Seniors who prefer to stay at home instead of moving to an assisted living facility can get care for about $6,006. It includes help with activities of daily living, meal preparation, housekeeping and other types of personal assistance. For $6,197, New Hampshire residents can get home health care, which includes some medical services in addition to the assistance regular home care provides. Adult day health care is much more affordable at $1,842. Nursing home care is best for people who need a very high level of supervision as a semiprivate room costs $10,950.

$6053

Assisted Living

$6006

Home Care

$6197

Home Health Care

$1842

Adult Day Health Care

$10950

Nursing Home Care (semiprivate)

Does Medicaid Cover Assisted Living in New Hampshire?

In New Hampshire, Medicaid covers the cost of assisted living services under the Choices for Independence Program, formerly known as the Home and Community-Based Care Program for the Elderly and Chronically Ill.

What Assisted Living Services Are Covered by Medicaid in New Hampshire?

New Hampshire Medicaid covers supportive services for seniors who are eligible for nursing home placement but want to receive care in their community or at home. Coverage is provided to people in assisted living, residential treatment facilities and other community-based settings. The type of services recipients can get depends on their care plan, but in general, will include:

  • Assistance with activities of daily living
  • Health support and medication assistance
  • Participant-directed managed care options

Assisted Living Waiver Programs in New Hampshire

Choices for Independence (CFI)

The Choices for Independence program is administered by the Bureau of Elderly and Adult Services. It covers the cost of services provided at approved assisted living facilities as long as costs don’t exceed a certain percentage of what recipients would pay for the same care in a nursing facility. CFI allows seniors to choose their preferred case manager and service providers. Services covered by this program include:

  • Adult day medical care
  • Case management
  • Community transition assistance
  • Environmental accessibility services
  • Financial management
  • Personal emergency response systems
  • Physical, occupational and speech therapy
  • Specialized medical equipment

To be eligible for CFI, applicants must be at least 65 years old and meet financial and medical requirements. Enrolling in CFI is a three-step process:

  1. Apply for services either by mail or online through the NH EASY portal.
  2. Undergo a financial and medical eligibility assessment by the Bureau of Family Assistance.
  3. If eligible, select a case manager who will help with choosing and arranging services.

How to Know if You’re Eligible for Medicaid in New Hampshire

Medicaid eligibility determinations are made by the Bureau of Family Assistance and the Bureau of Elderly and Adult Services under DHHS. To qualify, applicants must:

  • Be 65 years or older.
  • Be a current resident of New Hampshire.
  • Be a U.S. citizen or eligible qualified alien.
  • Meet income requirements.

As of 2022, single applicants can have an income up to $30,276 ($2,523 per month) and assets valued up to $2,500.

2022 Medicaid Income Limits for Seniors in New Hampshire

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,500

Two-Person Household (Only One Person Applying)

$30,276

$2,500 for applicant $137,400 for non applicant

Two-Person Household (Both People Applying)

$60,552 ($2,525 per month, per applicant)

$5,000 ($2,500 per applicant)

In addition to meeting income and asset limits, applicants must also be assessed by the Bureau of Elderly and Adult Services to determine if their condition meets the clinical requirements for a nursing facility level of care.

How to Apply for Medicaid in New Hampshire

To apply for Medicaid and the CFI program, complete a Long Term Care application online via the NH EASY Gateway to Services. Alternatively, complete a paper application, and deliver it to your local Department of Health and Human Services (DHHS) District Office. Paper applications can also be faxed to (603) 271-5621. To apply by phone, call (800) 852-3345, extension 9700.

Information You Will Need

Applicants must include the following information with their application:

  • Proof of age
  • Proof of assets and income, including retirement and VA benefits
  • Proof of New Hampshire residency and U.S. citizenship
  • Information about other medical insurance, including Medicare or coverage from a spouse’s employer

How to Get Help Applying for Medicaid

Seniors can get help with their Medicaid application through a number of free services available to New Hampshire residents. These resources provide application assistance, explain eligibility requirements and more.

Resource

Contact

Description

(603) 271-4375

New Hampshire's Office of the Ombudsman provides assistance for Medicaid application denials and appeals. If Medicaid denies a service or prescription that's considered medically necessary, the ombudsman can file an appeal to get it approved.

(888) 901-4999

Seniors can call this hotline to ask questions about their Medicaid application, Choices for Independence eligibility, medical bills and other services they might qualify for based on financial need. Individuals can also request help by emailing nhmedicaidcaremanagement@dhhs.nh.gov.

(603) 271-4292

Seniors have a right to a fair hearing when the New Hampshire DHHS reduces, suspends or terminates their Medicaid coverage or eligibility. DHHS is required to notify individuals about their right to appeal in these circumstances. By participating in a hearing, it's possible for certain decisions made by DHHS to be overturned.

Does Medicare Cover Assisted Living in New Hampshire?

