As of July 2019, New Hampshire had just under 1.36 million residents, according to the U.S. Census Bureau. Approximately 18.1% of these residents were aged 65 and older. Although the total population of New Hampshire is expected to decline over the next 20 years, officials project that seniors will make up nearly 26% of the state’s population by 2040. The Granite State regularly ranks as one of the top states for older adults because it has the lowest percentage of seniors living below the poverty line. Seniors living in New Hampshire don’t pay state tax on their retirement benefits or monthly Social Security payments, making it an excellent place to retire.

Due to its location in New England, New Hampshire has a relatively high cost of living. As a result, seniors can expect to pay higher costs for care than seniors across the country. As an example, assisted living in New Hampshire costs an average of $7,021 per month, which is nearly $3,000 per month more than the national average.

This guide provides information about the different types of senior care available in New Hampshire, a look at the average costs of care and information about programs available to help seniors cover the costs of senior living in the state.

The Cost of Senior Living in New Hampshire

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

New Hampshire seniors have several options for residential care, depending on their budget and medical needs. Independent living communities, which often have on-site restaurants and other amenities, may appeal to active seniors who want a low-maintenance lifestyle but don’t require daily care. Older adults who need help completing everyday activities may be better suited to assisted living, where trained staff are available around the clock. Some assisted living facilities also provide memory care in secure wings designed to accommodate individuals living with dementia. Seniors who need a higher level of care may be ideal candidates for skilled nursing homes. Some communities also offer a continuum of care, which lets seniors age in place as their care requirements change.

According to data obtained through the Genworth 2021 Cost of Care Survey, senior care expenses in New Hampshire are well above the national average. Because independent living communities rarely offer formal care services, they’re often the least expensive option, and New Hampshire seniors can expect to pay about $3,934 per month. For assisted living, costs are about $6,053 monthly to compensate for daily care services, while memory care averages around $7,566. Nursing homes, which provide around-the-clock services, are the costliest option at $10,950.

The Cost of Assisted Living in New Hampshire

Assisted living in New Hampshire costs about $6,053 per month, which is more than $1,500 higher than the national median of $4,500. Similar care services in neighboring Vermont and Maine are slightly less expensive at about $5,250 and $5,865, respectively. However, to the south, Massachusetts assisted living costs are much higher, averaging about $6,500.

The Cost of Nursing Home Care in New Hampshire

New Hampshire seniors who need nursing home care can expect to pay about $10,950 monthly, which is almost $3,000 more than the national median of $7,908. In nearby Vermont, individuals seeking a similar level of care pay about $10,585. In Maine, the cost is slightly lower at $10,494, while Massachusetts seniors have much higher costs, at about $12,623 each month.

Can You Use Medicaid to Pay for Senior Living in New Hampshire?

Residential care options can be costly, and New Hampshire seniors who require long-term care may need help paying for essential services. The state’s Medicaid program, which is commonly referred to as Medical Assistance, helps adults aged 65 and over cover the costs of nursing homes, assisted living programs and other residential care facilities. To qualify, seniors must meet stringent financial and medical guidelines defined by the state.

Depending on the type of care they require, New Hampshire seniors may qualify for one of Medicaid’s long-term care programs. Institutional/nursing home Medicaid, which pays for the cost of a skilled nursing facility, is available to older adults who meet the state’s income guidelines and require a nursing home level of care. Alternatively, individuals who are better suited to assisted living may apply for Medicaid’s Choices for Independence program, which covers a percentage of these care costs.

Because Medicaid is designed to provide medical coverage for low-income Americans, it doesn’t offer financial assistance for independent living. These communities are intended for active older adults who don’t require care services, so the cost of residency isn’t considered a medical expense.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Waiver	No
Independent Living	None	N/A	N/A
Memory Care	Partial	Waiver	No
Nursing Home Care	Full	Institutional/nursing home Medicaid	Yes

 *Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list.  

