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Assisted Living in New Hampshire
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 2024 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.
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The Cost of Assisted Living in New Hampshire
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in New Hampshire and its 10 cities.
The Cost of Assisted Living in New Hampshire's Top Cities
While New Hampshire's average cost of assisted living remains high at nearly one and a half times the national average, certain cities offer care at more affordable rates. Cities such as Nashua and nearby Bedford offer assisted living at $3,683 per month, while Concord and Keene come in below the state average at $5,295 and $5,758. Salem is 3.7% higher than the state average at $6,446.
New Hampshire
$6,217
Nashua
$3,683
Concord
$5,295
Keene
$5,758
Salem
$6,446
Inflation's Impact on the Cost of Assisted Living in New Hampshire
Inflation has continued to be a determining factor in the cost of assisted living for New Hampshire and its neighboring states. New Hampshire's average assisted living costs rose from $5,191 in 2022 to $6,217 in 2023, representing a significant 19.7% increase. The US average rose a more modest 9.5% during the same period.
Compared to its neighbors, New Hampshire experienced the highest inflation as expressed in assisted living costs, nearly double that of Vermont's 11.7% increase. Connecticut saw costs increase by 15.6%; only Massachusetts and Maine stayed beneath the national average at 7.6% and 1.7%, respectively.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| New Hampshire | $5,191 | $6,217 | $6,827 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| Maine | $5,513 | $5,609 | $5,855 |
| Massachusetts | $5,202 | $5,599 | $6,393 |
| Vermont | $6,004 | $6,710 | $7,147 |
| Connecticut | $5,122 | $5,919 | $6,129 |
The Costs of Other Types of Senior Living
Senior living costs vary significantly according to the care level and the additional services required. Independent living costs average $3,874, while intensive memory care programs can cost nearly double at $7,169. The cost of assisted living, $6,217, is closer to that of memory care in New Hampshire, though factors such as medication, specialized therapy and other auxiliary costs can affect the total.
Assisted Living
$6,217
Memory Care
$7,169
Independent Living
$3,874
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:
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 2023, single applicants can have an income up to $32,904 ($2,742 per month) and assets valued up to $2,500.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,500 | |
| Two People | 1 | $32,904** | $2,500 | $148,620 |
| Two People | 2 | $65,808*** | $5,000**** |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,500 per spouse
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.
| Program | Contact | Services provided |
|---|---|---|
| Office of the Ombudsman | (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. |
| NH Medicaid Care Management Program | (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. |
| Medicaid Fair Hearings | (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.
Paying for Assisted Living Facilities in New Hampshire
This is a statewide program funded by the Department of Health and Human Services that provides cash assistance to residents age 65 or older.
To be eligible, applicants must:
- Be age 65 or over
- Be a U.S. citizens
Eligibility for OAA depends on a number of different factors, including income, resources and living arrangements.
To learn more about eligibility requirements, visit the How to Apply for Assistance page on the DHHS website.
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.
| Name | 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
There are many resources in New Hampshire that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Adult & Aging Care | 800-351-1888 | New Hampshire Area Agencies on Aging are services that help adults ages 60 and older, or 18 and older with a disability, live independently. AAA programs in New Hampshire assist older adults with nutritious, hot, home-delivered meals and community dining, which offers socialization opportunities and promotes overall wellness. Other vital services include transportation to help seniors get to medical and dental appointments, obtain groceries and reach other destinations. |
Cash Assistance Programs
Cash assistance programs in New Hampshire provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
| New Hampshire Old Age Assistance | 844-275-3447 | New Hampshire residents aged 65 years or older can apply for Old Age Assistance cash benefits under the State Supplemental Program. An applicant must have a Social Security number and meet certain income and financial resources requirements. Income limits vary according to seniors' living arrangements, whether they're living on their own, with family members or in an assisted living facility. Seniors undergo interviews upon completion of application forms. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, New Hampshire seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Choices for Independence Waiver | 800-351-1888 | The NH Choices for Independence Waiver helps seniors receive the support and care they need, whether in an institutional setting like a nursing home or other community facilities. The Waiver can be used to cover the cost of personal care services, home health aides, transition services, skilled nursing care and durable medical equipment. It can also be used for respite care and case management services. The program is open to seniors aged 65 and over, as well as younger adults who are living with a disability. Under Choices for Independence, seniors are given a case manager who will work with them to develop a care plan that either allows them to live independently in their home or helps them access the skilled nursing care they require in order to maintain a high quality of life. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help New Hampshire seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Meals on Wheels | New Hampshire Meals on Wheels runs independently operated food assistance programs throughout the state. Eligibility is open to seniors ages 60 and over and those unable to shop for groceries or prepare their own meals. Meals are served in a congregate setting to help reduce isolation or delivered to seniors' front doors with a friendly visit and safety check. Although additional services vary, they may include pet meal delivery, telephone reassurance and transportation services to local health care appointments. | |
| New Hampshire Supplemental Nutrition Assistance Program (SNAP) | 844-275-3447 | The New Hampshire Supplemental Nutrition Assistance Program helps low-income residents obtain healthy food. Adults 60 and over who meet household size, income, expense and resource guidelines are eligible. Qualified seniors receive Electronic Benefits Transfer cards that are accepted at most grocery stores and supermarkets statewide. EBT card funds can buy dairy products, bread, rice and pasta, meat, fish and fresh produce. However, they cannot be used to purchase alcohol, tobacco, prepared foods or personal care items. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in New Hampshire collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Loaner's Closet | 603-432-8077 | The Community Caregivers of Greater Derry maintains a large medical equipment loan closet that includes a variety of mobility aids and other equipment. |
Health Insurance & Prescription Drug Coverage for Seniors
