After someone who received New Hampshire Medicaid dies, the state can file a claim against their estate to recover what it paid for their care. New Hampshire reaches further than many families expect: it recovers for all Medicaid medical assistance received at age 55 or older, not just nursing-home care, and its claim can follow property that passes outside probate. The good news for most families is that recovery never touches a living spouse, comes only out of the estate, and can be waived when it would cause real hardship.,

In This Guide

Who Is Affected by New Hampshire Medicaid Estate Recovery

New Hampshire's Estate Recovery Unit pursues a claim when all of these are true:

  • The person received New Hampshire Medicaid.
  • They were 55 or older when they received that assistance.
  • They have died, and any surviving spouse has also died.
  • No surviving child of theirs is under 21, blind, or permanently and totally disabled.

That third and fourth condition matter as much as the dollars. Under RSA 167:16-a, recovery may not touch the estate while a spouse is alive, and it is barred entirely while the recipient leaves a child who is under 21 or is blind or permanently and totally disabled.

Here is where New Hampshire is broader than the picture most families carry. Federal law sets a floor: states must at least recover the cost of long-term care, such as nursing facility and home- and community-based waiver services, for recipients 55 and older. New Hampshire goes past that floor. RSA 167:16-a limits recovery by the recipient's age and surviving family only, with no restriction to long-term care, and DHHS recovers for a list of programs that includes Old Age Assistance, Aid to the Needy Blind, Aid to the Permanently and Totally Disabled, Medicaid for Employed Adults with Disabilities, Granite Advantage (the state's Medicaid expansion program), and the Breast and Cervical Cancer Program. In plain terms, New Hampshire can recover for all Medicaid medical assistance a person received at 55 or older, not only their long-term-care bills.

What New Hampshire Can Claim

The state seeks repayment of the actual amount New Hampshire Medicaid spent on the recipient. The claim runs against the estate, and recovery can never exceed the total medical assistance the state paid for that person.

For most families the question is really about one asset: the house. New Hampshire does not routinely file a lien on a living recipient's home, and while a protected family member is living there, the home is safe. Once those protections end, the home can be reached. The important New Hampshire wrinkle is that reaching it does not depend on the home passing through probate.

Two limits cap what the state can take from a non-probate asset. Recovery is limited to the value of the recipient's own ownership interest in the property, and it does not extend to any interest that a non-recipient co-owner paid fair market value to acquire. So a child who genuinely bought into a property, for value, keeps the share they paid for.

One point worth separating out, because it causes real confusion. Medicaid's home-equity limit, the figure that can affect whether someone qualifies for long-term-care Medicaid in the first place, is an eligibility rule applied while the person is alive. It is not a ceiling on estate recovery. Recovery keys on what Medicaid actually spent, and can never exceed what the state paid for that person.

Who Is Protected

Federal law lists people whose presence blocks or delays recovery, and New Hampshire must honor them. While one of these protections applies, the state cannot collect.

Protected person What it protects How it works
Surviving spouse The whole estate No recovery may be taken while the recipient's spouse is living
Child under 21 The whole estate Recovery is barred while any child of the recipient is under 21
Blind or disabled child The whole estate Recovery is barred while the recipient has a child of any age who is blind or permanently and totally disabled
Sibling who lived in the home The home (hardship waiver) A sibling who lived in the home for at least a year before the recipient entered care and has resided there continuously since may qualify for a hardship waiver, no equity interest required
Caregiver child The home (hardship waiver) A path to a hardship waiver when an adult child gave years of at-home care (see below)

The spouse and minor-or-disabled-child protections above come from federal law and bar recovery outright. The sibling and caregiver-child protections are New Hampshire hardship-waiver grounds under He-W 895.04, covered in detail below. A separate one-year, equity-interest sibling test can block a pre-death lien, which is a different mechanism described in the next section, so do not assume the two tests are the same.,

If a protection may apply to you, notify the DHHS Estate Recovery Unit as soon as the recovery notice arrives, and be ready to document the relationship and the qualifying facts, such as a marriage certificate, birth records, or a disability determination.

