How to Pay for Assisted Living in New Hampshire (2026 Guide)

Emergency help now

• If a move, eviction, or discharge is happening right now: call ServiceLink at 1-866-634-9412 and say it is urgent.
• If the person already lives in assisted living or residential care and the facility is pressuring you: call the New Hampshire Long-Term Care Ombudsman at 1-800-442-5640.
• If there is abuse, neglect, or an unsafe situation: call 911 or Elder Abuse and Neglect at 1-800-949-0470.
• If the crisis also involves housing, food, or utilities: call NH 211 at 1-866-444-4211.

Quick help if you need the fastest realistic starting point

In New Hampshire, families lose time when they start with the wrong office. Use the first row that fits best.

One New Hampshire detail matters a lot: families often say “assisted living,” but the paperwork may say residential care facility or supported residential care facility. Before you sign anything, ask the residence two direct questions: “Do you take CFI?” and “What would still be owed each month for room and board and extra care?”

Best first places to start in New Hampshire for paying for assisted living

• ServiceLink / Aging and Disability Resource Center: this is usually the best first call for older adults who may need Medicaid long-term care, options counseling, or help with paperwork. The state’s CFI case management information sheet tells applicants to start with ServiceLink at 1-866-634-9412.
• NH EASY and the New Hampshire Department of Health and Human Services (DHHS): file the application right away through NH EASY or the DHHS application page. You can still ask ServiceLink to help you do it.
• The residence itself: ask for the full rate sheet, care-level charges, medication charges, community fees, and what the resident would owe if CFI starts later than expected.
• VA-accredited help: if the older adult is a wartime veteran or surviving spouse, start a pension/Aid & Attendance review at the same time as the state process. Do not wait for one before starting the other.

If you want local aging contacts first, our Area Agencies on Aging in New Hampshire page can help you find the closest office. For assisted-living payment questions, ServiceLink is usually the better first stop.

How assisted living is usually paid for in New Hampshire

Medicaid in New Hampshire: the main public program for care, not rent

In New Hampshire, the Medicaid path families usually mean is Choices for Independence (CFI). It is a home and community-based services waiver for adults age 18 and older who are financially eligible and meet nursing-facility level of care.

The state’s current CFI waiver description says the program can cover personal care, homemaker services, meals, adult day services, transportation, adult family care, supported housing, and residential care facility services.

What that means in plain English: CFI can help pay for the care side of assisted living or residential care if the setting is the right kind of licensed place and actually participates. It is not a simple rent voucher. Most families still need another source for room and board.

What Medicaid may pay for in an assisted-living-type setting

• Hands-on help with bathing, dressing, toileting, eating, and mobility
• Medication help and supervision tied to the care plan
• Homemaker and personal care services
• Case management and care planning
• Some nursing and therapy-related supports arranged through the program

What Medicaid usually does not solve

• The basic monthly housing charge
• Move-in fees and most everyday living costs
• Salon, cable, guest meals, or similar add-ons
• A guarantee that your first-choice residence accepts CFI

New Hampshire families also need to know that the state uses both the general term assisted living residence and the licensing terms residential care facility and supported residential care facility. The CFI rules specifically cover residential care facility services in facilities licensed under He-P 804 or He-P 805, which is why it is so important to ask the building about its license and Medicaid participation before move-in.

Time reality: the state’s current CFI case-management sheet says processing can take up to 45 days after the application and supporting documents are submitted. That is why the fastest realistic move is to start the Medicaid application and the ServiceLink call together.

Do not assume you are over assets without checking: DHHS says its January 1, 2024 long-term-services changes added a resource disregard of up to $6,000 for some regular waiver applicants and up to $5,000 for some medically needy applicants. In real life, that means some people who once looked over the line can now qualify.

Over income is not always the end: New Hampshire raised its medically needy income level to $939 a month for one person and $1,093 for two, effective 1 July 2025. If income is a little high, ask ServiceLink or DHHS to check both the regular and medically needy/spenddown routes.

Important warning: do not give away money, add someone to the deed, or move assets to relatives just to “get on Medicaid.” DHHS says its long-term-care review may start with 36 months of transfer review, but workers can still ask for up to 60 months of records when needed.

State supplement and cash help toward living costs

The other big New Hampshire piece is the State Supplement Program (SSP), which includes Old Age Assistance (OAA), Aid to the Permanently and Totally Disabled (APTD), and Aid to the Needy Blind (ANB). This is not the same as CFI. It is a cash-and/or medical assistance program for people who meet age or disability rules and have very limited income and assets.