New Hampshire seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Medication Bridge Program | 603-225-0900 | The NH Medication Bridge Program is sponsored by the Foundation for Healthy Communities. It helps individuals access prescription medications they might not otherwise be able to afford. |
| New Hampshire Rx Card | 800-9313-5542 | This is the state's free prescription assistance program. Residents can apply for a card that grants automatic discounts of up to 80% on prescription drugs at participating pharmacies. The program aims to help those who are uninsured or underinsured access affordable medication. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in New Hampshire have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Section 504 Home Repair Program | 603-223-6035 | The Section 504 Home Repair Program offers loans of up to $40,000 and grants of up to $10,000 for senior homeowners to make essential home improvements. The program is aimed at seniors who would otherwise not be able to cover the cost of home repairs. |
Legal Resources
Many organizations offer free or low-cost legal services to New Hampshire seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Legal Aid | 800-639-5290 | New Hampshire Legal Aid provides free legal services to those aged 60 and over in Dover and can help individuals navigate issues such as wills and trusts, guardianship and powers of attorney. This agency can also help older adults apply for benefits, such as Social Security and Supplemental Security Income. |
Senior Centers
Senior centers in New Hampshire bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Catholic Charities | 603-669-3030 | This faith-based charity offers a variety of programs that may be of use to local seniors, including financial literacy education, mental health services and legal aid. Health care services are also available, including dental, podiatry and optometry consultations. The CareGivers program connects volunteers with elderly citizens in need of transportation, chore assistance or friendly visits. |
Social Security Offices
Social Security offices in New Hampshire help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several New Hampshire resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Elder Property Tax Exemption | 603-230-5000 | The Elder Property Tax Exemption offers a reduction in property taxes for seniors who are homeowners. The state has additional exemptions for veterans and those living with certain disabilities. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. New Hampshire retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Electric Assistance Program (EAP) | 800-735-2964 | The Low Income Home Energy Assistance Program helps those who live in eligible households meet their utility bills. It offers support in the form of a one-time payment during the coldest months of the year. |
| New Hampshire Fuel Assistance Program | 800-735-2964 | The New Hampshire Fuel Assistance Program, part of the Low Income Home Energy Assistance Program, helps qualifying New Hampshire seniors stay warm during the cold months. The primary way it assists is by providing financial help for heating costs ranging from $243 to $2,419, with the average totaling $1,530.25. Aid may also be available for shut-off notices, emergency fuel delivery and referrals. Eligibility is based on income, the home's number of residents and energy costs totaling $100+. |
Veteran's Services
New Hampshire retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire VA Benefits and Health Care | New Hampshire VA Benefits and Health Care provides resources for senior veterans, with supportive services available through VA health and benefit offices. Seniors and their families can receive medical care, apply for benefits, receive mental health counseling and learn about cemetery benefits for senior vets in New Hampshire. Seniors can call (800) 698-2411 for further assistance. |
Assisted Living Laws and Regulations in New Hampshire
In New Hampshire, assisted living facilities — also called supported residential health care facilities (SRHCFs) or residential care facilities (RCFs) — 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.
| Topic | Rule |
|---|---|
| Assisted Living Service Plan Requirements | All assisted living communities 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 by someone trained with an approved assessment tool no more than 30 days before admission or within 24 hours of admission. Residents are reassessed every six months or after significant health changes. A nursing assessment may also be needed depending on the resident assessment outcome. |
| Assisted Living Admissions Requirements | There are no statewide admission requirements. General guidelines are that facilities may only admit an individual whose needs can be met by staff. Supported residential health care facilities (SRHCF) can admit those who need transfer assistance if staff can help them during fire evacuations. Residential care facilities (RCF) residents must be able to self-evacuate. Both facility types can admit those who need nursing care for less than 21 days and those in hospice. |
| Assisted Living Scope of Care | RCFs offer a lower level of care to those who need less assistance. Services may include supervising activities of daily living, medication service and appointment arrangement. SRHCFs directly assist with personal care such as bathing and grooming, offer health and safety services, and more. Both provide 24-hour care, medication assistance, housekeeping, on-site activities, crisis intervention and access to behavioral health care, rehabilitation and nursing services. |
| Assisted Living Medicaid Policy | New Hampshire Medicaid covers the cost of ALFs through the Choices for Independence waiver. Some ALFs may accept Medicaid to cover individual services, but not the cost of room and board. Facilities must be licensed by the state to accept funding through the program.The Old Age Assistance (OAA) benefit may also help offset some assisted living costs. Check with individual assisted living communities to find out about what financial assistance they accept. |
| 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 authorized staff. To administer medication, unlicensed staff must be trained by an on-site health care professional. In SRHCFs, staff may not handle medications, but unlicensed staff may administer oral medications if directed by a licensed nurse. In RCFs, medications are administered by a licensed nurse or other legally authorized individual. |
| Staffing Requirements | Facilities must employ a full-time administrator, direct care personnel, and a licensed nurse. There are no resident-staff ratio requirements. Administrators determine the necessary personnel level according to the number of residents, services required and size of the facility. Awake staff must be on duty at all times except for in smaller SRHCFs and RCFs if safety systems are in place, residents needs are met, and they comply with all other requirements. |
| 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. Administrators must complete 12 hours of continued education on care plans, characteristics of disabilities, and more. Annual continuing education for personnel must review resident rights, infection control, and emergency procedures. |
| Background Checks for Assisted Living Staff | 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 | Administrators and personnel are trained to recognize the signs of abuse or neglect. In New Hampshire, long-term care facility staff are mandated reporters who are required to report resident abuse whether it's suspected or verified. Reports can be filed any time by contacting the Bureau of Elderly & Adult Services at 603-271-7014 or toll-free 1-800-949-0470. You can also call your local County Attorney's Office or the long-term care ombudsman at 1-800- 442-5640. |
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