New Hampshire is one of the most expensive states in the country for senior care. Assisted living runs about $7,431 a month and a semi-private nursing-home room about $149,650 a year, both well above the national figures. Which setting a family needs can change the bill by tens of thousands of dollars a year.
This guide lays out what every senior-care setting in New Hampshire costs side by side, what pushes the price up or down, and how families actually pay, from private funds to Medicaid for those who qualify.
In This Guide
- Key Takeaways
- What Each Setting Costs in New Hampshire
- What Drives the Price
- How Families Pay
- How to Plan and Budget
- Frequently Asked Questions
What Each Setting Costs in New Hampshire
The figures below come from the CareScout (Genworth) Cost of Care Survey, the 2024 release that gives the most recent state-level data. These are medians from an industry survey, not government rates and not maximums, so the cost at any one provider can land higher or lower depending on location, room type, and how much care a person needs.
Read across the settings and one thing stands out: New Hampshire runs above the national figures in every category. A semi-private nursing-home room costs roughly $38,000 a year more than the national median for the same room, and even assisted living, often the more affordable facility option, sits nearly $19,000 a year above the national line.
| Care setting | New Hampshire (year) | New Hampshire (month) | National (year) |
|---|---|---|---|
| Assisted living | $89,175 | $7,431 | $70,800 |
| Nursing home, semi-private room | $149,650 | $12,471 | $111,325 |
| Nursing home, private room | $157,680 | $13,140 | $127,750 |
| Home health aide (44 hrs/wk) | $89,232 | $7,436 | n/a |
| Homemaker services (44 hrs/wk) | $86,944 | $7,245 | n/a |
The in-home figures assume a steady schedule of about 44 hours a week, which is closer to daily help than around-the-clock supervision. A home health aide, who can help with hands-on personal care like bathing and dressing, runs about $89,232 a year, while a homemaker, who handles household tasks like cooking and cleaning but not personal care, runs about $86,944. Notice how close those two come to the cost of a facility: in New Hampshire, part-time in-home help is priced near assisted living, and round-the-clock home care costs far more, because the hours multiply quickly. That math is why heavy daily needs often tip families toward a facility.
What Drives the Price
The single biggest driver of cost is the level of care a person needs. A nursing home provides 24-hour licensed nursing care, which means a staff of nurses and aides on every shift, plus the building, equipment, and oversight that skilled care requires. Assisted living, by contrast, is built for people who need help with daily tasks but not constant skilled nursing, so it carries a lighter staffing load and a lower price. In-home care falls along the same spectrum: a homemaker who handles chores costs less per hour than an aide who provides hands-on personal care.
New Hampshire layers a second driver on top of that: the state simply runs high. Its medians sit above the national figures across every setting, not just one. A high cost of living, a tight labor market for caregivers in a small state, and strong demand for a limited number of beds all push prices up. The result is that even the more affordable options here cost more than the national average, so a New Hampshire budget has to start from higher numbers than a national rule of thumb would suggest.
Within any single setting, the advertised rate is rarely the whole bill. A facility usually quotes a base rate for room and routine services, then adds charges as care needs grow: help with more activities of daily living, medication management, memory care, or a higher staffing tier. A resident who enters needing little help and later needs much more can see the monthly cost climb well past the opening figure. When you compare quotes, ask what the base rate includes and what triggers an add-on, because two facilities with similar headline prices can bill very differently once care needs rise.
How Families Pay
Almost no one pays for years of senior care out of a single source. Most families start with private funds and shift to other payers as the bills mount. Here's how the main options work in New Hampshire.
Private pay is savings, income, the proceeds of a home sale, and long-term care insurance if a person bought it. It's the most flexible option, since it covers any setting, but it's also the one that runs out, and at $149,650 a year for a nursing home, it can run out fast. Long-term care insurance, where it exists, can offset a share of the cost, though policies vary widely in what they pay and for how long.
New Hampshire Medicaid, administered by the state Department of Health and Human Services, pays for nursing-home care for people who meet a nursing-facility level of care and the financial rules. For a single applicant in 2026, the monthly income standard for institutional Medicaid is 300% of the SSI federal benefit rate, about $2,982, and the countable-asset limit is $2,500, which is higher than the $2,000 limit most states use. A married applicant whose spouse stays in the community can protect a higher resource allowance for that spouse, up to $162,660 in 2026, so the couple isn't held to the single-person figure. A resident on Medicaid pays most of their monthly income toward the cost of care and keeps a personal needs allowance of about $90 a month for small personal expenses.