The Pre-Death Lien on a Home

New Hampshire can, in narrow circumstances, place a lien on a recipient's home while they are still living. Under RSA 167:16-a, the state may not impose a lien to evict, partition, or force the sale of a living person's property on account of Medicaid, with two exceptions: a court order or judgment for benefits paid incorrectly, or the home of a recipient who is an inpatient in a nursing facility or other medical institution and whom DHHS determines, after notice and a chance for a hearing, cannot reasonably be expected to be discharged and return home.

Even then, a lien cannot be placed if certain people live in the home: the recipient's spouse; a child under 21 or a child who is blind or permanently and totally disabled; or a sibling who has an equity interest in the home and lived there for at least a year before the recipient entered the institution. And a lien placed under the inpatient exception dissolves if the recipient is discharged and goes home.

A lien is often misread as a seizure. According to DHHS, a lien does not mean the recipient has to move or sell the home, and it does not make the state the owner. The state collects on the lien when the property is later sold, transferred, or refinanced, and DHHS will not file one without first giving notice of its intent and an opportunity for a hearing.

When Property Passes Outside Probate

This is the part of New Hampshire's program that surprises families most, so it is worth slowing down on. Titling a house jointly, putting it in a revocable trust, or naming a beneficiary does not automatically place it beyond the state's reach.

Under RSA 167:14-a, New Hampshire's recoverable estate is larger than the probate estate. All property in a revocable trust is subject to recovery. So is property held at death in joint tenancy with right of survivorship or in a life estate, as long as that title or interest was created on or after July 1, 2005. Interests created before July 1, 2005 fall outside the expanded estate. That date is a genuine dividing line: an old joint deed signed decades ago is treated differently from one created in the last twenty years.

Because a non-probate asset never enters the probate court, New Hampshire uses a separate notice-and-payment process for it, set out in RSA 167:14-a. Here is how it runs:

1
Step 1

Notice

No sooner than 45 days after the recipient's death, DHHS sends the surviving co-owner or owners written notice of its claim. That notice must describe the categories of people who are exempt from recovery by family status, and it must state that a hardship waiver is available and how to request one.

2
Step 2

The co-owner's 30 days

Within 30 days of receiving that notice, the co-owner must acknowledge it and, unless doing so would cause undue hardship, either pay an amount equal to the deceased recipient's interest in the property (never more than the total Medicaid the state paid) or enter a binding agreement to pay as soon as practicable.

3
Step 3

If no one responds

If the co-owner will not acknowledge the claim or pay, or breaks a payment agreement without good cause, the DHHS commissioner can go to superior court or probate court to compel payment.

The family protections still apply here. Nothing in this non-probate process can be used to recover when the recipient is survived by a spouse, a minor or disabled child, or the siblings and caregiver children the exemptions describe.

The Undue-Hardship Waiver

New Hampshire must offer a way out when recovery would cause real hardship, and the state actually has two independent reasons it will waive a claim. Recovery is waived if it would cause undue hardship to the heir, or if DHHS decides recovery is not cost effective, meaning the amount recovered would exceed the department's own cost of pursuing it by less than $500. A recovery that nets the state under $500 over its costs is not worth pursuing, and the rules say so.

The undue-hardship side has six grounds under the state rules (He-W 895.04). DHHS must waive recovery when any one of them is met:

  • A business or farm on the estate's real property that has run at the heir's primary residence for at least a year, produces more than half the heir's livelihood, and would be lost to recovery.
  • Income-producing property the heir has maintained with their own money for the past year, which produces more than half their livelihood and would be lost.
  • Personal property only, where recovery would leave the heir needing public assistance.
  • A caregiver child or grandchild who lived in the recipient's home for at least two years before the recipient entered care, provided daily uncompensated care over those two years that kept the recipient out of an institution, and has lived in the home continuously since. This one carries an evidence burden: the request must be backed by affidavits from at least two medical professionals who cared for the recipient, confirming the care given.
  • A sibling who lived in the home for at least a year before the recipient entered care and has resided there continuously since.
  • A remainderman or surviving joint tenant who paid value for their interest, either when it was created or to cure a transfer penalty.

