Written & Reviewed by
Last updated: 19 September 2026
New Hampshire families often need more than one source of help to afford assisted living. Medicaid may help with approved care services, while room and board often need a separate plan. This guide shows the main payment paths, what changed in 2026, and what to ask before signing a residence agreement.
Bottom Line
New Hampshire does not have one program that automatically pays the full assisted living bill. The main public paths are Medicaid Choices for Independence (CFI) for approved care services, the State Supplement Program for some low-income residents, and VA pension with Aid and Attendance for eligible veterans or surviving spouses. CFI generally excludes ordinary room and board. For many families, the best first step is to call the state Aging and Disability Resource Center, still widely known as ServiceLink, at 1-866-634-9412 and ask for a CFI and State Supplement screening.
Urgent Help
- Unsafe discharge or move today: call the ADRC ServiceLink page at 1-866-634-9412. If a hospital or nursing facility says the person cannot safely leave without services, ask whether presumptive eligibility for home- and community-based care could apply.
- Resident-rights, billing, care, or discharge problem: contact the Long-Term Care Ombudsman rules office at 1-800-442-5640 or 603-271-4375.
- Abuse, neglect, or exploitation: call 911 for immediate danger. Otherwise contact Adult Protective Services at 603-271-7014, or 1-800-949-0470 from within New Hampshire.
- Food, shelter, utilities, or another crisis: call 211 New Hampshire at 2-1-1 or 1-866-444-4211.
For more crisis routes, use our New Hampshire emergency guide while the long-term care application is moving.
Start Here
- Get the full monthly price in writing. Ask for the base rate, care-level charge, medication charge, move-in fee, and every optional fee.
- Call ServiceLink the same week. Ask for screening for CFI, State Supplement, caregiver support, and other long-term care choices.
- Do not self-deny over income or savings. New Hampshire has different Medicaid income pathways, a current CFI resource disregard for single applicants, and special rules for married applicants. Let DHHS calculate the case.
Quick Help by Situation
| Situation | Start here | Ask first |
|---|---|---|
| Low-income older adult needs daily care | ServiceLink and NH Medicaid | “Can you screen us for CFI and State Supplement?” |
| Already in assisted living and money is running out | Facility billing office and ServiceLink | “What exact amount would remain if CFI or State Supplement starts?” |
| Veteran or surviving spouse | VA-accredited help | “Could pension with Aid and Attendance help with care costs?” |
| Income or savings seem too high | DHHS eligibility worker | “Please check every CFI income and resource pathway before closing the case.” |
| Hospital or nursing facility discharge is near | Discharge planner and ServiceLink | “Can you start a CFI referral and check presumptive eligibility?” |
If the main problem is finding other benefits that free up money for care, our New Hampshire benefits guide covers food, medical, housing, utility, and other assistance.
What Has Changed
- CFI has a newer federal approval: the Centers for Medicare & Medicaid Services lists New Hampshire’s CFI waiver as approved on July 1, 2026, with the waiver period still ending June 30, 2027.
- The State Supplement residential-care figure changed: the approved 2026 Residential Care income standard is $1,188 for an individual, effective January 1, 2026. The old article carried the 2025 figure of $1,161.
- Resource guidance is clearer: current New Hampshire Medicaid rules apply a disregard that brings the effective resource limit to $7,500 for a single adult applying for or receiving CFI. Married applicants have different rules, so do not apply the single-person figure to a couple.
How Assisted Living Payment Works
An assisted living bill usually has two parts: housing and care. Housing includes the room, meals, and ordinary living costs. Care can include help with bathing, dressing, medications, mobility, and other daily needs. Public programs are more likely to pay for approved care than for the full housing charge.
| Payment path | May help with | Main limit |
|---|---|---|
| Medicaid CFI | Approved long-term care services in home or certain residential settings | Ordinary room and board is excluded |
| State Supplement | Cash assistance for eligible low-income adults, including some residential-care residents | Actual payment depends on income, resources, and living arrangement |
| VA pension | Monthly pension, including higher Aid and Attendance amount when eligible | Pension, care-need, income, and net-worth rules apply |
| PACE | Coordinated medical and long-term care services | Service area and program eligibility apply |
| Private resources | Room, board, deposits, and charges not covered by public programs | Savings and insurance can run out or have policy limits |
If income is very limited, our low-income assisted living guide explains how families can combine public help and lower-cost options without assuming one benefit will pay everything.
