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Eligibility-Non-MAGI Programs for Adults

Certain medical assistance programs use the Modified Adjusted Gross Income (MAGI) rules to figure out whether you qualify for the program. MAGI rules use IRS-defined concepts of income and household. Programs described on this page do not use MAGI tax rules to determine eligibility. Programs on this page:

  • Figure out who your household members are based on who you are related to or married to and who lives with you in your home; and
  • Count income and resources using non-IRS based federal and state rules.

The general eligibility rules below apply to the following adult medical assistance programs:

  • State Supplement Program (SSP) medical assistance which is Aid to the Needy Blind (ANB) medical assistance, Aid to the Permanently and Totally Disabled (APTD) medical assistance, and Old Age Assistance (OAA) medical assistance;
  • Nursing Facility (NF) services and home and community-based care (HCBC) services, including Choices for Independence (CFI);
  • Medicare Savings Programs (MSP) which include the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB/SLMB135), and Qualified Disabled and Working Individual (QDWI) programs;
  • Medicaid for Employed Adults with Disabilities (MEAD);
  • Breast and Cervical Cancer Program (BCCP); and
  • Refugee medical assistance (RMA) and Emergency Medicaid for Noncitizens.

You must meet certain requirements to be eligible for Non-MAGI categories of medical assistance. If a rule below does not apply for a program, a DHHS District Office worker will tell you at the time of application.

General Requirements

elderlyCitizenship Status/Immigration & Identity: You must be either a US citizen or be a qualified alien and you must be who you say you are. There are some emergency medical services available for certain non-qualified aliens. Contact a DHHS District Office for more information.

Residency: You must live in New Hampshire, intend to remain in New Hampshire and not be getting medical assistance from another state. A student entering NH for educational purposes is not considered a resident of NH.

Age: You must be a certain age for some programs. If a program has an age limit, you must meet the age limit.

Social Security Number (SSN): Each individual requesting assistance must furnish an SSN or proof of an application for an SSN.

Financial Eligibility

Financial requirements are broken into two parts: income and resources. You must meet the program's resource requirements as well as the income requirements to be eligible for the program.

Household Income: Most kinds of income for all members of your household are counted when we determine your eligibility for medical assistance. Some examples of counted income are:

  • Wages
  • Self-employment income
  • Rental income
  • Social Security Benefits
  • Veterans Benefits

We do not count all of your income because we subtract certain expenses from your total income. If, after subtracting your expenses, your total net income equals or falls below the monthly net income limits for the number of people in your household, you are considered income-eligible. Please see the DFA Net Monthly Income Limits Adobe Acrobat Reader Symbol for the specific income requirements for the various programs. Please see the DFA Program Fact Sheet Adobe Acrobat Reader Symbol for the specific income deductions and disregards that are allowed for the various programs.

Potential Income: You must explore and apply for all potential sources of income. For example, you must apply for the following benefits if you are potentially eligible for them:

  • Social Security Benefits
  • Retirement Benefits or Pensions
  • Unemployment or Worker's Compensation
  • Third-Party Medical Coverage
  • VA Benefits (including Aid and Attendance)
  • Disability Benefits or Pensions
  • Contributions from any Liable Third Party

Household Resources: Resources owned by all household members are considered to determine eligibility. Examples of resources are cash, bank accounts, stocks, bonds, some vehicles, permanently unoccupied real estate and some trusts. We do not count certain resources such as the home you live in, your furniture and some vehicles. Please see the DFA Program Fact Sheet Adobe Acrobat Reader Symbol for the specific resource requirements for the various programs.

 

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


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