If your New Hampshire Medicaid was denied, reduced, or terminated, you have the right to appeal and request a fair hearing, and you can often keep your benefits while your case is decided. New Hampshire runs those hearings through the Department of Health and Human Services (DHHS) Administrative Appeals Unit, and it sets a filing deadline of 30 days from the date on your Notice of Decision. Ninety days is the most federal law lets a state allow, not a minimum you are owed, so the 30-day date printed on your notice is the deadline that binds you.

In This Guide

What You Can Appeal in New Hampshire Medicaid

Federal law guarantees every Medicaid applicant and beneficiary the right to a fair hearing before the state agency. Section 1902(a)(3) of the Social Security Act (42 USC 1396a(a)(3)) requires New Hampshire's Medicaid plan to grant a hearing to anyone whose claim for medical assistance is denied or is not acted on with reasonable promptness, and 42 CFR 431.220 extends that right to anyone who believes the agency acted erroneously or made an adverse determination.

In practice, that means you can appeal:

  • An application denial (income, assets, household composition, or documentation)
  • A termination or reduction of your eligibility or covered services
  • A cut in service hours, such as a reduction in personal care or in-home support
  • A prior authorization denial or a level-of-care determination
  • A managed care plan's denial, reduction, suspension, or termination of a service

The right reaches across the program, which is why federal law also lets you keep your benefits while an appeal is pending. The deadline you meet, more than the argument you make, is what usually decides whether that protection applies.

New Hampshire Medicaid Appeal Deadlines That Decide Your Case

Three windows matter, and they are not the same number. Read the date off your own Notice of Decision and count from there.

The request window is 30 days in New Hampshire, against a 90-day federal ceiling. Under 42 CFR 431.221(d), a state must allow a reasonable time, not to exceed 90 days from the date the notice is mailed, to request a hearing. New Hampshire sets a shorter operational window: DHHS states that an appeal must generally be filed within 30 days from the date on the Notice of Decision, with SNAP the exception at 90 days., Do not assume you have 90 days; for most Medicaid decisions the governing deadline is 30 days.

The keep-your-benefits window is 15 days. This is the earlier, tighter deadline, and it is the one that decides whether coverage continues while you appeal. It is covered in the next section.

The managed care windows are 60 days, then 90 to 120 days. If a managed care plan denied the service, you have 60 calendar days from the date on the plan's adverse benefit determination notice to file the plan's internal appeal. After the plan resolves that appeal against you, the state must give you no fewer than 90 and no more than 120 calendar days from the date of the plan's notice of resolution to request a state fair hearing.

One more deadline protects renewals. If your coverage ended only because you did not return a renewal form on time, you do not always have to reapply: under 42 CFR 435.916, if you submit the renewal form within 90 days after the termination date, the agency must reconsider your eligibility without a new application. That duty covers eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, New Hampshire may offer the same window but is not required to, so ask DHHS.

How to Keep Your Benefits During a New Hampshire Medicaid Appeal

Continued benefits turn on a deadline earlier than the one to file your appeal: 15 days from the date on the Notice of Decision.

The federal rule sits at 42 CFR 431.230(a). If the agency sent the required advance notice and you request a hearing before the date the action takes effect, the agency may not terminate or reduce your services until a decision is rendered after the hearing, unless the only issue is one of federal or state law or policy. This is called aid paid pending, or continued benefits.

New Hampshire applies it this way: DHHS states that if you appeal an action within 15 days of the date on the Notice of Decision, you may be able to continue receiving benefits at the same level until a decision on your appeal is issued. The practical takeaway is to act early. When an adverse notice arrives, do not wait out the 30-day filing window if you want to keep coverage. Appeal within 15 days.

There is a cost if you lose. If your benefits continue and DHHS's action is later upheld, the continued benefits will have to be repaid. Federal law permits this recovery: under 42 CFR 431.230, if the agency's action is sustained at the hearing, it may recoup the cost of the services furnished while the appeal was pending. Weigh that before you ask for continued benefits on a case you expect to lose.

Managed Care (MCO) Appeals: Exhaust Your Plan First

New Hampshire delivers most Medicaid through Medicaid Care Management, its managed care program, and as of 2026 there are three Medicaid Health Plans, also called managed care organizations (MCOs): AmeriHealth Caritas New Hampshire, NH Healthy Families, and WellSense Health Plan. If your denial came from your plan, you appeal to the plan before you can reach a state fair hearing. These rules come from the federal managed care regulations at 42 CFR Part 438.

The plan must first give you notice of its decision. Under 42 CFR 438.404, that notice of an adverse benefit determination must be timely and in writing, including for any termination, suspension, or reduction of a previously authorized service. It must explain the reasons for the decision, tell you how to appeal and how to exhaust the plan's one level of appeal, and tell you how to request that your benefits continue during the appeal.

