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Medical Assistance Eligibility




Welcome to Medical Assistance Eligibility
 

The Division of Family Assistance determines financial eligibility and all non-financial eligibility, with the exception of medical necessity determinations, for Medicaid and NH Healthy Kids for children under the age of 19, pregnant women, low-income families with children, blind individuals, refugees, non-citizens, seniors and disabled adults. 

 

There are three basic areas of criteria that DFA evaluates to make an eligibility determination for Medical Assistance: income, resources and non-financial criteria.  Specific income and resource limits are used to determine eligibility for each group of Medicaid services.  While non-financial information is generally the same for each set of services, there are some differences -- for example, an application for services under the Aid to the Needy Blind program requires an individual to have a medical necessity determination of legally blind, while an application for services from Healthy Kids has no medical necessity requirement.  Specific details regarding income, resource and non-financial requirements are explained for each set of services on the pages reserved for eligibility for Medical Assistance.

 

DFA coordinates eligibility determinations with the Office of Medicaid Business and Policy and the Bureaus of Adult and Elderly Services and Developmental Services. 

 

  • The Office of Medicaid Business and Policy has overall authority regarding Medicaid programs and is responsible for making medical necessity determinations for Aid to the Permanently and Totally Disabled, Child Severely Disabled, Home Care for Child Severely Disabled, Aid to the Needy Blind, emergency medical assistance to non-citizens, Medical Eligibility for Adults with Disabilities, and the Temporary Assistance for Needy Families Incapacity program. 

 

  • The Bureau of Elderly and Adult Services provides and coordinates services for Nursing Facility Assistance and Home and Community Based Care for the Elderly and Chronically Ill as well as making the medical necessity determination for these two programs. 

 

  • The Bureau of Developmental Services provides and coordinates services for Home and Community Based Care for Acquired Brain Disorders and Home and Community Based Care for Developmental Disabilities as well as making the medical necessity determination for these two programs. 

Daughter, mother, grandmother

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