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Last updated: 27 May 2026
Bottom Line: New Hampshire does not have one simple program that pays the full assisted living bill. Most families use a mix of Medicaid Choices for Independence (CFI) for care, State Supplement Program cash help for some very low-income residents, VA pension with Aid & Attendance for eligible veterans or surviving spouses, and private income or savings for room and board. Medicare usually does not pay for long-term custodial care in assisted living. The best first move for many families is to call ServiceLink and start the Medicaid application in the same week.
Emergency help now
- If a move, eviction, or discharge is happening right now: call the ADRC ServiceLink line at 1-866-634-9412 and say the situation is urgent.
- If the person is already in assisted living or residential care: call the Long-Term Care Ombudsman at 1-800-442-5640 if there is a discharge, billing, care, or rights problem.
- If there is abuse, neglect, exploitation, or danger: call 911 for immediate danger, or call Adult Protective Services at 1-800-949-0470 for a vulnerable adult concern.
- If the crisis also involves food, rent, shelter, or utilities: call 211 New Hampshire at 2-1-1, or 1-866-444-4211 from outside the state.
For a wider crisis list, our New Hampshire emergency guide can help you look for food, utility, housing, and local charity help while the long-term care application is moving.
Best first starts in New Hampshire
Use the row that fits your situation. This can save days of calling the wrong office.
| If this sounds like you | Start here | Ask this first |
|---|---|---|
| Low-income senior needs daily help and may need assisted living | 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, ServiceLink, and Ombudsman | “What is the exact monthly gap if Medicaid starts?” |
| Veteran or surviving spouse | ServiceLink and VA-accredited help | “Could pension with Aid & Attendance help with care costs?” |
| A little over income or assets | DHHS eligibility worker or ServiceLink | “Can you check medically needy, spenddown, and married-spouse rules?” |
| In a hospital or nursing home and trying to move to the community | Discharge planner and ServiceLink | “Can you send a long-term care referral before discharge?” |
New Hampshire families often say “assisted living,” while the paperwork may say residential care facility or supported residential health care facility. Before move-in, ask the residence two direct questions: “Do you take CFI?” and “What would still be owed each month for room, board, and extra care?”
How payment usually works
Assisted living has two main parts: care and room and board. Public programs are more likely to help with care. The housing part is often the hardest gap.
| Payment source | May help with | Usually does not pay | Best fit |
|---|---|---|---|
| Medicaid CFI waiver | Care services in a home or some licensed residential settings | Most room and board | Low-income adults who meet nursing-facility level of care |
| State Supplement Program | Monthly cash help tied to age, disability, income, and living setting | The full assisted living bill | Very low-income residents in a qualifying setting |
| VA pension with Aid & Attendance | Monthly cash that can be used toward care or assisted living costs | Fast emergency payment or guaranteed approval | Wartime veterans and surviving spouses who meet VA rules |
| PACE | Coordinated medical and long-term care services in a service area | A statewide assisted-living rent benefit | People who can use the local PACE model |
| Private pay and insurance | Room, board, and extra care, based on contract or policy | Unlimited coverage | People with savings, pension income, long-term care insurance, or family support |
For a broader state benefits path, our New Hampshire benefits guide covers other help that may lower food, medical, housing, and utility costs.
Medicaid CFI waiver
In New Hampshire, the main Medicaid long-term care path for assisted-living-type care is Choices for Independence, often called CFI. It is a home and community-based services waiver. Medicaid lists the waiver as approved through 30 June 2027, and it covers services such as personal care, homemaker help, adult day services, transportation, adult family care, residential care facility services, skilled nursing, and other supports.
The state’s home care page says CFI is for seniors and adults with chronic illness who are financially eligible for Medicaid and medically qualify for the level of care given in nursing facilities. In plain English, the person must need a high level of help with daily care. A simple need for cheaper rent is not enough.
What CFI may pay in a residential setting
- Help with bathing, dressing, toileting, eating, and moving around
- Homemaker or personal care services in the care plan
- Case management and care planning
- Some nursing or therapy-related support, if approved
- Services in certain licensed residential care settings that take CFI
What CFI usually does not solve
- The basic monthly room-and-board charge
- Move-in fees, deposits, and many personal living costs
- Optional charges such as salon, cable, guest meals, or upgrades
- A guarantee that the residence you like accepts CFI
New Hampshire’s CFI rule says waiver payment excludes room and board, with limited exceptions. This is why a family can be approved for care help and still owe a monthly housing amount.
Licensing words matter. New Hampshire lists assisted living residence residential care rules under He-P 804 and supported residential health care facility rules under He-P 805 on its health facility rules page. Ask the building what license it has and whether that license fits CFI billing.
Income, assets, and timing
Do not assume the person is over the limit without a real screen. The approved medically needy update lists a medically needy income level of $939 for one person and $1,093 for two, effective 1 July 2025. This does not mean every person with that income qualifies. It means over-income cases deserve a spenddown review before the family gives up.
Time also matters. New Hampshire’s Medicaid manual lists processing time frames of up to 90 calendar days for Home and Community-Based Care services, including CFI. Missing bank records, deeds, transfers, insurance papers, or medical details can slow the case. Start before savings are gone.
