New Hampshire is an aging state with a growing population of older adults. Senior citizens aged 65 and older already account for more than 18.7% of the state’s 1,359,711 residents, and this number is expected to increase as more baby boomers enter their golden years.

It’s estimated that 70% of older adults will require long-term services and supports, and nearly half will require paid care during their lifetimes. Many older adults receive personal care and medical services from assisted living centers or home health agencies. Individuals with more significant needs can choose from 74 licensed nursing homes that provide skilled 24-hour care for subacute medical conditions.

The average cost of skilled nursing in New Hampshire is $10,646 for a semiprivate room or $11,315 for a private room, which is higher than the national average and most neighboring states. This guide explores long-term care costs in New Hampshire as well as financial assistance programs, such as Medicaid. It also includes helpful information about state regulations, nonprofit resources and free services that are available to seniors and caregivers.

The Cost of Nursing Home Care in New Hampshire

Nursing homes in New Hampshire typically charge $10,646 per month according to provider responses collected in the Genworth Cost of Care Survey 2020. Average rates are $2,890 higher than the U.S. median of $7,756, which represents an increase of 37%. New Hampshire is also more expensive than most neighboring states with the exception of Massachusetts, where seniors pay $12,623 per month for skilled nursing. In other parts of New England, rates are more competitive. Seniors in Vermont pay $9,779 per month, or $867 less, and rates in Maine are about $1,000 lower at $9,642. Rhode Island is also more affordable. Seniors in the nation’s smallest state pay $1,977 less per month of skilled care than their counterparts in New Hampshire.

$10646

New Hampshire

$7756

The United States

$9642

Maine

$9779

Vermont

$12623

Massachusetts

$8669

Rhode Island

Manchester is one of 440 metropolitan areas included in Genworth Financial’s long-running Cost of Care Survey. Most of the state’s largest cities, including Nashua, Concord and Derry, fall within this geographic region. In these communities, seniors can expect to pay $11,330 per month for skilled nursing, which is $686 more than the state median. New Hampshire compares favorably to cities in Massachusetts, including Worcester and Boston where seniors pay $12,486 and $13,383 per month, respectively. Burlington, Vermont, is slightly more affordable than Manchester at $10,737, and nursing homes in Maine provide a more competitive value. Seniors in Portland pay $10,220 per month, and average rates in Lewiston are $1,521 lower than the New Hampshire median at $9,125.

$11330

Manchester

$10737

Burlington, VT

$10220

Portland, ME

$9125

Lewiston, ME

$13383

Boston, MA

$12486

Worcester, MA

Long-term care prices vary significantly depending on the type of services provided. In New Hampshire, adult day health care is the most affordable option. Programs that provide recreational activities and daytime care in a group setting cost $1,842 per month on average. In-home care costs $5,434 per month or $5,577 with added medical support. Assisted living facilities in New Hampshire cost $6,650 per month, which is significantly higher than the U.S. median of $4,300. At $10,646 per month, nursing homes charge almost $4,000 more due to the level of skilled care they provide 24 hours a day.

$5434

In-Home Care

$5577

Home Health Care

$1842

Adult Day Care

$6650

Assisted Living Facility

$10646

Nursing Home Care

Does Medicaid Cover Nursing Home Care in New Hampshire?

Over 227,000 residents are enrolled in New Hampshire’s Medicaid program. For qualifying seniors looking for long-term care, the program can pay for the cost of room and board, as well as various types of rehabilitation therapies and assistive devices. Pharmaceutical services and visits with in-house physicians are also covered by Medicaid. 

New Hampshire is home to over 70 nursing homes, all of which accept Medicaid. Seniors who may benefit from in-home care can apply for home and community-based services waivers, which can delay nursing home placement and allow seniors to remain in their own home while still receiving the appropriate level of care. Services typically include housekeeping and nursing care, in addition to emergency response system installation.

Medicaid Eligibility in New Hampshire 

When applying for Medicaid in New Hampshire, single applicants can have a monthly income of $2,523 or less ($30,276 per year), along with $2,500 in assets. The requirements are the same for a two-person household with only one applicant. However, the Spousal Impoverishment Act allows non-applicant spouses to have up to $137,400 in assets. For couples, the monthly income cap is $5,046 ($60,552 per year), and assets can’t exceed $5,000.

