This page provides a plain-English summary of key elder care and estate planning information specific to New Hampshire residents. It covers New Hampshire Medicaid limits, estate tax rules, advance directive information, and links to important New Hampshire agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
New Hampshire Medicaid — 2026 Eligibility Limits for Long Term Care
New Hampshire’s Medicaid program is administered by the New Hampshire Department of Health and Human Services — DHHS. New Hampshire expanded Medicaid under the Affordable Care Act through the Granite Advantage Health Care Program which provides coverage to adults aged 19 to 64 with incomes up to 138 percent of the federal poverty level.
Income limit — single applicant The income limit for a single New Hampshire nursing home Medicaid applicant is $2,982 per month in 2026. New Hampshire is an income cap state meaning applicants whose income exceeds this limit must establish a Qualified Income Trust — also called a Miller Trust or QIT — to qualify. New Hampshire also offers a medically needy spend-down pathway for applicants who prefer that route — the medically needy income standard is $591 per month calculated over a six-month period.
Asset limit — single applicant — slightly higher than most states A single applicant must have $2,500 or less in countable assets — slightly higher than the $2,000 standard used by most states. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, a burial plot, and burial funds up to $1,500. Note that IRAs and 401(k)s are counted as countable assets in New Hampshire.
Home and community based care — Choices for Independence Waiver New Hampshire’s primary HCBS program for seniors is the Choices for Independence — CFI — Waiver which provides home and community based services for New Hampshire residents aged 18 and older who need nursing facility level care but want to remain at home. The asset limit is $2,500 for a single applicant and the income limit is $2,982 per month.
Unique spousal asset rule for CFI Waiver applicants New Hampshire has an important and distinctive rule for CFI Waiver applicants — when only one spouse applies for the CFI Waiver the non-applicant spouse’s assets are not counted toward the applicant’s eligibility. This is structurally different from nursing home Medicaid where the community spouse’s assets are counted jointly and subject to the Community Spouse Resource Allowance rules. This favorable rule can make CFI Waiver planning significantly more flexible for married couples in New Hampshire.
Granite Advantage Health Care Program New Hampshire’s Medicaid expansion program is called Granite Advantage. It provides comprehensive health coverage to adults aged 19 to 64 with incomes up to 138 percent of the federal poverty level — approximately $1,732 per month for a single person in 2026. Granite Advantage does not cover long term care services. Seniors aged 65 and older use the standard Medicaid long term care programs described above.
Married couples — one spouse applying — nursing home Medicaid When only one spouse applies for New Hampshire nursing home Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,500.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,643.75 per month in 2026. The maximum is $4,066.50 per month for community spouses with high housing costs.
Personal needs allowance New Hampshire nursing home Medicaid recipients are allowed to keep $90 per month as a personal needs allowance — higher than many states. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty New Hampshire has a 60-month — five year — look-back period for nursing home Medicaid and CFI Waiver applications. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The 2026 divestment penalty divisor in New Hampshire is based on the statewide average monthly cost of nursing facility care.
Estate recovery New Hampshire requires Medicaid estate recovery. After a New Hampshire Medicaid recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for New Hampshire Medicaid Applications can be submitted online through NH EASY at nheasy.nh.gov, by phone at 1-844-275-3447, or in person at your local New Hampshire DHHS district office.
New Hampshire Medicaid administering agency New Hampshire Department of Health and Human Services — dhhs.nh.gov
New Hampshire Estate Tax — 2026
New Hampshire is one of the most tax-friendly states in the country — with no state income tax no estate tax no inheritance tax and no sales tax. The last remaining piece of New Hampshire income taxation — the Interest and Dividends tax — was fully repealed effective January 1 2025. New Hampshire now has zero state tax on personal income of any kind.
No New Hampshire state estate tax New Hampshire does not impose a state estate tax. No New Hampshire estate tax applies to any estate regardless of size.
No New Hampshire inheritance tax New Hampshire does not impose an inheritance tax. Beneficiaries who receive assets from a New Hampshire decedent owe no New Hampshire inheritance tax regardless of the size of the inheritance or their relationship to the deceased.
Federal estate tax New Hampshire residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No New Hampshire gift tax New Hampshire does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
No New Hampshire income tax — complete repeal as of 2025 New Hampshire has no state income tax of any kind as of January 1 2025 when the Interest and Dividends tax — the state’s last remaining income tax — was fully repealed. Social Security benefits pension income IRA and 401(k) distributions wages and all other personal income are completely free from New Hampshire state income tax. This makes New Hampshire one of only nine states with no income tax and one of the most attractive states in the country for retirees and high earners.
No New Hampshire sales tax New Hampshire has no state or local sales tax — one of only five states without a sales tax. This provides meaningful ongoing savings for New Hampshire residents on everyday purchases.