Medicaid’s Coverage of Assisted Living & Memory Care in New Hampshire

Qualifying seniors can get help paying for assisted living and memory care through New Hampshire Medicaid. Coverage for these residential services is provided through a waiver program, which is designed to help state seniors delay placement in a nursing home.

Choices for Independence Program

New Hampshire’s Choices for Independence program enables eligible seniors to receive services and support in an assisted living or memory care facility rather than through a nursing home. However, the cost of services and support may not exceed the Medicaid-approved amount, which typically represents a percentage of the costs of similar care, if provided in a skilled nursing facility. Covered services may include:

• Medical supplies
• Medical day services
• Assistive equipment designed to promote independence
• Assistance with activities of daily living, including eating, bathing and other personal care tasks

To qualify for coverage through the CFI waiver, applicants must be 18 or older and Medicaid eligible. Financial guidelines vary depending on the size of the household, and a clinical assessment is required to evaluate an applicant’s ability to perform daily care tasks, to determine if a nursing home level of care is necessary.

For additional eligibility requirements or to apply for the CFI program, interested seniors should contact their local ServiceLink Aging and Disability Resource Center. 

Medicaid’s Coverage of Nursing Home care in New Hampshire

New Hampshire Medicaid covers the cost of nursing home care for older adults who are financially and medically eligible, according to the program’s long-term services guidelines. To evaluate medical eligibility, Medicaid requires an in-person assessment, which is conducted by a registered nurse. Appropriate care options are typically also determined at this time.

Individuals receiving nursing home care through Medicaid must use their income to offset the cost of care, with Medicaid paying the balance due. However, individuals are typically allotted $74 monthly for personal expenses, and an additional allowance may be approved to cover the needs of a spouse or dependent.

Eligibility for Medicaid in New Hampshire

Because Medicaid provides health care coverage to low-income New Hampshire residents, eligibility guidelines include strict income requirements. To qualify for the program, a single senior must make no more than $855 per month before taxes and have less than $1,500 in assets. Two-person households, regardless of whether one or both spouses are applying, must make less than $1,262 monthly and have less than $1,500 in assets. 

All income an applicant receives is counted, including wages, veteran benefits and SSI payments. Countable assets may include cash, bank accounts, investments and real estate. However, an applicant’s primary home and personal belongings, including their car, are exempt.

2022 New Hampshire Medicaid Income Limits

	Income Limits*	Asset Limits
Single Person	$10,260	$1,500
Two-Person Household (Only one applicant)	$15,144	$1,500 for applicant
Two-Person Household (Two applicants)	$15,144	$1,500

* Per year

New Hampshire Medicaid has several additional eligibility guidelines that must be met before an applicant may be approved. To qualify for coverage, individuals must be:

• A U.S. citizen, national, legal alien or permanent resident
• A New Hampshire resident
• At least 65 years old (younger individuals who are blind, disabled or pregnant may also qualify)
• In need of medical insurance

Applying for Medicaid in New Hampshire

To apply for Medicaid, including long-term services, state seniors may apply online at NHEasy or in person at a local branch of the New Hampshire Department of Health and Human Services. Applications may also be submitted by mail to any DHHS office or by faxing the completed paperwork to (603) 271-8604. Eligible seniors may also apply for benefits over the phone by calling the DHHS at (800) 852-3345 ext. 9700.

Before You Apply

To reduce processing delays, it may be helpful to review Medicaid eligibility guidelines prior to applying for coverage. Potential applicants can also streamline the application process by gathering supportive documentation, including:

• Proof of name, date of birth and address
• Documentation of income
• Recent statements from checking, savings and investment accounts
• Information about any current or expiring medical insurance

How to Get Help

The Medicaid application process can be complex, but resources are available for applicants who need help. Seniors who have questions about eligibility requirements or supporting documentation, or who need help applying, should reach out to one of the following agencies:

	Contact	What You Should Know
Bureau of Elderly and Adult Services	(603) 271-9203	BEAS staff can provide information and support for seniors who are looking into or applying for Medicaid benefits. Seniors in need of long-term care may find additional resources through the agency.
Office of the Long-Term Care Ombudsman	(603) 271-4375	New Hampshire’s long-term care ombudsman provides advocacy for seniors in long-term care facilities and can help connect individuals to appropriate community resources.
American Council on Aging	Contact form	The American Council on Aging maintains a comprehensive database of information on Medicaid, including eligibility and application information for benefits in New Hampshire. Representatives can help applicants find local resources that can help them navigate the application process.

