How Medicaid Can Help Pay for Long-Term Care in New Hampshire

Q: Does my spouse's assets count against my Choices for Independence Waiver eligibility?

No — this is a genuinely unique rule in New Hampshire. When only one spouse applies for the CFI Waiver, the non-applicant spouse's assets are not counted, treating the applicant as an assistance group of one even though a spouse lives in the same household. This is structurally different from nursing home Medicaid, where a couple's assets are counted jointly.

Q: What is New Hampshire's actual Medicaid asset limit?

$2,500 for a single applicant — not the $2,000 figure commonly applied to other states.

Q: Can I hire my spouse as my caregiver in New Hampshire?

In some cases, yes — the Choices for Independence Waiver's self-direction option allows choosing your own care providers, including family members and, in certain cases, a spouse, for unskilled and custodial care services. This makes New Hampshire one of relatively few states allowing spousal compensation for personal care.

Published August 28, 2026 How we keep this accurate

This page is New Hampshire-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.

A genuinely unique rule about spousal assets

New Hampshire's Choices for Independence (CFI) Waiver — named to reflect the state's "Live Free or Die" emphasis on individual autonomy — treats spousal assets in a way that's genuinely different from most states.

When only one spouse applies for CFI, the non-applicant spouse's assets aren't counted at all. The applicant is treated as an assistance group of one, even though a spouse lives in the same household. This is structurally different from nursing home Medicaid, where a couple's assets are counted jointly regardless of who's applying.

Why this genuinely matters for your decision

	CFI Waiver (home care)	Nursing Home Medicaid
Spouse's assets counted?	No	Yes — jointly owned
2026 asset limit (single applicant)	$2,500	$2,500
Guaranteed if eligible?	No — limited slots, waitlists possible	Yes — an entitlement

Source: New Hampshire Department of Health and Human Services (DHHS); figures effective 2026.

If a couple has meaningful assets in the non-applicant spouse's name, CFI can be genuinely more accessible than nursing home Medicaid — worth discussing with a caseworker or elder law attorney if you're weighing home care against a nursing facility for financial reasons as much as care preference.

A rare option for spousal caregiving

CFI's self-direction option lets participants choose their own care providers, including family members — and in some cases, a spouse — for unskilled and custodial care services. This makes New Hampshire one of relatively few states nationally allowing spousal compensation for personal care.

A distinctive delivery structure

Unlike standard New Hampshire Medicaid, which runs through managed care organizations, long-term care services — nursing facility care, home health, and CFI Waiver services — are delivered through fee-for-service instead. This is a real structural difference worth knowing if you're used to navigating managed care plans for other coverage.

The 2026 financial numbers

Income limit: $2,982/month — this resets every January, tied to 300% of the SSI benefit rate.

Community Spouse Resource Allowance: up to $162,660 for nursing home Medicaid, with a $32,532 minimum.

Spousal income allowance: up to $4,067/month, depending on the community spouse's housing and utility costs.

A real estate market worth knowing about

New Hampshire's proximity to Boston and its vacation-property culture in the Lakes Region and White Mountains means home values — and therefore home equity considerations — can run higher than in many other states. Worth factoring in if a family vacation property is part of the financial picture.

How to actually start

Contact the Bureau of Elderly and Adult Services at 1-800-351-1888 to determine which program — CFI Waiver or nursing home Medicaid — actually fits your household's financial situation, especially if you're married.

If a spouse's individual assets are significant, ask specifically how CFI's assistance-group-of-one rule applies before assuming standard joint-asset counting rules apply.

Common Questions

Does my spouse's assets count against my Choices for Independence Waiver eligibility?

No — a genuinely unique rule treats the applicant as an assistance group of one, unlike nursing home Medicaid's joint-asset counting.

What is New Hampshire's actual Medicaid asset limit?

$2,500 for a single applicant — not the more commonly cited $2,000.

Can I hire my spouse as my caregiver in New Hampshire?

In some cases, yes, through CFI's self-direction option for unskilled and custodial care.