New Hampshire property taxes — among the highest in the country Despite its many tax advantages New Hampshire has very high property taxes. The average effective property tax rate is approximately 1.50 percent — among the highest in the nation. New Hampshire’s heavy reliance on property taxes to fund local education and services makes this a significant financial consideration for New Hampshire homeowners and for heirs who inherit real estate.
New Hampshire as a premier trust jurisdiction New Hampshire has deliberately built itself into one of the top trust jurisdictions in the country and the premier trust state in New England. Key features include perpetual dynasty trusts since 2004 domestic asset protection trusts since 2009 directed trusts with trust protectors and trust advisors quiet trusts and decanting without court approval. More than $311 billion sits in trusts regulated by New Hampshire. These features make New Hampshire trust law particularly valuable for high-net-worth families engaged in sophisticated estate planning.
Step-up in basis Inherited assets in New Hampshire receive a stepped-up tax basis to fair market value at the date of the original owner’s death. This can significantly reduce capital gains taxes when beneficiaries later sell inherited property.
New Hampshire Advance Directives
New Hampshire law recognizes the following advance directive documents:
New Hampshire Durable Power of Attorney for Health Care Names a healthcare agent to make medical decisions on your behalf when you are unable to do so. Must be signed and witnessed by two adults or notarized.
New Hampshire Living Will — Terminal Care Document Documents your wishes regarding life-sustaining treatment when you have a terminal condition. Must be signed and witnessed by two adults.
New Hampshire POLST — Physician Orders for Life-Sustaining Treatment New Hampshire uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or advanced practice registered nurse.
New Hampshire Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. New Hampshire has standardized out-of-hospital DNR protocols.
New Hampshire Advance Directive Registry New Hampshire does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare agent physician and any hospital or care facility where you receive care.
Free New Hampshire advance directive forms Free New Hampshire-specific advance directive forms are available at caringinfo.org and from the New Hampshire Medical Society at nhms.org.
New Hampshire Key Agencies and Resources
New Hampshire Department of Health and Human Services — DHHS Administers New Hampshire Medicaid including long term care programs. Website: dhhs.nh.gov NH EASY Portal: nheasy.nh.gov Phone: 1-844-275-3447
New Hampshire Bureau of Elderly and Adult Services — BEAS Coordinates programs and services for older New Hampshire residents including home care nutrition programs caregiver support and the New Hampshire SHIP program for free Medicare counseling. Website: dhhs.nh.gov/programs-services/senior-services Phone: 1-603-271-9203 New Hampshire SHIP — free Medicare counseling: 1-800-852-3388
New Hampshire Area Agencies on Aging New Hampshire is served by Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
New Hampshire Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: dhhs.nh.gov/programs-services/senior-services/long-term-care-ombudsman Phone: 1-800-442-5640
New Hampshire Bar Association Lawyer Referral Service Connects New Hampshire residents with attorneys including those who specialize in elder law and estate planning. Website: nhbar.org Phone: 1-603-229-0002
New Hampshire Legal Assistance Provides free civil legal services to low income New Hampshire residents including seniors on issues related to Medicaid benefits housing and elder law. Website: nhla.org Phone: 1-800-639-5290
New Hampshire Veterans Resources
New Hampshire Division of Veteran Services — NHDVS Provides services and benefits to New Hampshire veterans and their families including free VA claims assistance and connections to New Hampshire veterans resources. Website: nh.gov/nhveterans Phone: 1-603-624-9230
New Hampshire State Veterans Home New Hampshire operates a state veterans home providing long term care to eligible veterans and their spouses located in Tilton. Website: nh.gov/nhveterans/veterans-home
New Hampshire Senior Property Tax Benefits
Elderly Exemption New Hampshire municipalities offer property tax exemptions for qualifying seniors aged 65 and older who meet income and asset requirements. The exemption amount and eligibility criteria vary significantly by municipality. Contact your local assessing office for details on the program available in your town or city.
Low and Moderate Income Homeowners Property Tax Relief New Hampshire offers a state-administered property tax relief program for low and moderate income homeowners including seniors. Apply through the New Hampshire Department of Revenue Administration.
Disabled Veteran Property Tax Exemption New Hampshire veterans who are totally and permanently disabled due to a service-connected disability may qualify for a property tax exemption on their primary residence. Contact your local assessing office for details.
Finding Elder Law and Estate Planning Attorneys in New Hampshire
The following resources can help you find a qualified elder law or estate planning attorney in New Hampshire:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- New Hampshire Bar Association Lawyer Referral Service — nhbar.org — 1-603-229-0002
- New Hampshire Chapter of NAELA — New Hampshire has an active NAELA chapter with members throughout the state
- New Hampshire Legal Assistance — nhla.org — free legal assistance for income-qualifying seniors — 1-800-639-5290
The information on this page is for general informational purposes only and does not constitute legal or financial advice. New Hampshire Medicaid rules and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026