For assisted-living families, SSP matters because it can help with the part of the bill that feels most like room and board. In its latest public BFA fact sheet, updated October 2024, DHHS says group living arrangements have higher income limits than ordinary living arrangements. The state plan also lists a 2025 Residential Care income standard of $1,161 for one person and $2,322 for a couple, compared with an Independent Living standard of $981 for one person.

But be careful: that does not mean SSP pays the whole assisted-living bill. It means the program is worth checking when a senior is in, or moving into, a qualifying residential care setting and needs cash help on top of CFI, Social Security, or SSI-level income. New Hampshire does not have a separate broad statewide assisted-living voucher beyond these existing routes.

The same DHHS fact sheet says the resource limit for OAA, APTD, and ANB is $1,500. If a parent looks close, do not guess. Ask DHHS or ServiceLink to screen for SSP while the Medicaid review is moving.

Veterans and surviving spouses

If the older adult is a wartime veteran or a surviving spouse of one, VA pension with Aid & Attendance can be one of the few benefits that sends cash that may be used toward assisted living.

• Good fit: the person needs help with daily activities, has wartime service history, and has limited income and net worth.
• Not a fast emergency fix: VA decisions can take time, and Aid & Attendance is not paid unless the person also qualifies for pension.
• Surviving spouses matter too: VA publishes current Survivors Pension rates, and rate tables for veterans are explained in the current VA pension rate tables.

Use accredited help only: the VA warns families about “pension poaching” and other scams. Be very cautious if someone wants a fee up front, promises approval, or tells you to hide assets in a trust or annuity. If you apply, VA says most people will need medical evidence and often VA Form 21-2680. Nursing-home residents may also need VA Form 21-0779.

PACE in New Hampshire: real, but not the answer for most assisted-living bills

New Hampshire does have a Program of All-Inclusive Care for the Elderly (PACE), but it is not a statewide assisted-living rent program. PACE is a local model that wraps medical care, therapies, transportation, and long-term care supports around eligible older adults in its service area.

When PACE is worth checking: the senior is trying to stay in the community, already uses a lot of medical and long-term care services, and lives in the local PACE service area. When it is not enough: you need a simple statewide payment source for assisted-living room and board. If PACE sounds possible, ask the program directly whether your town is in the service area and whether your housing plan fits how they deliver care.

Private-pay gap strategies for families who are above Medicaid or waiting on an answer

If the older adult is not approved yet, or is just above the limits, focus on keeping options open instead of making irreversible money moves.

• Use existing monthly income first: Social Security, pension, SSI, and VA cash benefits usually go toward the room-and-board side first.
• Read long-term care insurance carefully: check whether the policy covers assisted living, what the elimination period is, and whether the residence must meet a certain licensing standard.
• Ask the residence about a written private-pay bridge: some communities will hold a spot or accept a short private-pay period while CFI or VA is pending. Get the terms in writing.
• Cut optional charges: ask what fees are truly required and whether a smaller room or lower service package is safe and realistic.
• If a home sale is the plan, map the timing before move-in: do not count on money that is not liquid yet.

What not to do: hide money, gift money to children, buy complicated products you do not understand, or sign a contract before you know the monthly gap.

How to start without wasting time

1. Get the real monthly number: ask the residence for the base rate, care-level charge, medication fee, move-in fee, and what would still be owed if CFI starts later.
2. Call ServiceLink the same day: say you need screening for CFI, SSP, and any other long-term-care help that fits.
3. File the Medicaid application right away: use NH EASY or file through DHHS. Do not wait until savings are almost gone.
4. Ask specifically about over-limit rules: if income or assets are a little high, ask about medically needy/spenddown, the resource disregard, and married-spouse rules.
5. Start the VA track in parallel if it applies: do not wait on the VA before starting the state process.
6. Keep copies of everything: missing documents are one of the biggest reasons cases stall.

Document checklist

• Photo ID, Social Security number, Medicare card, and health insurance cards
• Social Security, pension, annuity, VA, and other income proof
• Bank statements and investment records
• Deeds, mortgage statements, burial contracts, life insurance, trust papers, and annuity contracts
• Records of gifts, transfers, or property changes for at least 36 months, with the understanding that DHHS can ask for up to 60 months
• The assisted living or residential care contract, rate sheet, and move-in charges
• Doctor notes, hospital discharge papers, medication list, and proof of daily care needs
• Marriage certificate, spouse information, and power of attorney or guardianship papers if relevant
• Military discharge papers such as DD-214 for veterans benefits

Reality checks in New Hampshire

• CFI is not instant: the state says it can take up to 45 days after the application and supporting documents are in.
• Not every residence participates: a building may be licensed as assisted living but still not take CFI residents, may limit them, or may have no openings that fit the resident payment level.
• The biggest gap is still room and board: even when Medicaid helps with care, families often still need SSP, VA money, SSI income, or private funds for the housing portion.
• Provider supply varies by area: the state says case managers are assigned by preference or by provider availability, so rural areas can look very different from southern New Hampshire.
• The fast-track HCBS presumptive-eligibility plan is not live yet: as of 17 April 2026, CMS still lists New Hampshire’s PE for HCBS amendment request as pending.

