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Learn About Requirements for Medicaid in New Hampshire

What are the requirements for Medicaid in New Hampshire? Medicaid eligibility requirements are determined by the New Hampshire Department of Health and Human Services and are specific to the state. Therefore, who is eligible for Medicaid in New Hampshire will unlikely match up with the Medicaid benefits eligibility in Vermont.

What are the Medicaid application guidelines to qualify for Medicaid? There are several requirements for Medicaid that all candidates must meet. There are general Medicaid requirements, as well as Medicaid income requirements.

Regarding, “What are the income requirements for Medicaid?” these are based on household size and earnings. Once a patient meets all of the Medicaid eligibility requirements in NH, he or she will be qualified to receive Medicaid benefits.

What Are the Financial Medicaid Requirements in New Hampshire?

What are the New Hampshire Medicaid application steps in terms of income for interested patients? NH Medicaid benefits eligibility relates mainly to income because it is low-earning patients who need medical assistance from the state. In most cases, earnings separate who is eligible for Medicaid from who is not eligible.

The income requirements for Medicaid in New Hampshire are determined by reviewing the current Federal Poverty Levels (FPLs) through a system known as the Modified Adjusted Gross Income calculator. This Medicaid eligibility tool compares the FPLS to household sizes and their incomes.

What are the income requirements for Medicaid in NH? Due to Medicaid expansion that took effect in March of 2015, state plans have been amended, thus modifying the former income Medicaid eligibility requirements in New Hampshire. Now covered under the expansion of Medicaid benefits in New Hampshire are:

  • Non-working parents earning 38 to 138 percent of the FPL.
  • Working parents earning 47 to 138 percent of the FPL.
  • Childless adults earning 0 to 138 percent of the FPL.

What Are the Non-financial Medicaid  Requirements in New Hampshire?

Low-income applicants who are unsure about how to qualify for NH Medicaid must be aware of the requirements for Medicaid eligibility that are not associated with finances. Non-financial Medicaid eligibility depends on a number of factors, such as proof of United States citizenship, proof of state residency and proof of identity.

Moreover, registered Social Security Numbers are considered mandatory Medicaid eligibility requirements in the state of New Hampshire. Download our helpful guide to learn about the different requirements for Medicaid.

Who meets the requirements for Medicaid in New Hampshire?

Regarding who is eligible for Medicaid services, the state of New Hampshire has certain categorized patient groups that can receive benefits from the program. Even if the above financial requirements for Medicaid and the general Medicaid requirements are met, each applicant must fall into one of these specified patient groups. The following patients are eligible for Medicaid in New Hampshire:

  • Patients who are disabled
  • Patients who are blind
  • Pregnant women
  • Elderly patients age 65 and up
  • Children
  • Parents and caretaker relatives

Note that all the patients who qualify for Medicaid have an open enrollment period for Medicaid benefits. However, so long as a qualifying event occurs, applicants can submit Medicaid paperwork within 60 days of the event. This is better known as a Special Enrollment Period (SEP). Learn more about Medicaid requirements by downloading our comprehensive guide.

Learn About Medicaid Health Plans in New Hampshire

For residents who meet the Medicaid eligibility requirements, two health plan choices are available. The plans that supply Medicaid benefits in New Hampshire are:

  • Well Sense Health Plan – This health care plan has been in effect for more than 15 years. Medicaid members who meet the Medicaid eligibility requirements in New Hampshire and enroll will have the privilege of working closely with a wide scope of professionals as beneficiaries of the Well Sense Health Plan. Included in the participating network are state-wide pharmacies, doctors, health specialists, and behavioral health workers. Preferred doctor selection is available, as well as 24-hour nurse advice, free dental kits, and assistance with specific health conditions.
  • New Hampshire Healthy Families – Medicaid eligibility rules state that NH residents who are seeking preventative care coverage, program coordination, transportation, health coaches and pharmaceutical services will likely enroll in this health plan. Improving the health of community members, New Hampshire Healthy Families can be applied for by recipients who meet the Medicaid benefits eligibility guidelines.

Understanding How Medicaid and Medicare Work Together

What are the requirements for Medicaid if patients are also qualified for Medicare? Around 9.2 million people living in the United States will be dual-eligible for both Medicare and Medicaid. Often referred to as “duals,” these candidates typically require more extensive healthcare than other recipients of Medicaid benefits.

The requirements for NH Medicaid state that beneficiaries can receive their services separately. Application guidelines for Medicaid might not apply in this situation, because if proof of citizenship, identity and residency were previously provided for Medicare, they will not be required again.

What Are Rights for Eligible Medicaid Recipients in New Hampshire?

The state of New Hampshire has a right to protect NH residents and approach Medicaid requirements with the best interests of citizens in mind. According to the Department of Health and Human Services, recipients who know how to meet Medicaid qualifications will have the right to:

  • Select a care coordinator that best meets their needs within 90 days of meeting the income requirements for Medicaid.
  • Be informed of the reason(s) why a plan refuses treatment and/or services. Once informed, recipients who meet the requirements to be eligible for Medicaid in New Hampshire can take action and request a fair hearing.
  • Book an appointment at the doctor’s office or a hospital when necessary.
  • Request prescription drugs outside of the Medicaid benefits plan’s operating hours.