Can You Use Medicare to Pay for Senior Living in New Hampshire?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

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

What Nursing Home Care Services Aren’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.

Medicare Support & Resources in New Hampshire

Choosing the right medical benefits package is crucial, particularly for seniors who are exploring long-term care options. New Hampshire residents who qualify for Medicare may have questions about their available coverage options. The following table lists national and local resources that can help state seniors and their caregivers understand the complexities of Medicare.

Resource	Contact	What You Should Know
New Hampshire Insurance Department	(603) 271-2261	The New Hampshire Insurance Department maintains a database of links and resources designed to help seniors navigate Medicare, Medicare Advantage and long-term care. The department is also responsible for protecting state seniors against health insurance-related fraud.
ServiceLink Aging & Disability Resource Center	(866) 634-9412	Specialists at ServiceLink are certified through the State Health Insurance Assistance Program and can provide health care counseling for seniors, including an overview of available Original Medicare and Medicare Advantage programs. Every county in New Hampshire has one of these centers, which have lending libraries of Medicare-related materials and other useful senior resources.
Medicare.gov	(800) 633-4227	Medicare.gov is the official source for up-to-date information on eligibility requirements, benefits, copays, deductibles and annual enrollment periods for Original Medicare. The site also provides comprehensive information about Part D prescription plans, Medicare Advantage and Medicare supplement insurance.

Are There Other Financial Assistance Options for Senior Living in New Hampshire?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in New Hampshire. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in New Hampshire

Regardless of their income level or care requirements, older adults may need help finding the resources that can help them maintain a high quality of life throughout their golden years. Organizations throughout New Hampshire have staff available to provide counseling and assistance in areas such as insurance, elder law and health care. The following table lists resources that are available to seniors residing in New Hampshire.

	Contact	What You Should Know
New Hampshire Legal Assistance	(888) 353-9944	The NHLA’s Justice in Aging project provides legal advice and representation to economically needy seniors with civil issues such as financial exploitation, health care access and residential care disputes. The program can accommodate housebound or institutionalized individuals.
Home Care, Hospice & Palliative Care Alliance of New Hampshire	(800) 639-1949	The alliance provides education and advocacy for seniors and their families, helping them find reputable local home care, hospice and palliative care providers.
AARP New  Hampshire	(866) 542-8168	AARP New Hampshire helps Granite State residents aged 50 and over keep up-to-date on state news and legislation that may impact their medical benefits and long-term care services. The organization hosts in-person and virtual events year-round, including exercise classes and wellness seminars. Its membership benefits include travel and recreation discounts, financial planning services and a subscription to AARP: The Magazine.
Alzheimer’s Association: Massachusetts/New Hampshire Chapter	(800) 272-3900	The Alzheimer’s Association’s Massachusetts/New Hampshire Chapter offers supportive services for individuals living with dementia and their caregivers. The organization offers care consultations, which are designed to help individuals and families navigate the challenges associated with the disease. Statewide support groups are also available for individuals diagnosed with dementia and their caregivers, including Spanish-language groups.
New Hampshire State Office of Veterans Services	(603) 624-9230	New Hampshire’s Division of Veterans Services helps veterans and their spouses get the benefits they’re entitled to through the state or VA. Veterans may schedule a benefit review consultation or find out information about state and federal laws.
New Hampshire Coalition Against Domestic and Sexual Violence	(866) 644-3574	The coalition sponsors 12 crisis centers throughout New Hampshire, with programs that support victims and survivors of domestic violence, including elder abuse. Services are free and confidential and can help affected individuals find services, support groups, legal referrals and medical care.