Common mistakes to avoid

• Assuming Medicare will pay the assisted living bill
• Choosing a residence before confirming whether it accepts CFI or state-supplement residents
• Focusing only on Medicaid and forgetting SSP or VA cash benefits
• Giving away money or changing title to property to try to qualify faster
• Not asking for the full fee sheet in writing
• Missing document checklists or deadlines from DHHS
• Using a non-accredited VA claim company
• Waiting until the crisis week to ask for help

What to do if denied, delayed, or overwhelmed

If DHHS says no, or the process stalls, ask for the reason in writing. Do not rely on a phone summary alone. The written notice should tell you how to appeal and the deadline. If the problem is access to CFI services or disability-related barriers, you can contact the Disability Rights Center – New Hampshire. If the person is already in assisted living or residential care and there is a dispute over discharge, billing, or resident rights, call the New Hampshire Long-Term Care Ombudsman at 1-800-442-5640.

Phone script: ServiceLink

“I’m calling about paying for assisted living in New Hampshire. The person is age ___, lives in ___, and needs help with ___ every day. We think they may need CFI, SSP, or both. What should we file first, and what documents do you want right now?”

Phone script: assisted living billing office

“If my parent gets CFI or State Supplement, exactly what monthly amount would still be owed here? Do you accept residents using those programs, and do you have any limits on availability?”

Phone script: VA or accredited representative

“We need to know if this veteran or surviving spouse may qualify for pension with Aid & Attendance for assisted living costs. What service record, medical form, and income documents do you want first?”

Backup options if assisted living is still not affordable

• CFI at home instead of assisted living: for many New Hampshire families, home-based CFI services are the more realistic answer.
• Adult family care: CFI also covers adult family care, which can cost less than a larger assisted living residence.
• Subsidized housing plus home care: if the main problem is rent, our New Hampshire housing help page may help you combine affordable housing with community-based care.
• Short-term gap help: our New Hampshire grants guide can help you find utility, food, and other support that keeps the rest of the budget from collapsing while you wait.
• Long-term care insurance: if a policy exists, check whether it covers assisted living, what the waiting period is, and what daily or monthly cap applies.
• Nursing facility Medicaid: if care needs are too high for assisted living and the money is gone, a nursing facility may be the safer and more financially realistic Medicaid path.

Resumen breve en español

En New Hampshire, normalmente no existe un solo programa que pague toda la factura de assisted living. La ayuda pública principal es Choices for Independence (CFI), que puede pagar servicios de cuidado, pero por lo general no paga la parte de room and board. Muchas familias necesitan combinar CFI con el State Supplement Program, beneficios de VA Aid & Attendance si aplica, y dinero privado. El mejor primer paso suele ser llamar a ServiceLink y presentar la solicitud de Medicaid al mismo tiempo. Si una residencia no acepta CFI o sigue siendo demasiado cara, pida una revisión de opciones como cuidado en casa con CFI, adult family care, o vivienda subsidiada.

FAQ

Does Medicaid pay for assisted living in New Hampshire?

Sometimes. The main path is CFI, which can pay for care services in certain licensed residential settings if the person meets both financial and clinical rules. It does not usually erase the whole monthly bill.

Does New Hampshire Medicaid pay room and board in assisted living?

Usually no. That is the biggest gap. Families often need SSP, VA cash benefits, SSI income, or private funds for the housing portion.

What is the fastest first call in New Hampshire?

For most families, it is ServiceLink at 1-866-634-9412. Start that call and the Medicaid application in the same week.

Can a veteran or surviving spouse use Aid & Attendance for assisted living?

Yes, if the person qualifies for VA pension and meets the medical-need rules. It is cash assistance, so it can help with assisted living costs, but approval is not automatic or fast.

What if my parent is a little over income or assets?

Do not assume the answer is no. Ask about medically needy or spenddown rules, the 2024 resource-disregard changes, and married-spouse rules before giving up.

What if no local assisted living residence will take CFI?

Ask ServiceLink about home-based CFI services, adult family care, PACE if local, or whether nursing facility Medicaid is the safer backup if care needs are high.

About This Guide

This guide uses official federal, state, and other high-trust nonprofit and community sources mentioned in the article.

Editorial note: This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.

Verification: Last verified 17 April 2026, next review 17 August 2026.

Corrections: Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we will respond within 72 hours.

Disclaimer: This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, and availability can change. Readers should confirm current details directly with the official program before acting.