The internal appeal comes before any state hearing. You have 60 calendar days from the date on the determination notice to file the plan's internal appeal, which can be requested orally or in writing, and the plan has only one level of appeal. DHHS instructs members to request a state fair hearing after completing the plan's appeal process if the plan continues to deny a service. Going straight to a state hearing without finishing the plan's appeal gets the request dismissed.

The plan must resolve a standard appeal within 30 calendar days and an expedited appeal within 72 hours of receiving it, and either timeframe may be extended by up to 14 calendar days if you request the extension or the plan shows the state that more information is needed and the delay is in your interest. Ask for the expedited 72-hour track whenever waiting on the standard timeline could seriously jeopardize your life, health, or ability to regain function.

If the plan fails to meet 42 CFR 438.408's notice and timing requirements for resolving your appeal, the appeal is deemed exhausted, and you may go straight to a state fair hearing., When the plan does resolve the appeal and upholds its denial, you have 90 to 120 days from the plan's notice of resolution to request the state fair hearing.

How to Request a New Hampshire Medicaid Fair Hearing

New Hampshire routes Medicaid fair hearings through the DHHS Administrative Appeals Unit (AAU), which DHHS describes as independent of its Program Offices and Divisions and charged with conducting impartial hearings. You do not file with a separate court or a central hearings agency; the request goes to DHHS.

Generally, your appeal request must be in writing. You can use the DHHS Appeal Request form or simply write a letter, and you can submit it in any of these ways:

  • Drop it off or mail it to your local DHHS District Office
  • Mail it to the Administrative Appeals Unit
  • Email it to the AAU at dhhs.aau@dhhs.nh.gov

If you cannot complete the form or write a letter, you may start an appeal by telling a DHHS representative that you want to file one. The Administrative Appeals Unit is located at 105 Pleasant Street, Concord, NH 03301, and can be reached at (603) 271-4292 or (800) 852-3345.

Frequently Asked Questions

How long do I have to appeal a New Hampshire Medicaid denial?

The deadline depends on who denied you. If the denial came from DHHS, you file within 30 days from the date on the Notice of Decision. If a managed care plan denied the service, you first have 60 calendar days from the plan's notice to file the plan's internal appeal, then a separate 90-to-120-day window to request a state fair hearing once the plan rules. SNAP decisions keep the full 90-day federal maximum, which is the ceiling New Hampshire's shorter 30-day window operates under.,

If I keep my benefits during the appeal and lose, do I have to pay them back?

Yes. Continued benefits are repayable if you lose: under 42 CFR 431.230, if DHHS's action is sustained at the hearing, it may recoup the cost of the services furnished while the appeal was pending. To get continued benefits at all, you must appeal within 15 days of the date on the Notice of Decision, and they run at the same level until a decision is issued. Weigh that repayment risk before you request them on a case you expect to lose.

Do I need a lawyer for a New Hampshire Medicaid fair hearing?

You can handle a New Hampshire Medicaid appeal yourself. DHHS lets you start an appeal by submitting the Appeal Request form, writing a letter, or simply telling a DHHS representative you want to appeal, so you do not need a lawyer to begin one. Representation can still help on medical-necessity, level-of-care, and prior authorization disputes, where a letter from your treating provider documenting the need often decides the case.

What is the difference between a managed care plan appeal and a state fair hearing?

A managed care plan appeal (also called an MCO, or managed care organization, appeal) is the internal appeal you file with AmeriHealth Caritas New Hampshire, NH Healthy Families, or WellSense Health Plan, and it is the required first step when your plan denies a service. The plan must resolve a standard appeal within 30 days or an expedited one within 72 hours. Only after the plan upholds its denial can you request a state fair hearing through the DHHS Administrative Appeals Unit, and you then have 90 to 120 days from the plan's notice of resolution to do so.

Learn More

MedicaidHow to Appeal a Medicaid DenialDenied Medicaid? You can appeal, and one deadline decides whether your benefits keep flowing during the appeal. Know your fair-hearing rights and act fast. MedicaidNew Hampshire Medicaid: The Complete GuideSee who New Hampshire Medicaid covers, the 2026 income and asset limits, the Choices for Independence home-care waiver, and how to apply through NH EASY. MedicaidNew Hampshire Medicaid Eligibility and Income LimitsNew Hampshire Medicaid eligibility and 2026 income limits: expansion adults, the long-term-care income cap and asset limit, and the over-income pathway. MedicaidHow to Apply for New Hampshire MedicaidHow to apply for New Hampshire Medicaid in 2026: the three ways to apply, what documents to bring, the decision timeline, and the over-income pathway.

Find personalized help navigating a New Hampshire Medicaid appeal 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.

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