NH Medicaid (Medical Assistance) Eligibility

The Department of Health and Human Services (DHHS) determines Medicaid financial eligibility and all non-financial eligibility, including disability determinations, for the following:

• infants and children under the age of 19 
• pregnant women 
• parents/caretaker relatives 
• former foster care children 
• individuals age 19 and under 65 (Granite Advantage Health Care Program)
• family planning expansion category (limited coverage)
• individuals with blindness 
• refugees 
• non-citizens
• seniors 
• individuals with disabilities 
• individuals requiring long-term care services

Eligibility Criteria

There are three basic criteria that DHHS uses to make an eligibility determination for Medical Assistance:

• income
• resources (based on eligibility group)  
• non-financial criteria, such as NH residency

Specific income and resource limits are used to determine eligibility for each Medicaid group. While non-financial information is generally the same for each Medicaid group, there are some differences – for example, an application for services under the Aid to the Needy Blind eligibility group requires an individual to have a medical necessity determination of legally blind, while an application for services for seniors has no medical necessity requirement, but does have an age requirement. Specific details regarding income, resource, and non-financial requirements are explained for each kind of medical assistance on the NH Medicaid (Medical Assistance) eligibility pages under Related Resources. 

Disability Determinations

DHHS is responsible for making disability determinations for:

• Aid to the Permanently and Totally Disabled (APTD)
• Home Care for Children with Severe Disabilities (HC-CSD) (Commonly known as the "Katie Beckett" option.)
• Aid to the Needy Blind (ANB)
• Medicaid for Employed Adults with Disabilities (MEAD)
• Medicaid for Employed Older Adults with Disabilities (MOAD)

In and Out Medical Assistance

In and Out Medical Assistance helps individuals whose income is not enough to pay their medical bills but is too much to qualify for Medicaid. Individuals are given a Spenddown, similar to a car insurance deductible. When qualifying medical expenses add up to the spenddown amount, Medicaid can then help pay for bills incurred for the duration of the Spenddown period. For more information about In and Out Medical Assistance read:

What Is In And Out Medical Assistance? (Form 77j)