Medicaid Choices for Independence
Choices for Independence, usually called CFI, is New Hampshire’s Medicaid home- and community-based services waiver for adults who need a nursing-facility level of care. The current CFI waiver record shows an approval dated July 1, 2026 and an expiration date of June 30, 2027. CMS lists residential care facility services among the services available through the waiver.
CFI is not an assisted living rent subsidy. A person must meet financial rules and a clinical care-need test. The current New Hampshire CFI rules describe the eligibility and service requirements. In practical terms, a person who only needs cheaper housing will not qualify just because assisted living is unaffordable.
What CFI can cover
An approved care plan may include personal care, homemaker help, case management, adult day services, non-medical transportation, adult family care, nursing, medical equipment, and residential care services. The exact services depend on the assessment and approved plan.
Reality check: New Hampshire’s CFI rules say payment for waiver services excludes room and board, except for a narrow respite-care exception. A person can qualify for CFI care and still have a large monthly housing balance.
Income and resource rules
CFI financial eligibility is not one simple monthly-income cutoff. New Hampshire rules use different pathways, including medically needy rules and cost-of-care calculations. If income looks too high, ask DHHS to complete the full review instead of stopping the application.
For resources, the current Medicaid resource rules state that adults applying for or receiving CFI get a disregard that brings the effective single-person resource limit to $7,500. New Hampshire law also gives married applicants special treatment for some resources. Because account ownership, transfers, trusts, and spouse rules can change the result, do not give away money or retitle property to try to qualify.
If forms are difficult, our NH EASY guide explains the state benefits portal and where a human helper may still be useful.
Ask the residence before moving
New Hampshire law allows certain licensed residential care settings to serve people who qualify for the Medicaid home- and community-based waiver when the facility can meet the person’s needs. The residential care licensing law does not mean every licensed residence accepts CFI payment. Ask the admissions office whether it is enrolled for the service you need and whether it has an opening for a CFI participant.
State Supplement Program
The State Supplement Program (SSP) is separate from CFI. For older adults, the most common cash category is Old Age Assistance. Other adult categories include Aid to the Permanently and Totally Disabled and Aid to the Needy Blind. Eligibility depends on the person’s category, income, resources, and living arrangement.
For 2026, the approved 2026 supplement standards set the Residential Care income standard at $1,188 for an individual, effective January 1, 2026. This number is a program income standard, not a guaranteed $1,188 monthly payment. The actual cash amount depends on countable income and the state’s calculation.
The same CMS approval displays $2,376 in a couple field, but it also says New Hampshire generally treats people in Residential Care and several similar group-living arrangements as a household of one. Do not simply double the individual figure for a married couple.
State rules for residential care assistance say eligible residential-care residents are treated as an assistance group of one and that financial assistance is paid to the individual, not directly to the facility.
Important property warning: OAA, APTD, and ANB cash assistance can carry reimbursement and lien consequences. New Hampshire law allows claims and liens tied to this financial assistance. If the applicant or spouse owns real estate, read the state lien law and ask DHHS how it applies before relying on SSP cash assistance.
Because CFI and SSP solve different parts of the problem, ask to be screened for both rather than choosing one first.
Veterans and Surviving Spouses
An eligible wartime veteran or surviving spouse may qualify for VA pension. People who qualify for pension and need help with daily activities may also qualify for a higher amount through Aid and Attendance. The benefit is paid monthly and can help with assisted living costs, but it is not automatic and it is not an emergency same-week payment.
VA considers factors such as service history, age or disability, income, net worth, and unreimbursed medical expenses. The current VA pension rates page is the safest place to check current limits and rates because they can change each year.
Use accredited help. The VA’s accredited VA representatives finder explains how to locate a Veterans Service Organization representative, accredited attorney, or accredited claims agent. VSO representatives provide claim help without charging a fee.
Our New Hampshire veteran guide lists state and local veteran-help routes that may make the application easier.
PACE and Private-Pay Bridges
Neighborhood PACE offers the Program of All-Inclusive Care for the Elderly in its service area. PACE combines medical and long-term care services for people who meet its rules and can live safely in the community with support. It is not a statewide assisted living rent benefit, so use the ZIP-code check before building a payment plan around it.