If you need help with the online path, our NH EASY guide explains what the portal can and cannot do for seniors.
State Supplement Program
The State Supplement Program (SSP) is separate from CFI. It includes Old Age Assistance (OAA), Aid to the Permanently and Totally Disabled (APTD), and Aid to the Needy Blind (ANB). New Hampshire’s cash assistance page says SSP supports elderly adults and people who are disabled or blind, with eligibility and benefit amounts based on income, resources, and living arrangement.
SSP can matter because it may help with the part of the bill that feels like room and board. It is still not a full assisted living voucher. The resident may still need Social Security, SSI-level income, VA benefits, savings, or family help.
The current BFA fact sheet was updated in March 2026 and covers eligibility, income, and resource rules for SSP and other programs. It is worth asking DHHS to screen for SSP at the same time as CFI.
The approved state supplement standards list a 2025 Residential Care standard of $1,161 for an individual and $2,322 for a couple. The same document notes that for several group-living settings, the couple amount is entered as the individual amount doubled, even though the state usually treats people in those living arrangements as a household of one. That is another reason to let DHHS calculate the case instead of guessing.
Reality check for SSP
- SSP is needs-based. Small changes in income or resources can matter.
- The living arrangement matters. Independent living and residential care can be treated differently.
- The payment may reduce the gap, not erase it.
- Ask for the calculation in writing if the answer is confusing.
Veterans and surviving spouses
If the older adult is a wartime veteran or surviving spouse, VA pension may be part of the payment plan. Aid & Attendance is an added amount for people who need another person’s help with daily activities, are bedridden, have limited eyesight, or meet other VA care-need rules.
You can read the VA’s Aid and Attendance page for the current rules and application paths. The money is paid as a monthly VA benefit. It can help with assisted living, but it is not a same-week fix. The person must also qualify for pension, and VA may need medical evidence.
Use the VA’s veteran rate table or survivor rate table for current amounts. Rates can change each year. Do not use an old private chart for a 2026 decision.
Use accredited help only. VA explains that accredited representatives can help with claims, and VSO representative services are free. The VA also warns about pension poaching, where people charge fees or push financial products that can hurt eligibility.
Our New Hampshire veteran guide can help senior veterans and surviving spouses find state and local veteran contacts.
PACE and private-pay bridges
New Hampshire has a Program of All-Inclusive Care for the Elderly option in parts of the state. Neighborhood PACE describes PACE as an alternative to nursing home care that gives health care and social support to help aging adults remain in the community. It can be a good fit for the right person in the service area. It is not a statewide assisted living rent program.
Medicare is often misunderstood here. Medicare long-term care guidance says Medicare does not cover long-term custodial care unless medical care is needed. Medicare may still pay for doctor visits, hospital care, therapy, or short-term skilled care that a person receives while living in assisted living. It usually will not pay the monthly assisted living bill.
If you are waiting for CFI, SSP, or VA, ask the residence about a written bridge plan. Do not rely on a verbal promise. Ask for the private-pay rate, the care-level charge, what happens if approval is delayed, and whether the resident can stay if the public payment starts later than expected.
| Monthly cost question | Why it matters | Where to get it |
|---|---|---|
| Base room and board | This is often the part Medicaid will not pay | Residence rate sheet |
| Care-level fee | This can rise when needs increase | Nursing or billing office |
| Medication fee | Some homes charge extra for medication help | Residence contract |
| Move-in fee | This may not be covered by public benefits | Admissions office |
| Likely public help | Shows the real monthly gap | DHHS, ServiceLink, VA, or billing office |
If the main problem is rent, not daily care, our New Hampshire housing guide may be a better starting point.
How to start without wasting time
- Get the real bill: ask for the base rate, care charge, medication charge, move-in fee, and extra services.
- Call ServiceLink: ask for screening for CFI, SSP, caregiver support, and other long-term care help.
- File with DHHS: use the DHHS application page or ask for help filing if online forms are hard.
- Ask about over-limit rules: request a medically needy, spenddown, resource, and married-spouse review.
- Start VA in parallel: do not wait for Medicaid if the person may qualify as a veteran or surviving spouse.
- Keep copies: save every upload, mailed form, notice, bank record, and facility rate sheet.
Phone script for ServiceLink
“I am calling about paying for assisted living in New Hampshire. The person is age __, lives in __, and needs help with __ every day. We need screening for CFI, State Supplement, and any other long-term care help. What should we file first, and what documents do you need?”
Phone script for the residence
“If my parent gets CFI or State Supplement, what exact monthly amount would still be owed here? Do you accept residents using those programs, and are there any limits or waiting lists?”
Phone script for VA help
“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 should we gather first?”
Phone script for DHHS
“We received a notice or are waiting on a long-term care decision. Can you tell us what is missing, the deadline, and whether the case is being reviewed for CFI, State Supplement, and medically needy spenddown?”