COVID-19 Rules and Restrictions for New Hampshire Senior Living Facilities

The following information is based on research done on several government websites, including covid19.nh.gov and cms.gov. These rules apply to nursing homes 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in New Hampshire

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

The Bureau of Health Facilities Administration is charged with regulating senior living facilities in New Hampshire. Every senior living facility in the state must have a valid license to operate. If this license lapses, or if a facility is found to be in violation of any laws or regulations, the Bureau may impose administrative remedies. Senior living facilities must follow all of the laws outlined in the New Hampshire Code of Administrative Rules.

Staffing Requirements

The Bureau of Health Facilities Administration will deny an senior living facility’s request for a license if the facility administrator has been convicted of a felony in any state, if the administrator has been convicted of a violent crime or if the administrator is believed to pose some type of threat to the residents’ safety and well-being.

Senior living facilities are also prohibited from employing staff members convicted of certain crimes, including fraud, abuse, exploitation and neglect. In limited circumstances, the Department of Health and Human Services may issue a waiver permitting a person convicted of one of these offenses to work in a senior living facility. This waiver is permanent unless the DHHS sets a time limit on it.

Training Requirements

All staff members must receive annual training covering residents’ rights, facility-specific procedures for preventing infections, the facility’s written emergency plan and the requirements for reporting suspected abuse, neglect or exploitation. Staff members who aren’t licensed health care providers must complete four hours of training before assisting with medication management. This training must cover documentation requirements, proper handwashing techniques, medication precautions, medication categories and making sure each resident receives the right dosage of the correct medication at the right time.

Abuse and Neglect Reporting

Any staff member who suspects that a resident is being abused, neglected or exploited must make an immediate oral report to the Bureau of Elderly and Adult Services. Reports can be made by calling 1-603-271-7014 or 1-800-949-0470 anywhere within the state of New Hampshire. This oral report must be followed by a written report describing the incident in detail. If the BEAS is closed, the oral report must be made to the local police department or sheriff’s office. After receiving a report, the BEAS commissioner will start an investigation within 72 hours.

Frequently Asked Questions

How much does assisted living cost in New Hampshire?

In New Hampshire, seniors can expect to pay an average of $7,021 per month for assisted living. Costs are higher in Manchester and Nashua than in Lewiston and Bartlett.

Are there financial assistance programs for assisted living in New Hampshire?

Yes. Several programs may help New Hampshire seniors cover the costs of assisted living. New Hampshire Medicaid has a special program known as the Home and Community Based Care Choices for Independence Medicaid waiver. This waiver is available to seniors who are eligible for Medicaid and require a nursing facility level of care. Applicants must meet certain eligibility requirements related to their income and assets.

New Hampshire also offers the Old Age Assistance Program, which provides cash assistance to seniors with no more than $1,500 in countable resources who meet certain income guidelines. The cash payments may be used to pay for room and board or personal services provided by an assisted living facility.

What types of care are provided by assisted living facilities?

Assisted living facilities don’t provide medical care, but they may provide assistance with some activities of daily living. Many facilities also offer medication management services, such as reminding residents to take their medicine or request prescription refills.

What types of services are available in assisted living?

Assisted living facilities typically provide three meals per day, housekeeping services, laundry services and help with activities, such as dressing and bathing. Most facilities also organize social activities for residents.

Who should consider assisted living?

Seniors who are in stable health but need a little help with activities of daily living should consider assisted living. At an assisted living facility, seniors typically have a great deal of freedom when it comes to decorating their living spaces and engaging in social and recreational opportunities. For many seniors, assisted living provides the right balance of independence and help with personal care.

Learn More About Senior Living in New Hampshire

For more information about specific types of senior living in New Hampshire read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in New Hampshire

Learn more about the cost of senior living in the top New Hampshire cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.