Medicare is often misunderstood in this decision. Federal Medicare long-term care guidance says Medicare does not pay for most long-term custodial care. Medicare can still cover covered medical services a person receives while living in assisted living, but it generally does not pay the residence’s ordinary monthly room-and-board charge.
If benefits are pending, ask the residence for a written bridge plan and full price. New Hampshire’s residential services agreement law requires rates, included services, extra costs, rate-increase policies, and termination rules. State law also says prospective residents must receive a copy at least 24 hours before signing.
If the main problem is housing cost rather than daily care needs, our New Hampshire housing guide may be a better first route.
Check the Residence Before You Commit
Use the Medicaid provider search to check enrollment, then call the residence. Medicaid enrollment does not prove it accepts new CFI residents or has a bed at the payment level you need.
- Ask for the full residential services agreement before signing.
- Ask what the base rate includes and what costs extra.
- Ask whether the residence accepts CFI for the person’s needed service.
- Ask whether State Supplement is accepted as part of the payment plan.
- Ask what happens if the resident’s care level increases.
- Ask what notice is given for rate increases or discharge.
- Ask for every promise about a Medicaid or benefit transition in writing.
If you are unsure whether assisted living or care at home fits better, our home care comparison can help organize that decision.
How to Start Without Wasting Time
- Write down the care need. List help needed with bathing, dressing, toileting, eating, medication, mobility, memory, and safety.
- Get the residence price. Ask for a written rate sheet and service agreement before you plan around benefits.
- Call ServiceLink. Ask for CFI, State Supplement, and options counseling. If the person is being discharged from a facility, say that clearly.
- File the Medicaid application. Use DHHS application help or NH EASY. Keep the confirmation number and copies of uploads.
- Run VA in parallel. If veteran or surviving-spouse status may apply, do not wait for the Medicaid decision first.
- Track every deadline. Keep notices, requests for proof, names of workers, dates called, and what was sent.
Phone script: ServiceLink
“I am trying to pay for assisted living in New Hampshire. The person is age __ and needs help with __ every day. Please screen us for CFI, State Supplement, and any other long-term care options. What should we file first?”
Phone script: Residence
“Do you currently accept CFI for the care this person needs? If CFI or State Supplement starts, what exact amount would still be owed each month? Please give me the answer and rate sheet in writing.”
Phone script: DHHS
“Please tell me which financial eligibility path is being used for this CFI case, what proof is still missing, and the date each item is due. If income or resources are over a basic limit, please check the other applicable rules before denying the case.”
Phone script: VA helper
“We want to check pension with Aid and Attendance for assisted living costs. What service records, medical evidence, income information, and unreimbursed care expenses should we gather before filing?”
Documents to Gather
Start a paper or digital folder before savings are nearly gone. Missing financial or medical proof can slow a long-term care case.
| Document | Why it matters | Practical tip |
|---|---|---|
| Photo ID, Social Security number, Medicare and insurance cards | Identity and coverage | Copy both sides of cards |
| Social Security, pension, annuity, VA, and other income proof | Income review | Use current award letters |
| Bank, investment, deed, trust, insurance, and burial records | Resource review | Ask how many months are required |
| Records of gifts, transfers, or property changes | Transfer review | Do not move assets to hide them |
| Facility contract, rate sheet, fees, and service plan | Shows the real payment gap | Mark what public programs may cover |
| Doctor notes, discharge papers, medication list, care notes | Clinical care-need review | Describe help needed each day |
| Marriage, power-of-attorney, or guardianship papers | Spouse rules and helper authority | Bring copies to calls |
| DD-214 or other discharge records | VA pension review | Ask accredited VA help if missing |
If staying at home is still possible, our family caregiver guide explains New Hampshire caregiver-payment paths that may delay or avoid a move.
Reality Checks
- CFI has two gates: the person must meet both financial and clinical eligibility rules.
- Room and board remains the hardest gap: CFI usually pays approved care, not ordinary housing costs.
- Facility participation can change: Medicaid enrollment, CFI participation, bed openings, and private-pay requirements are different questions.
- State Supplement has strings: actual payments are calculated case by case, and OAA/APTD/ANB cash assistance can involve reimbursement and property liens.
- Do not transfer assets casually: Medicaid transfer, trust, and spouse rules are complex. A rushed gift or deed change can create a larger problem.
