Page Reviewed / Updated - November 05, 2020
The costs associated with senior care can be complicated, particularly since different geographic ranges within New Hampshire have differing costs. On this page, the costs of assisted living, home care, and adult day care in various geographic regions throughout the state will be explored. Programs that provide financial and care assistance, both in the home and in the community, will also be covered.
The programs listed on the page include all of the programs provided by the state of New Hampshire. However, there are also other options that are available on a national level and these programs are not listed on this page. To assist in your search for these other options, please use our Resource Locator Tool. This tool is free of charge to use, is easy to navigate, and is very instrumental in exploring all of your options for elderly care.
Cost of Care Calculator
As of 2020, according to Genworth’s Cost of Care Survey 2019, the average cost of assisted living in New Hampshire is very high throughout the state when compared to the nationwide average cost. That said, the nationwide average is $4,051 / month, while New Hampshire’s statewide average is $7,021 / month. In Manchester, the monthly average is even higher at $7,182. Memory Care assisted living, also called Alzheimer’s Care, is available for individuals suffering from moderate to severe dementia. On average, one should expect to pay an additional $1,795 / month more than for traditional assisted living, as this type of care generally costs 20% - 30% more.
The average cost of home care (non-medical) throughout the state of New Hampshire in 2020, as indicated by Genworth’s 2019 Cost of Care Survey, is $27.50 / hour. As with the cost of assisted living, Manchester is slightly more costly at $27.75 / hour. Home health care (medical care) is another option for senior care and costs approximately $.75 / hour more than home care.
For seniors who wish to remain living in their own home, or the home of a family member, adult day care, which provides daytime supervision and assistance, is one of the most affordable options for elderly care in New Hampshire. Statewide, per Genworth’s Cost of Care Survey 2019, the average daily cost is $82 /day in 2020. Hillsborough County, which includes Manchester, is the costliest geographic area in New Hampshire, with an average daily cost of $86.
Medicaid is a jointly funded (state and federal) health care program for low-income residents of the United States. While the parameters of the program are set federally, each state is able to work within these parameters to run the program to best fit the needs of their particular state. As in all states, nursing home care is paid for by the state Medicaid plan in New Hampshire. Some limited personal care is also covered. The Medicaid state plan is an entitlement program, which means that anyone who meets the eligibility requirements of the program is able to receive services.
The Personal Care Attendant Services (PCAS) Program is part of New Hampshire’s Medicaid plan and is intended for physically disabled state residents who are 80% wheelchair-bound. Intended to prevent premature nursing home placements, PCAS provides supports to promote independence and aging at home, the home of a relative, or an adult foster care home. Benefits include assistance with daily living activities, such as mobility, bathing, hygiene, shopping for essentials, and light housecleaning.
In addition to the state Medicaid plan, New Hampshire also has a Home and Community Based Services (HCBS) Waiver for elderly and disabled residents, which is not an entitlement program. This means that the number of New Hampshire residents who are able to receive services via this waiver is limited. Therefore, a wait list may exist. This HCBS waiver is intended to assist those who are seniors and/or disabled in remaining in the community, rather than require nursing home placement.
The Choices for Independence Waiver, previously called the Elderly and Chronically Ill Waiver, provides services for those who require a nursing home level of care. Supports may be received in a variety of settings, including the individual’s home, a residential care home, an adult foster care home, or an assisted living facility. A number of supports are provided via this waiver, including personal emergency response services, home health services, specialized durable medical equipment, meal delivery, home and vehicle modifications, and adult day care. This waiver allows for self-direction, allowing individuals to choose their own providers for care services.
In order for seniors to be eligible for Medicaid in New Hampshire, there are both income and asset restrictions. As of 2020, an individual’s income must not be greater than $797 / month. However, New Hampshire allows applicants to “spend down” their income, and therefore, qualifying for Medicaid. For instance, after an applicant’s medical expenses are paid, if their remaining income is at / or under $591 / month, they will qualify for services under Medicaid, as far as income is concerned. (This is often called the medically needy pathway or a “Spend Down” program). Furthermore, Supplemental Security Income or SSI is not counted as income, so the effective income limit is $1,374 ($591 + $783 in SSI).
The asset limit is set at $1,500 and includes all liquid assets (assets that can quickly be turned to cash without losing value or losing very little value), such as cash, mutual funds, stocks, and retirement funds. (For the medically needy pathway, the asset limit is $2,500). A senior’s primary home, if his / her equity interest is valued under $595,000 and he / she (or his / her spouse) lives in it, is considered exempt.
If one is over the asset limit, it’s extremely important that one does not give away assets or sell them very cheaply to meet the asset limit. Doing so violates Medicaid’s 5-year look-back period, which will result in a period of Medicaid ineligibility as a penalty. There are ways in which one can effectively spend down assets without violating Medicaid’s look-back period. For instance, one can make home and safety modifications, such as adding a first floor bedroom to their house, installing a chair lift, and updating heating and plumbing systems.
Please note, the income limit for the Choices for Independence Medicaid Waiver is higher than it is for the state Medicaid plan. As of 2020, the income limit is $2,349 / month. The asset limit is also higher at $2,500.
The process of applying for Medicaid can be tricky, especially if one has income and / or assets over the allowable amount(s). In this instance, consulting a Medicaid planning professional may be very beneficial, as they are very knowledgeable on restructuring finances for eligibility purposes.
Unfortunately, New Hampshire does not have any non-Medicaid state programs offering assistance with elderly care. However, the following two programs may free up income that could in turn be used to pay for senior care.
The Low Income Home Energy Assistance Program (LIHEAP) offers financial assistance for low-income individuals and families to assist in paying for heating and cooling their home.
Discount Prescription Drug Cards offer discounts anywhere from 15% to 85% off prescription medications.
In addition to the state specific programs that assist in covering the cost of elderly care in New Hampshire, there are also federal and non-profit programs available. In order to find other programs that assist in paying for care or reduce your out-of-pocket cost, make sure to use our Resource Locator Tool. This tool makes it easy to locate and consider all of your options and choose the program that best fits the circumstances. Eldercare loans and programs that aid veterans with assisted living are other available options.
With such a wide range of cost for elderly care in New Hampshire, it is extremely important to find care at an affordable rate. In order to do so, one should accurately assess what care is needed and check rates with multiple providers. Our organization has paired with multiple organizations that are able to match your needs with high quality providers within your budget and geographic location. There is no charge for this service. Click here for help in finding assistance options.
For more information about the costs and resources available in New Hampshire cities, click on the links below.