New Hampshire is a popular state for retirees. In fact, 18.7% of its almost 1.4 million residents are aged 65 or older. Seniors pay a premium to live in the state since the overall cost of living is slightly above the U.S. average and assisted living facilities typically charge $6,053 per month. However, for that fee, seniors gain access to top-rated hospitals, such as the Dartmouth-Hitchcock Medical Center and the Concord Hospital. Those on a low income may be able to offset some of their care costs thanks to the state’s Choices for Independence Waiver. This can make assisted living in New Hampshire more affordable.

The following guide looks at the cost of assisted living in New Hampshire and surrounding states. It also briefly examines the costs of other types of senior care, and it provides a list of financial support options and organizations that offer other practical help for older adults.

How Much Does Assisted Living Cost in New Hampshire?

The 2021 Genworth Cost of Care Survey lists the average cost of assisted living in New Hampshire as $6,053 per month. This is $1,553 more than the national average, and it’s also more costly than the fees charged by facilities in nearby Maine ($5,865) and Vermont ($5,250). Seniors in neighboring Massachusetts, however, pay even more with the typical facility charging $6,500 per month for assisted living.

The Cost of Assisted Living in New Hampshire’s Top Cities

The fees charged by assisted living facilities vary depending on location. In Manchester, seniors pay far more than the state average. Assisted living facilities in this metropolitan area typically charge $8,061 per month. Just over the state border in Portland, Maine, facilities typically charge $6,525 per month. Some of the most affordable facilities can be found to the south in Worcester, Massachusetts, where average fees are $5,685 per month. Larger cities are more costly, however, as reflected by the prices in nearby Boston ($6,819).

The Cost of Assisted Living vs. Other Types of Care

Some seniors may feel more comfortable living in their own homes, while others may require more care than an assisted living facility can provide. Adult day health care services delivered in a group setting are the most affordable option for seniors who are generally mobile and healthy. This type of care costs an average of $1,842 per month. Homemaker services, such as housekeeping and general personal care, cost $6,006. Home health care providers offer similar services plus basic health care for an additional $191 per month. Seniors who require 24-hour skilled nursing and supervision can expect to pay $10,950 for a semiprivate room in a New Hampshire nursing home.

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

Medicaid in New Hampshire does not cover the cost of assisted living directly. However, the Choices for Independence Waiver covers part of the cost of assisted living for seniors who would otherwise require nursing home care. The waiver supports low-income seniors to help them remain in the community, either by receiving personal care services in their own homes or in an assisted living setting.

Medicaid’s Coverage of Assisted Living in New Hampshire

New Hampshire’s Choices for Independence Waiver covers the cost of some assisted living services. The waiver cannot be used for room and board, but it covers many supports, such as meals, personal care, medication reminders and certain assistive therapies. The waiver is aimed at seniors who would otherwise require nursing home placement and aims to help them receive the care that they need in a more affordable community setting where they can retain their independence.

Waiver Programs for Assisted Living in New Hampshire

Choices for Independence Waiver

The Choices for Independence Waiver is a Home- and Community-Based Services waiver aimed at low-income individuals who require a nursing home level of care. The waiver helps these individuals avoid moving to a nursing home facility and gives them the opportunity to remain in their own homes or an assisted living facility. Seniors can receive support with personal care and medical services provided at an assisted living facility. The waiver does not cover the cost of room and board because this is not considered a medical service.

To be eligible for the waiver, seniors must be assessed as having a clinical need for care, and they must also meet residency requirements and income/asset limits. There’s a spend-down option for those whose assets exceed the Medicaid limit. Seniors can apply for the Choices for Independence Waiver online or by calling (866) 634-9412.

Eligibility for Medicaid in New Hampshire

The income and asset thresholds for institutional Medicaid and home- and community-based services in New Hampshire depend on whether the applicant is single or part of a household. The income limits are $30,276 for an individual applicant or $30,276 each for a couple applying together. Asset limits are $2,500 for one person or $2,500 each if both people in a two-person household are applying. If only one member of a household is applying, community asset protections allow the nonapplicant to hold $137,400 in assets.