2022 Medicaid Income Limits for Seniors in New Hampshire

Income Limits*
Asset Limits
Single Applicant

$30,276

$2,500

Two-Person Household
(Only One Person Applying)

$30,276

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

Two-Person Household
(Both People Applying) 

$60,552

$5,000

*Per year

Along with financial limitations, individuals must be medically needy and meet citizenship requirements. In some cases, the applicant can “spend down” on necessities to meet the income and asset limits, if they meet the other requirements as well. To be approved, applicants are required to:

  • Be 65 years of age or older
  • Reside in New Hampshire
  • Be in need of skilled nursing care

How To Apply for Medicaid in New Hampshire

Individuals can apply for Medicaid online using the NHEASY Gateway to Services. For questions or issues using the website, call customer service at (844) 275-3447. The Medicaid application can be printed out and mailed in or faxed to (603) 271-8604. Applications are also accepted in person at local Department of Health and Human Services (DHHS) offices or over the phone by calling (800) 852-3345. Applicants should prepare the appropriate documents beforehand to prevent delays in the application process. It can take up to 3 months for an application to be reprocessed and approved.

Information You Will Need:

  • Birth certificate or other proof of age
  • Medicare cards
  • Social Security card, or green card if born outside the United States
  • Proof of earned and unearned income, including stocks and 1099s
  • Bank statements from the previous 60 months prior to the date on the application
  • Proof of private and government pensions, including a letter of verification from the provider
  • Car registration and insurance
  • Copies of life insurance
  • Proof of any real property sold or transferred in the previous 60 months
  • VA discharge papers (DD 214), for veteran applicants
  • Any other documents supporting the applicant’s claim

Additional Medicaid Support & Resources in New Hampshire

Seniors and families applying for Medicaid in New Hampshire may find assistance through any of the websites listed below. Both the Medicaid Planning Assistance and Benefits.gov sites go into detail about eligibility requirements and offer free online eligibility tests.

Resources
Contact
Service

(603) 271-9700

The Medicare Savings Program helps low-income seniors and families pay for medical costs associated with Medicare Parts A and B. There are three tiers to the program to assist individuals based on their needs and eligibility. The program can cover premiums and deductibles, along with full medical assistance coverage for qualifying individuals.

Online Only

Medicaid Planning Assistance, a website overseen by the American Council on Aging, provides in-depth and state-specific guides to Medicaid eligibility and nursing home placement. Individuals can also read about how Medicaid works with other benefits, such as VA pensions, and how to apply for HCBS waivers. In addition to a Medicaid eligibility test, the website can also help find affordable Medicaid planners.

(800) 852-3345

Benefits.gov, which is administered by the U.S. Government, is the official website for resources ranging from disaster assistance to medical programs that focus on the long-term care needs of seniors. Financial assistance, such as tax relief and housing assistance programs, is also available. The Social Security Administration provides a Benefit Eligibility Screening Tool (BEST) to give seniors peace of mind during the application process.

Does Medicare Cover Nursing Home Care in New Hampshire?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

What Isn’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support and Resources in New Hampshire

Medicare doesn’t cover the cost of nursing care past the first 2 days, but it does give families time to find other ways to pay for long-term care. Below is a short list of organizations and programs that can assist seniors with applying and maintaining their Medicare benefits.

Resources
Contact
Service

(603) 271-0527

The New Hampshire State Commission on Aging advocates for aging adults and coordinates their efforts with the Department of Health and Human Services and the Bureau of Elderly and Adult Services to help seniors find the resources they need. Seniors and families can subscribe to a monthly newsletter that covers topics such as new laws affecting seniors and how to spot common Medicare scams.

(866) 634-9412

Provided by the ServiceLink Aging and Disability Resource Center, New Hampshire SHIP offers free and unbiased insurance counseling to Medicare beneficiaries. Counselors are certified by the state to assist seniors with filing claims and appealing claim denials, as well as reporting fraudulent transactions found on monthly statements. Qualifying seniors can apply for financial aid to cover out-of-pocket expenses for prescription medication and medical supplies.

(800) 794-6559

BenefitsCheckUp is a free online tool provided by the National Council on Aging. It helps users find services and programs that can assist with long-term care and financial aid. After answering a quick questionnaire, users use their zip code to find resources closest to them. Available in English and Spanish, the website connects users to over 2,500 federal and state benefits.

(800) 633-4227

The official Medicare website provides a self-service portal for applying and managing benefits, as well as finding local Medicare-registered providers and medical equipment suppliers. Seniors can find information about health insurance policies and supplemental plans, as well as a 24/7 live chat feature and a directory for finding local professionals. 

Other Financial Assistance Options for Nursing Home Care in New Hampshire

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

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 skilled nursing care.

