NH Medicaid (Medical Assistance) Eligibility for Adults

NH Medicaid (Medical Assistance) Eligibility for Adults

To participate in NH Medicaid (Medical Assistance), federal law requires the Department to cover certain groups of individuals. Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups. This page outlines NH Medicaid (Medical Assistance) criteria for adults. Details on children’s eligibility can be found on NH Medicaid (Medical Assistance) Eligibility for Children.

Eligibility - MAGI Programs for Adults

Certain medical assistance programs use the Modified Adjusted Gross Income (MAGI) rules to determine whether you qualify for the program. MAGI rules use IRS-defined concepts of income and household. This means that your federal tax filing status and who you claim as tax dependents determines your household size and whose income we count.

Adult medical assistance programs that use the MAGI rules include:

General Eligibility Rules

  • Citizenship Status/Immigration & Identity: You must be either a US citizen or be a qualified alien and you must be who you say you are.
  • 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 New Hampshire for educational purposes is not considered a resident of New Hampshire.
  • 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): You must furnish an SSN or proof of an application for an SSN.
  • Tax Filing Status: You must tell us about your expected IRS tax filing status and your tax dependents.

Financial Eligibility Rules

You must meet the program's income rules to qualify for the program.

Household Income: Most kinds of income for all members of your household are counted when we see if you qualify for medical assistance. Some examples of counted income are:

  • Wages and Salary
  • Self-employment income
  • Tips, bonuses, and gratuities
  • Unemployment benefits
  • Social Security Benefits

We may not count all of your income because certain expenses can be subtracted 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 Net Monthly Income Limits for the specific income requirements for the various programs. Please see the Program Fact Sheet for the specific deduction 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 potentially qualify 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

Special Rules for Pregnant Women Medical Assistance

You must be pregnant to qualify for this type of assistance. Coverage for this type of assistance continues for sixty (60) days post-partum.

Special Rules for Parent/Caretaker Relative Medical Assistance

You must be a caretaker relative or parent of a dependent child, defined as a child under age 18 (or under age 19 and a full-time student in secondary school or equivalent vocational or technical training). The dependent child must live with you and must be deprived of parental care. Deprivation of parental care means a parent is unable to support or care for the child. A child is considered deprived of parental care when:

  • at least one parent has died,
  • at least one parent is continually absent from the home,
  • at least one parent is unemployed, which is considered to be working less than 100 hours per month, or 
  • at least one parent is physically or mentally incapacitated.

Each one of these reasons has specific rules associated with the definition of the deprivation type, and proof of the deprivation must be given to us as a condition of eligibility.

Special Rules for the Granite Advantage Health Care Program 

  • You must be at least age 19 but younger than age 65
  • You cannot be pregnant at the time of application
  • You cannot be entitled to or enrolled in Part A or B Medicare benefits
  • You cannot otherwise qualify for or be enrolled in any mandatory Medicaid coverage (like APTD or ANB)
  • You must have household income that is at or below 133 percent of FPL

Special Rules for Family Planning Medical Assistance (FPMA)

FPMA offers limited coverage for family planning or family planning-related medical services or supplies only. For this type of assistance, you cannot be pregnant or already receiving Medicaid. FPMA services are only available to eligible individuals who have reached reproductive maturity.

Eligibility - Non-MAGI Programs for Adults

Eligibility for Non-MAGI medical assistance programs is determined by your household size (based on who you are related to or married to and who lives with you in your home), income and resources using non-IRS based federal and state rules.

The General Requirements below apply to the following adult medical assistance programs:

You must meet certain requirements to be eligible for Non-MAGI categories of medical assistance. DHHS will tell you at the time of application.

General Requirements

  • Citizenship 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 New Hampshire for educational purposes is not considered a resident of New Hampshire.
  • 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): You 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
  • Retirement Benefits or Pensions
  • Unemployment Compensation Benefits
  • Child Support
  • Alimony
  • Veterans Benefits
  • Worker’s Compensation 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 Program Fact Sheet for the specific income requirements 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. 

Interested in Applying?

To find out if you are eligible for NH Medicaid, visit NH EASY. NH EASY is an EASY, fast, and secure way to look at and manage your benefits online. You may apply for all types of assistance we offer, including cash, Supplemental Nutrition Assistance Program (SNAP) and child care.

Questions?

  • Contact the DHHS Customer Service Center toll-free at 1-844-ASK-DHHS (1-844-275-3447) (TDD Relay Access: 1-800-735-2964), Monday through Friday, 8:00 a.m. to 4:00 p.m. ET.
  • Contact your local District Office.
  • Review the Program Fact Sheet.
  • Visit Related Resources for additional eligibility information.

Our Mailing Address is:

Division of Medicaid Services
NH Department of Health & Human Services
129 Pleasant Street
Concord, NH 03301

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Right to an Administrative Appeal Hearing

If you disagree with any decision made on your benefits, you may request an Administrative Appeals hearing. Follow the instructions on the Request Form.