The short answer is that no, Medicare does not cover the cost of assisted living in New Hampshire. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in New Hampshire.

Other Financial Assistance Options for Assisted Living in New Hampshire

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in New Hampshire

Several government agencies and nonprofit organizations in New Hampshire can help seniors find financial aid programs and resources that they can use to pay for care. Through these resources, seniors may also get legal aid, Medicare counseling, veterans benefits information and more.

Resource

Contact

Description

(603) 226-4900

SANH is an organization comprised of residents from assisted living facilities, nursing homes and independent living communities throughout the state. Members work with policymakers and key state leaders regarding issues that affect people living in long-term care. Seniors are welcome to participate by joining a SANH group near them.

(603) 225-1200 

Through this agency, New Hampshire veterans can get help applying for VA benefits, such as health care and Aid & Attendance, which provides funds that seniors can use to help pay for assisted living. It also handles eligibility screenings for the New Hampshire State Veterans Home, a 250-bed long-term care facility located in Tilton.

(866) 634-9412

ServiceLink has information about choosing an assisted living community, applying for Medicaid/Medicare and planning for future long-term care needs. It hosts educational events throughout the state, and its website features a list of financial assistance programs for low-income people and options that seniors can use to pay for care.

(800) 949-0470

BEAS provides assistance with Medicaid, long-term care facility selection, transportation services and meal deliveries for seniors living at home. It also investigates reports of neglect, abuse and exploitation of seniors in long-term care facilities. Individuals can meet with BEAS staff at the DHHS office near them.

(800) 639-5290

New Hampshire Legal Aid offers online self-help guides that have information about SSI, Social Security retirement benefits, Medicare and potential funding sources for assisted living costs. Low-income seniors may qualify for free legal assistance with trusts, wills, estates, powers of attorney, advance care directives and matters related to family law.

(800) 772-1213

New Hampshire has six Social Security Field Offices located across the state. Seniors can visit an office to apply for SSI, Social Security Disability Insurance and other public benefits. These offices also issue new and replacement cards for Medicare and Social Security.

COVID-19 Rules for Assisted Living in New Hampshire

The following information is based on research done on several government websites, including cms.gov and cdc.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/22/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for New Hampshire Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for New Hampshire Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for New Hampshire Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in New Hampshire

In New Hampshire, assisted living facilities are licensed and regulated by the Health Facilities Administration of the Department of Health and Human Services. Facilities must comply with regulations for quality of resident care, staffing, safety, medication management and reporting abuse.

NEW HAMPSHIRE LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

All facilities must assess every resident's level of independence, medical needs and mental status to develop a service plan for care. This assessment must be completed no more than 30 days before admission or within 24 hours of admission. Residents must be reassessed every six months or after any significant change in health.

Assisted Living Admissions Requirements

Facilities may only admit an individual who requires assistance with personal care and whose needs can be met by personnel. Facilities cannot admit anyone who is incapable of self-evacuating the building or an individual who requires special equipment for transferring to chairs or their bed.

Assisted Living Scope of Care

Facilities are required to provide 24-hour oversight and care, medication assistance, housekeeping, maintenance, meals, on-site activities, crisis intervention and safety devices to minimize the likelihood of accident or injury. Facilities must also provide access to behavioral health care, rehabilitation and nursing services.

Assisted Living Medicaid Policy

New Hampshire Medicaid covers the cost of assisted living facilities through the Choices for Independence waiver. Facilities must be licensed by the state to accept funding through the program.

Assisted Living Facility Requirements

Facilities licensed for 16 or fewer residents must provide a minimum of 80 square feet per single-occupancy room and 160 square feet per double-occupancy room. Facilities licensed for 17 or more residents must provide a minimum of 100 square feet per resident in private bedrooms and at least 80 square feet per resident in semiprivate rooms. Facilities must have at least one sink, toilet and shower/bathtub per six residents.

Medication Management Requirements

Residents can receive medication through self-administration, self-directed administration or administration by staff who are authorized to do so by law.

Staffing Requirements

Facilities must employ a full-time administrator to oversee daily operations. New Hampshire doesn't have resident-staff ratio requirements. Administrators determine the necessary personnel level according to the number of residents, services required and size of the facility.

Staff Training Requirements

Staff must complete orientation and training regarding job duties, resident rights, food safety, medication management, evacuation procedures, complaint procedures and mandatory reporting requirements. Facilities are required to provide annual continuing education on these and other relevant subjects.

Background Checks for Assisted Living

Facilities must obtain a criminal background check for each staff member through the New Hampshire Department of Safety. Facilities may not employ any individual who has been convicted of a felony in any state or anyone who has been convicted of abuse, neglect, exploitation, fraud, assault or another violent crime.

Requirements for Reporting Abuse

In New Hampshire, long-term care facility staff are mandated reporters who are required to report resident abuse whether it's suspected or verified. Staff can report abuse to the long-term care ombudsman at (800) 442-5640.