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 nursing care. 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 skilled nursing care. 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 skilled nursing care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in New Hampshire

Seniors and families looking for ways to pay for long-term care in a nursing home can find referrals and application assistance through any of the organizations listed below. Seniors already residing in nursing homes can find resources through the Office of the Long-Term Care Ombudsman and New Hampshire Legal Assistance.

Resource
Contact
Service

(603) 271-9203

A part of the Department of Health and Human Services (DHHS), the Bureau of Elderly & Adult Services helps senior residents aged 60 and older find local and statewide programs and plan for the future. Case managers can help seniors assess their long-term needs, apply for HCBS waivers and search for local nursing homes, including facilities that accept Medicaid.

(866) 634-9412

ServiceLink acts as the state's designated Aging and Disability Resource Center. Representatives can connect seniors and families to certified Medicare counselors, as well as any of the services provided by the National Family Caregiver Support Program. The website also has a page of caregiver resources from other organizations, such as training opportunities and publications dedicated to caregiving.

(603) 271-4375

Ombudsmen can assist seniors residing in long-term care facilities, including nursing homes, ensuring they receive the appropriate level of care in a respectful manner and comfortable setting. Families and seniors can reach out to ombudsmen for help with filing a complaint against a facility and to learn about their rights as nursing home residents. Ombudsmen are certified by the state and stay up to date on local and federal nursing home regulations.

(888) 353-9944

Administered by the Justice in Aging Project, New Hampshire Legal Assistance can help seniors with civil matters including Social Security issues, disputes with nursing homes, utility shut-off issues, property tax relief, financial exploitation and abusive debt collection. 

(603) 271-9700

In addition to administering programs designed to improve quality of life and promote independence in older adults, the New Hampshire Department of Health and Human Services offers adult protective services and educational resources for disease and injury prevention. The NH EASY Gateway to Services website is the official platform for managing benefits, such as Medicaid and SNAP, and for receiving appointment reminders.

COVID-19 Rules for Nursing Homes in New Hampshire

The following information is based on research done on several government websites, including covid19.nh.gov/resources/long-term-care-facilities. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/10/2022, 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)

Nursing Home Laws and Regulations in New Hampshire

Nursing Home Laws and Regulations in New Hampshire
Licensing
Nursing homes and residential care facilities in New Hampshire are licensed and overseen by the Department of Health and Human Services, Health Facility Licensing Unit.
Staffing
Facilities must maintain sufficient staff to meet residents' needs during all hours of operation. Licensed nursing staff must be on-site 24 hours a day, and an RN must be available for at least eight hours during every 24-hour period.
Staff Training
All personnel, including nurses, clinical staff, administrators and food service employees, must be adequately trained and have demonstrated their ability to perform assigned tasks adequately. Additionally, facilities must conduct annual in-service training to instruct members on the facility's policies and procedures. Certified nursing assistants in New Hampshire must complete at least 100 hours of training through a state-approved program.
Admission Restrictions
Nursing homes may not admit residents under 18 unless the facility has appropriate age- and gender-segregated accommodations.
Care Planning
At the time of admission, nursing homes must obtain orders for medication, treatment, diet and direct care from a licensed practitioner to ensure the residents' health and safety. Individuals must undergo a comprehensive medical exam at least once every 30 days for the first 90 days and once every 60 days thereafter. Additionally, facilities must perform an initial needs assessment within 48 hours and a comprehensive needs assessment within 14 days of admission.
Dietary and Nutrition Services
Nursing homes must provide at least three daily meals to each resident, including therapeutic dietary options if ordered by a qualified medical provider. Facilities must have adequate dining facilities and food supplies, and they must follow record-keeping requirements, such as posting menus in advance and documenting residents' nutritional intake and compliance with special diets.
Specialized Rehabilitative Services
Skilled nursing facilities may provide rehabilitative treatments and therapeutic services as part of a physician-ordered direct-care plan.
Medication and Pharmaceutical Services
Nursing homes must provide all medications, including over-the-counter drugs, as directed by a qualified practitioner. Medications must be provided within 24 hours of the order, and facilities must meet strict standards for dispensing, labeling and tracking residents' medications.
Recreational Activities
Nursing homes must provide on-site or community-based activities that accommodate residents' interests and promote their physical, social and emotional well-being.
Infection Control
Nursing homes must establish a comprehensive infection control program that includes provisions to prevent the spread of diseases, manage residents who have contagious illnesses and monitor the health of employees who provide direct care.
Medicaid Coverage
Medical Assistance, the state's Medicaid program, pays for nursing home care, including room and board. Individuals must meet income and asset limits to qualify, and they must use the majority of their income to pay for nursing home care before benefits become available.