Two more Medicaid rules shape long-term-care planning. New Hampshire applies a 60-month look-back to assets transferred for less than fair value, which can trigger a penalty period of ineligibility, so giving money away to qualify can backfire. And the state recovers from the estates of people who received long-term-care services at age 55 or older, with recovery deferred while a surviving spouse or a child who is under 21 or disabled is living. If a nursing home isn't the right fit, New Hampshire funds home and community-based care for older adults mainly through the Choices for Independence waiver, which supports people who would otherwise need nursing-facility care in their own homes and communities.
One gap trips up many families: Medicaid does not pay the room-and-board cost of assisted living. New Hampshire's Medicaid long-term-care coverage centers on nursing-facility care and the Choices for Independence waiver; it does not cover the rent-and-meals portion of an assisted-living bill the way it covers a nursing-facility stay. A family choosing assisted living should plan to cover room and board privately, even where a waiver or other support helps with the care services.
A note on Medicare, because the assumption is common: Medicare covers only short-term skilled rehab after a hospital stay, not the long-term custodial care, the ongoing help with daily living, that most families are budgeting for. That long-term care is what private pay and Medicaid cover.
How to Plan and Budget
Start by matching the setting to the actual need, not the other way around. Because the gap between assisted living and a nursing home in New Hampshire is wide, about $60,000 a year, it's worth a candid assessment of how much help a person truly needs before defaulting to the most intensive option. Many people who need help with daily tasks but not skilled nursing are well served by assisted living, though in this state the savings over a nursing home are real but smaller than families often expect, and in-home care is priced close to a facility too.
Then build a realistic timeline. Estimate the monthly cost of the right setting, list the resources available to pay for it, and work out how long private funds will last before Medicaid would come into play. If Medicaid is likely to be part of the plan, the look-back and estate-recovery rules reward starting early and getting advice, because last-minute moves to qualify often trigger penalties. Two Brevy guides go deeper here: Medicaid Planning Strategies walks through how to position assets and income within the rules, and Medicaid Personal Needs Allowance, Explained covers the small monthly amount a resident keeps.
Finally, budget for the add-ons, not just the base rate. Care needs tend to rise over time, so the figure you start with is rarely the figure you finish with. A plan that assumes some increase is more likely to hold up than one built on today's lowest quote.
Frequently Asked Questions
It depends heavily on the setting. Per the 2024 CareScout (Genworth) Cost of Care Survey, assisted living runs about $89,175 a year (roughly $7,431 a month), a semi-private nursing-home room about $149,650 a year, a private room about $157,680, a home health aide about $89,232, and homemaker services about $86,944 (the in-home figures at roughly 44 hours a week). These are statewide medians from an industry survey, not maximums, so an individual provider can cost more or less.
New Hampshire's medians run above the national figures in every setting, not just one. A high cost of living, a tight labor market for caregivers in a small state, and strong demand for a limited number of beds all push prices up. On top of that, the level of care a setting delivers is the biggest single driver, which is why a nursing home, with 24-hour licensed nursing, costs far more than assisted living.
For nursing-facility care, yes, if a person meets a nursing-facility level of care and the financial rules. New Hampshire Medicaid, run by the state Department of Health and Human Services, sets a 2026 income standard of about $2,982 a month and a $2,500 countable-asset limit for a single applicant, with a higher resource allowance protected for a community spouse. A resident pays most of their income toward care and keeps about $90 a month as a personal needs allowance. New Hampshire also funds home and community-based care through the Choices for Independence waiver.
Not the room-and-board cost. New Hampshire's Medicaid long-term-care coverage centers on nursing-facility care and the Choices for Independence waiver, and it does not cover the rent-and-meals portion of an assisted-living bill the way it covers a nursing-facility stay. A family choosing assisted living should plan to pay room and board privately.
Most start with private pay, savings, income, home-sale proceeds, and long-term care insurance if they have it, then turn to New Hampshire Medicaid once a person meets a nursing-facility level of care and the financial rules. Because Medicaid has a 60-month look-back on transferred assets and recovers from the estates of people who got long-term care at age 55 or older, planning early and getting professional advice usually pays off.
Learn More
Find personalized help building a realistic senior-care budget for New Hampshire at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.