Home Care in New Hampshire

According to Genworth’s 2021 Cost of Care Survey, you can expect to pay around $6,006 per month for home care in New Hampshire. This rate covers help with daily living and personal care activities, such as bathing, getting dressed, light housekeeping, errands, meal preparation and companionship services. Home health care, which provides skilled nursing for seniors with medical needs, costs $6,197.

At $6,006 per month, New Hampshire is one of the priciest states for home care in the northeast. In Vermont and Massachusetts, monthly rates average $5,720, or nearly $300 less. Massachusetts has prices similar to those in New Hampshire at around $5,911 per month. Connecticut is the region’s cheapest state for home care at $5,243 per month. Compared to New Hampshire’s prices, the national average is $4,957, or $1,049 less.

New Hampshire’s home health care cost is also above the national average, which is $5,148. Prices in Vermont and Maine are $5,720, the same cost as home care. Massachusetts residents pay $5,911, and Connecticut is the cheapest at $5,339.

Aside from home care, you have several options to consider. Assisted living can be a good fit for people who’d prefer to live in a community-based setting or don’t want to worry about maintaining their own homes. It costs $6,053, about $50 more than home care. Adult day care is priced at around $1,842 and provides assistance and supervision during regular business hours. Nursing home care is the most expensive, with a semiprivate room costing approximately $10,950.

In New Hampshire, regular Medicaid pays for services and supports that enable seniors to remain in their homes. It also covers certain clinical services for people with medical needs determined by a physician.

New Hampshire offers two Medicaid programs that cover home care: Choices for Independence and the Personal Care Attendant Services program. You must meet medical and financial requirements to qualify for these programs. The Choices for Independence program can only accommodate a certain number of people per year. If it exceeds this cap, it may place you on a waitlist for services.

Choices for Independence

Choices for Independence provides home care for seniors eligible for Medicaid and medically qualified for a nursing home level of care. The Bureau of Elderly and Adult Services administers this program and offers care options to help prevent unnecessary institutionalization. Services include in-home care, adult medical day care, housekeeping, home-delivered meals, emergency support and respite for family caregivers.

To qualify for Choices for Independence, you will need to:

• Complete an application for a Home- and Community-Based Services Waiver
• Apply and be approved for Medicaid to determine financial eligibility
• Undergo a medical assessment by the DHHS Division of Client Services
• Apply for Social Security Disability benefits, if necessary

It can take up to 45 days to determine eligibility for the program. If approved, you’ll choose a case manager who will help you select and manage the services you need.

Personal Care Attendant Services

Personal Care Attendant Services is a medically oriented program that provides care in your home or another non-institutional setting. It’s aimed at seniors and others who have severe physical disabilities. The program helps with your activities of daily living, meals, light household tasks, mobility, medication management, grocery shopping and service animal care.

The New Hampshire Medicaid state plan includes these services. To qualify, you must:

• Be a New Hampshire Medicaid member
• Reside in your home or a family member’s home
• Be able to self-direct care
• Need assistance with at least two daily living activities, including mobility, eating, bathing/grooming, taking medication, dressing and toileting
• Require at least two hours daily for medically oriented care
• Be wheelchair mobile

Granite State Independent Living (GSIL) provides this program. To learn more about how to access Personal Care Attendant Services, contact a GSIL office near you.

You must meet financial eligibility requirements for income and assets to qualify for Medicaid. In New Hampshire, the income limit is $10,260 per year ($855/month) for a single person and $15,144 per year ($1,262/month) for a married couple. The asset limit is $1,500 for single people and married couples.

To get started, visit the NH EASY Gateway to Services website and create an account or sign in to your existing account. Once you’ve signed up, you can complete a Medicaid application online. You can also print and complete a paper application and mail it to your local Department of Health and Human Services (DHHS) office or apply at your DHHS office in person.

What Information You Will Need

You will need to provide the following information with your application:

• Proof of income, such as tax returns or recent pay stubs
• Assets, including bank accounts, property, vehicles and life insurance
• Current health insurance and/or Medicare
• Personal information such as your birth date and Social Security number
• Expenses for housing, utilities and medical care

How to Get Help Applying for Medicaid

If you have questions about Medicaid and the application process, the state offers several resources that can help.

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

Throughout New Hampshire, you’ll find a variety of programs and resources to help you stay at home for as long as possible. These resources include financial help for low-income residents, home modifications and repairs, free legal aid and more.

On January 14, 2022, the Centers for Medicare & Medicaid Services issued a memo on COVID-19 vaccination compliance for home care agencies and their employees. In New Hampshire, all Medicaid- and/or Medicaid-certified provider workers must be vaccinated against SARS-CoV-2. This requirement aims to help prevent the virus from spreading to the state’s elderly and most vulnerable residents. If a provider is not Medicaid- and/or Medicare-certified, it doesn’t require its employees to be vaccinated, but providers can still choose to implement their own vaccine mandates.

Note: The rule is current as of April 2022 but may be subject to change in the future. Contact your nearest Area Agency on Aging to learn more about vaccination requirements for workers entering your home.

In New Hampshire, the Bureau of Health Facilities Administration licenses and regulates home care and home health care agencies. It is responsible for enforcing standards aimed at promoting appropriate treatment for seniors in all types of long-term care.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

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