Documents checklist
Missing documents are one of the biggest reasons long-term care cases stall. Start a folder before the crisis week.
| Document | Why it helps | Tip |
|---|---|---|
| Photo ID, Social Security number, Medicare card, and insurance cards | Confirms identity and coverage | Copy front and back of cards |
| Social Security, pension, annuity, VA, and other income proof | Needed for income review | Use current award letters if possible |
| Bank statements, investment records, deeds, trusts, life insurance, and burial papers | Needed for asset review | Ask how many months DHHS wants |
| Records of gifts, transfers, or property changes | Needed for transfer review | Do not move assets before asking |
| Assisted living contract, rate sheet, and move-in charges | Shows the real monthly gap | Ask for a written CFI estimate |
| Doctor notes, discharge papers, medication list, and care notes | Supports the care-need review | List daily help needed |
| Marriage papers, spouse income, power of attorney, or guardianship papers | Needed for spouse rules or helper authority | Bring copies to calls |
| DD-214 or other discharge papers | Needed for VA pension review | Ask VA help if records are missing |
If care at home is still possible, our family caregiver guide explains New Hampshire caregiver payment paths that may fit better than assisted living.
Reality checks in New Hampshire
- CFI is not instant: plan for the state review, medical assessment, missing-document requests, and provider availability.
- Not every residence participates: a licensed building may not take CFI, may limit CFI residents, or may have no open bed at the payment level.
- Room and board is the main gap: CFI can help with care, but families often need SSP, VA money, income, or savings for housing costs.
- Local supply varies: rural areas may have fewer participating providers and fewer assisted living openings.
- Medicare is not the rent payer: Medicare may cover medical care, but not ordinary long-term assisted living room and board.
Common mistakes to avoid
- Assuming Medicare will pay the assisted living bill
- Moving into a residence before asking whether it takes CFI
- Forgetting to check State Supplement while applying for Medicaid
- Waiting to start VA pension until Medicaid is finished
- Giving away money, changing deeds, or hiding assets to “get on Medicaid”
- Accepting a verbal private-pay bridge without written terms
- Using a non-accredited VA claims company
- Ignoring appeal deadlines on DHHS notices
What to do if denied, delayed, or overwhelmed
If DHHS says no, ask for the decision in writing. The written notice should explain the reason, the appeal right, and the deadline. Do not rely on a phone summary alone.
If the problem is access to services, disability-related barriers, or a rights issue, Disability Rights Center may be able to point you toward help. If the person is already in assisted living or residential care and the issue is discharge, care, billing, or resident rights, call the Long-Term Care Ombudsman.
Local aging offices can also help families find the right door. Our New Hampshire aging offices page can help when you need a local contact, though ServiceLink is still the main long-term care access point.
Backup options if assisted living is still not affordable
- CFI at home: home-based care may cost less than assisted living and may keep the person in familiar housing.
- Adult family care: this can be a smaller setting and may fit some CFI care plans.
- Subsidized housing plus services: combine affordable housing with home care if the main problem is rent.
- PACE: check it only if the person lives in the service area and the care model fits.
- Charity and church help: our New Hampshire charity guide can help with short-term basic needs, not the whole assisted living bill.
- Medicare cost help: if premiums are squeezing the budget, our Medicare Savings guide may help lower medical costs.
- Nursing facility Medicaid: if care needs are too high for assisted living and money is gone, nursing facility care may be safer and more realistic.
Resumen breve en español
En New Hampshire, normalmente no hay un solo programa que pague toda la factura de assisted living. La ayuda principal puede ser CFI de Medicaid para servicios de cuidado, pero por lo general no paga room and board. Algunas personas también pueden recibir ayuda del State Supplement Program. Los veteranos o cónyuges sobrevivientes pueden revisar VA pension con Aid & Attendance. El mejor primer paso suele ser llamar a ServiceLink y presentar la solicitud de Medicaid lo antes posible. Antes de firmar con una residencia, pregunte si acepta CFI y cuánto quedaría por pagar cada mes.
FAQ
Does Medicaid pay for assisted living in New Hampshire?
Sometimes. The main path is CFI. It can help pay for approved care services in some licensed residential settings. It usually does not pay the full room-and-board bill.
Does New Hampshire Medicaid pay room and board?
Usually no. Room and board is the biggest gap. Families may need State Supplement, VA benefits, Social Security, SSI, savings, or family help.
What is the fastest first call?
For most families, call ServiceLink at 1-866-634-9412 and ask for CFI and State Supplement screening. Start the DHHS application the same week.
Can Aid & Attendance help with assisted living?
Yes, if the veteran or surviving spouse qualifies for VA pension and meets the care-need rules. It can help, but it is not fast or automatic.
What if my parent is over income or assets?
Ask for a full review before giving up. New Hampshire may have medically needy, spenddown, resource, and married-spouse rules that change the answer.
What if no local residence takes CFI?
Ask ServiceLink about home-based CFI, adult family care, PACE if local, subsidized housing with services, or nursing facility Medicaid if care needs are high.
About This Guide
This guide uses official federal, state, local, 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 27 May 2026, next review 27 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.
Last updated: 27 May 2026
Next review: 27 August 2026
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