The deadlines here are strict, and they are the reason to act quickly. DHHS must tell you about the waiver in writing at the same time it sends its claim. A hardship waiver request must be filed within 30 days of the recipient's death or within 30 days of the date DHHS filed its claim with the probate court, whichever is later. DHHS then has 90 days to decide, must put the decision in writing, and must explain your appeal rights if it says no. A denial can be appealed within 30 days.

How to Respond to a New Hampshire Medicaid Estate Recovery Notice

If you are reading this because a parent or spouse has died and a notice has arrived, take a breath first. You are grieving and being handed a deadline, which is a hard combination. The dates are real, but they are workable, and you do not have to solve everything in one sitting.

1
Step 1

Read the notice for the amount and every date

New Hampshire's response windows are firm, so the deadlines matter as much as the dollar figure. Note the 30-day hardship-waiver window in particular.

2
Step 2

Raise any protection that applies

If there is a surviving spouse, a minor or disabled child, a qualifying sibling, or a caregiver child, put it in writing to the Estate Recovery Unit right away, with documents that prove it.

3
Step 3

File a hardship waiver request if one fits

Do it within the deadline. A well-documented, on-time request stands a far better chance than a late or thin one, and a caregiver-child claim needs those two medical affidavits.

4
Step 4

If a non-probate asset is involved, answer the notice

A surviving joint owner or life-estate holder has only 30 days to acknowledge the claim and either tender the recipient's interest or agree to a payment plan. Ignoring it invites a court action.

5
Step 5

Talk to a New Hampshire elder law attorney

The expanded-estate rules, the July 2005 date, and the probate process carry real technical nuance. An attorney who knows New Hampshire Medicaid can spot defenses, handle the paperwork, and represent the estate at a hearing.

6
Step 6

Resolve the claim

If recovery is proper and no waiver applies, the estate pays the state's claim before assets pass to heirs. Heirs are not on the hook for anything beyond the estate.

Frequently Asked Questions

Will New Hampshire Medicaid take my house?

It can, but only after death, and not while a protected person is living. Recovery is barred while a surviving spouse is alive, or while the recipient leaves a child under 21 or a blind or disabled child. Once no protection applies, the home can be reached, and because New Hampshire uses an expanded estate, that holds true whether the home passes through probate or outside it (for interests created on or after July 1, 2005). A caregiver child, a sibling who lived in the home, or a co-owner who paid value for their share may qualify for a protection or hardship waiver.

Does putting the house in joint names or a trust protect it?

Not by itself in New Hampshire. Property in a revocable trust is fully recoverable, and joint-tenancy and life-estate interests created on or after July 1, 2005 are part of the recoverable estate. Interests created before that date are treated differently. This is the single most important thing to understand about how New Hampshire recovery works, and it is where families most often assume they are safe when they are not.

Are heirs personally responsible for the Medicaid bill?

No. The claim runs against the estate. Recovery can never exceed what New Hampshire Medicaid actually paid for the recipient, and if the estate cannot cover the claim, heirs receive less but owe nothing out of their own money.

What is the deadline to ask for a hardship waiver?

You must file within 30 days of the recipient's death or within 30 days of the date DHHS filed its claim with the probate court, whichever is later. DHHS must decide within 90 days and give you a written decision, and a denial can be appealed within 30 days. Because the clock is short, read the notice for its dates the day it arrives.

What if the estate is small?

New Hampshire will still waive recovery if it is not cost effective, meaning the state would net less than $500 over its own costs of collecting. Separately, if recovery would leave an heir needing public assistance and the estate is only personal property, that is one of the six hardship grounds. A modest estate is exactly the situation the waiver exists for.

New Hampshire's expanded estate and short waiver deadlines make an early response important. A New Hampshire elder law attorney can review the estate, identify who is protected, and help the family members who qualify for an exemption or hardship waiver.

Learn More

MedicaidNew Hampshire Medicaid: Eligibility and How to ApplySee 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 Long-Term Care: Nursing Home and Home CareNew Hampshire Medicaid pays for long-term care in a nursing home or at home through the Choices for Independence waiver. See the 2026 income and asset limits. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting.

Find personalized help understanding New Hampshire Medicaid estate recovery 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.