Medicaid Medical Eligibility Determination for Long Term Care
Individuals seeking Long Term Care services covered by the Medicaid Program, which include both nursing home care and Choices for Independence home and community based services, must meet specified medical and financial eligibility requirements.
Medical eligibility is determined through an application and assessment process administered by the Bureau of Elderly and Adult Services (BEAS) in accordance with medical criteria established by law. Financial eligibility is determined by the Bureau of Family Assistance (BFA) in accordance with defined criteria for income and resources specific to the Medicaid Long Term Care Program. The Bureau of Elderly and Adult Services and the Bureau of Family Assistance work together to determine ultimate eligibility decisions.
- Applying for NH Medicaid Financial Eligibility
You must be eligible for NH Medicaid to receive nursing home care and Choices for Independence home and community based services. A ServiceLink representative can help navigate the process to complete a Medicaid application and make your appointment with a family service specialist with the Bureau of Family Assistance.
- Apply for Long Term Care Medical Eligibility
You must be medically eligible for Medicaid-covered long term care services. Medical eligibility will be determined by an in-person, face-to-face assessment by a registered nurse employed or designated by BEAS. Nurses will use a comprehensive, objective assessment instrument, the Medical Eligibility Assessment (MEA) form to determine Nursing Facility Level of Care, medical eligibility, and service options for the long term care program. A medical eligibility assessment will be scheduled by the nurse shortly after the financial eligibility application has been initiated with the Bureau of Family Assistance. Assessments will be conducted at the applicant's current location. The assessment process will be the same for both Nursing Facility and CFI services.
How to apply
To apply for a Long Term Care eligibility, contact the nearest regional NH ServiceLink Resource Centers located throughout the state or apply online through NH EASY. The ServiceLink Long Term Care Counselors will assist the applicant to navigate through with the application process.
The Long Term Care application process includes:
- Complete a BFA Form 800, Application for Assistance
- Undergo a BFA interview
- Undergo an a Medical Eligibility Assessment