- Medicare is not the assisted living payer: it may pay covered medical care, but not ordinary custodial room and board.
Common Mistakes to Avoid
- Assuming Medicare will pay the monthly assisted living bill.
- Moving in before confirming whether the residence accepts the person’s CFI payment path.
- Treating the $1,188 State Supplement income standard as a guaranteed monthly benefit.
- Applying for CFI but forgetting to ask about State Supplement.
- Giving away savings or changing a deed to try to get under a Medicaid limit.
- Waiting for Medicaid to finish before starting a possible VA pension claim.
- Relying on a verbal promise about future public-payment acceptance.
- Ignoring a DHHS notice or appeal deadline because a worker said the case could be fixed by phone.
Denied, Delayed, or Overwhelmed
If DHHS denies or reduces help, keep the written notice. If proof is missing, ask what document is needed and its due date. If the issue is financial eligibility, ask which rule and calculation were used.
If disability access, due process, or another rights issue is involved, Disability Rights Center may be able to provide information or assistance. If the problem involves a resident’s care, discharge, billing, or rights inside an assisted living setting, contact the Long-Term Care Ombudsman.
Our New Hampshire aging offices guide explains how the statewide Aging and Disability Resource Center network works when you need local navigation help. For disability-specific benefit and access routes, see our New Hampshire disability guide.
Backup Options if Assisted Living Is Still Too Expensive
- CFI at home: home-based services may be more affordable when the home itself is safe.
- Adult family care: a smaller residential setting may fit some CFI care plans.
- Affordable housing plus services: if rent is the main problem, compare lower-cost housing with in-home support.
- PACE: consider it if the ZIP code is served and the person can safely live in the community.
- Short-term community help: our New Hampshire charity guide lists urgent basic-needs help, not permanent assisted living payment.
- Lower medical expenses: our Medicare Savings guide may reduce Medicare costs and free household income for care.
- Nursing facility Medicaid: if the person’s needs are too high for assisted living and home care is no longer safe, ask whether nursing-facility care is the more realistic Medicaid path.
Resumen Breve en Español
En New Hampshire, normalmente no hay un solo programa que pague toda la factura de vivienda asistida. Medicaid CFI puede pagar servicios de cuidado aprobados, pero normalmente no paga el costo normal de habitación y comida. Algunas personas con bajos ingresos también pueden recibir ayuda del State Supplement Program. Veteranos y ciertos cónyuges sobrevivientes pueden revisar VA Pension con Aid and Attendance. Llame a ServiceLink/ADRC al 1-866-634-9412 y pregunte por CFI y State Supplement. Antes de firmar con una residencia, confirme por escrito cuánto costará cada mes, si acepta CFI y qué pasa si la ayuda pública tarda o es denegada.
Frequently Asked Questions
Does Medicaid pay for assisted living in New Hampshire?
Sometimes. New Hampshire’s CFI waiver can pay for approved care services in certain residential settings when the person meets financial and clinical rules. It does not automatically pay the full assisted living bill.
Does CFI pay room and board?
Generally no. New Hampshire’s CFI rules exclude room and board from waiver payment except for a narrow respite-care exception. Families often need State Supplement, VA benefits, income, savings, or another housing plan for that part of the bill.
What is the 2026 State Supplement residential-care standard?
The approved 2026 Residential Care income standard is $1,188 for an individual, effective January 1, 2026. It is an eligibility and payment-calculation standard, not a guaranteed $1,188 monthly benefit.
What is the CFI resource limit for a single applicant?
Current New Hampshire Medicaid rules apply a resource disregard that brings the effective limit to $7,500 for a single adult applying for or receiving CFI. Married applicants have different rules, so ask DHHS to review the actual household before moving money or changing account ownership.
Can Aid and Attendance help with assisted living?
It can help when a veteran or surviving spouse first qualifies for VA pension and also meets the Aid and Attendance care-need rules. The amount depends on the VA pension calculation and is not guaranteed for every veteran.
What if no nearby residence accepts CFI?
Ask ServiceLink about home-based CFI, adult family care, PACE if available in the ZIP code, affordable housing with in-home services, or nursing-facility Medicaid when care needs are too high for a safe assisted living plan.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Last verified: 13 September 2026. Next review: 13 December 2026.
Corrections
Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
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, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 19 September 2026 · Next review: 19 January 2027
About the Authors