Long-Term Care Funding in New Hampshire
New Hampshire recently adopted a Uniform Real Property Transfer on Death Act, giving homeowners a new nonprobate title tool — but the state's Medicaid recovery rules already reach well beyond a typical probate estate, extending to surviving joint tenants and life-estate remaindermen. That combination means a TOD deed should be evaluated as a title device, not marketed as a guaranteed way around Medicaid recovery.
New Hampshire also runs an income-cap system for its nursing-facility and home-care Medicaid pathways, paired with a medically needy spend-down option for people whose income runs over that cap. Below, the ten topic pages break down exactly how eligibility, transfers, the home, facility and community care, veterans benefits, and insurance regulation work under current New Hampshire rules.
Why New Hampshire is different
- New Hampshire Medicaid is run through the Department of Health and Human Services (DHHS), which requires a separate medical-eligibility determination on top of the standard financial application for anyone seeking long-term-care services.
- The state's home- and community-based waiver is called Choices for Independence (CFI), a section 1915(c) program currently approved by CMS through June 30, 2027, though enrollment is capacity-limited.
- New Hampshire adopted its Uniform Real Property Transfer on Death Act (RSA chapter 563-D) effective July 1, 2024 — a meaningfully new option that didn't exist in older New Hampshire planning guidance.
- Despite that new deed law, New Hampshire's Medicaid Estate Recovery Program reaches property held in a revocable trust and includes a recipient's joint-tenancy-with-survivorship and life-estate interests for qualifying interests established on or after July 1, 2005.
- An income cap applies to the nursing-facility and CFI pathways, but a medically needy "In and Out" spend-down option exists for people whose income runs above that cap.
New Hampshire at a glance
Which situation matches yours?
| If this is your situation | Start here |
|---|---|
| Care Needed NowA hospital discharge is coming up, a facility decision feels immediate, or home care has already begun. | New Hampshire Medicaid Look-Back PeriodNew Hampshire VA Aid & Attendance |
| Care Within 1-3 YearsA recent fall, memory changes, or a new diagnosis have made the timeline feel real, even though care isn't needed yet. | New Hampshire VA Aid & AttendanceNew Hampshire Long-Term Care Planning |
| Planning AheadNo crisis and no diagnosis yet — just the recognition that long-term care is a likely eventual need. | New Hampshire Long-Term Care InsuranceNew Hampshire Long-Term Care Planning |
| Veteran or surviving spouse of wartime serviceA federal pension benefit can stack on top of whatever other planning applies. | New Hampshire VA Aid & Attendance |
| Owns significant home equityThe home is typically exempt from countable assets during life but factors into recovery and how long private-pay funds will last. | New Hampshire Transfer-on-Death DeedNew Hampshire Medicaid Long-Term Care |
| Already holds LTC insurance or a hybrid life/LTC policyThat policy is usually the first funding source used, with other strategies filling gaps once benefits run out. | New Hampshire Long-Term Care InsuranceNew Hampshire Medicaid Long-Term Care |
The 10 funding pillars in New Hampshire
Every pillar below has its own dedicated New Hampshire page with the current rules, dollar figures, and what to do next.
New Hampshire Medicaid Long-Term Care
How NH Medicaid, DHHS medical eligibility, nursing facilities, and the CFI waiver fit together for long-term services and supports.
Financial EligibilityNew Hampshire Medicaid Asset Limits
New Hampshire's published 2026 long-term-care resource, income, home-equity, and community-spouse figures.
Look-Back & PenaltiesNew Hampshire Medicaid Look-Back Period
New Hampshire's 60-month transfer review, penalty concept, and the need to confirm a current state divisor.
Asset Protection ToolNew Hampshire Transfer-on-Death Deed
New Hampshire's 2024 TOD-deed statute offers a nonprobate title tool, not a demonstrated Medicaid-planning safe harbor.
Estate RecoveryNew Hampshire Medicaid Estate Recovery
New Hampshire recovery is not limited to a conventional probate file, and published rules provide an undue-hardship request route.
Nursing Home CoverageNew Hampshire Nursing Home Medicaid
The nursing-facility pathway pairs financial eligibility with DHHS medical eligibility and a $90 monthly personal-needs allowance.
Home & Community CareNew Hampshire Home Care Medicaid
The Choices for Independence 1915(c) waiver supports nursing-facility-level care in community settings, subject to enrollment capacity.
Planning AheadNew Hampshire Long-Term Care Planning
New Hampshire planning combines an income cap, medically needy spend-down option, 60-month review, and newer TOD-deed law.
VA BenefitsNew Hampshire VA Aid & Attendance
VA Aid and Attendance can supplement pension for qualified veterans, alongside one state Veterans Home and locally adopted tax credits.
LTC InsuranceNew Hampshire Long-Term Care Insurance (*)
New Hampshire Insurance Department rules include a Long-Term Care Partnership program with asset-protection features for qualifying coverage.
Participates in the State Long-Term Care Partnership Program.
See what LTC insurance could mean for your New Hampshire plan
A policy in place before care is needed can change every one of these pillars in your favor. Get a free, no-obligation quote.
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