2022 Medicaid Income Limits for Seniors in Florida

	Income Limits*	Asset Limits
Single Applicant	$30,276	$2,500
Two-Person Household (Only One Person Applying)	$30,276 for applicant	$2,500 for applicant $137,400 for nonapplicant
Two-Person Household (Both People Applying)	$60,552 ($30,276 per applicant)	$5,000 ($2,500 per spouse)

*per year

In addition to the financial requirements, seniors must also meet age, residency and medical criteria to claim Medicaid. Those requirements include:

• Being aged 65 or over
• U.S. citizenship and New Hampshire residency
• Requiring a nursing home level of care

Applying for Medicaid in New Hampshire

Seniors can apply for Medicaid using the NH Easy online portal. Alternatively, they can download an application form and fax the completed form to (603) 271-8604. Medicaid applications can also be made via the telephone at (800) 852-3345, ext. 9700.

Before You Apply

As a part of the application process, seniors will be asked to provide evidence of their age, citizenship, residency and income. It may be beneficial to have the following documents on hand:

• Passport/birth certificate
• Utility bills or other proof of address
• Bank statements
• Proof of Social Security or VA benefits
• Proof of any relevant medical conditions
• Property deeds/car titles and evidence of any other investments or assets

Where to Go to Get Help

The following websites and organizations provide advice and information about Medicaid in New Hampshire. Seniors can visit these websites to find answers to common Medicaid questions, application information or helplines to contact for more personalized advice.

Resource	Contact	Service
Department of Health and Human Services	(800) 852-3345	The Department of Health and Human Services oversees the Medicaid program in New Hampshire and offers a useful page of information for would-be applicants, including downloadable copies of the application form in English and Spanish, along with helplines and useful contacts for those who require help with the application process.
Benefits.gov	(844) 872-4681	The Benefits.gov website is a federal website that offers a huge database of information about the benefits and support programs available in each state. The New Hampshire Medicaid page offers a clear summary of the eligibility criteria for the program, along with what it covers and how to apply. It also provides a list of useful local contact details for those who require personalized advice.
NH Easy	(844) 275-3447	The NH Easy portal allows seniors to apply for Medicaid online and manage their claims once they’re signed up for the program. It also offers information about health plans, and it has a quick and easy eligibility checker. Seniors can call the NH Easy helpline for more information or support with the application process.

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

Unfortunately, Medicare does not cover the cost of assisted living in New Hampshire. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about Medicare visit medicare.gov.

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

	How to Apply	How It Works
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 and Low-Cost Resources for Seniors in New Hampshire

Seniors living in New Hampshire may find the following resources useful. These local government organizations and nonprofits offer practical help for older adults, including health and wellness programs, assistance with benefits applications and support when dealing with long-term care providers.

Resource	Contact	Service
ServiceLink Aging and Disability Resource Center	(866) 634-9412	The ServiceLink Aging and Disability Resource Center provides New Hampshire’s older adults with a list of service providers and resources in their local areas. The center has offices across the state to help seniors connect to organizations close to them for transportation, benefits assistance, wellness programs and other services.
Department of Military Affairs and Veterans Services	(603) 225-1200	The Department of Military Affairs and Veterans Services assists veterans and their relatives with accessing the benefits and services they’re entitled to receive under state and federal regulations. It supports veterans with applications and appeals for VA pensions and benefits and helps with health care, long-term care and housing-related issues.
Office of the Long Term Care Ombudsman	(603) 271-4375	The Office of the Long-Term Care Ombudsman serves New Hampshire’s long-term care residents and their families. It investigates complaints or reports of possible elder abuse or neglect and advocates for families to ensure that residents are receiving the highest standard of care. Volunteer ombudsmen serve as a contact point for seniors or family members to raise issues, and they work with the facility to resolve complaints.
New Hampshire Legal Aid	(800) 639-5290	New Hampshire Legal Aid provides online resources, legal advice and pro bono assistance to low-income or vulnerable individuals. It offers a variety of legal services to seniors, including help with benefits appeals, probate, estate planning or family law issues.
Social Security Offices	See Directory for Nearest Office	New Hampshire has several Social Security offices. Seniors can use the online directory to find the nearest location. These offices help local residents apply for benefits, such as Supplemental Security Income and Social Security Disability Insurance. Seniors can also contact the office to request benefits letters and documentation that’s needed to process their application for Medicaid or other programs.

COVID-19 Rules for Assisted Living in New Hampshire

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)

Assisted Living Laws and Regulations in New Hampshire

Assisted living facilities in New Hampshire are divided into two categories: Residential care facilities, which provide minimal supervision and basic support with the activities of daily living, and supported residential health care facilities that are licensed to provide short-term medical care. These facilities are regulated by the Department of Health and Human Services, and must pass regular inspections.