New Hampshire Medicaid pays for care at home and in the community, and it does that mainly through the Choices for Independence (CFI) waiver. CFI is the state's main Medicaid Home and Community-Based Services (HCBS) waiver, and it serves seniors 65 and older, along with adults ages 18 to 64 who have a physical or other disability, who medically qualify for the level of care a nursing facility provides but want to stay in their own home, in assisted living, or in another community setting.

New Hampshire Medicaid HCBS waivers can feel complicated at first, but the rules are manageable once you see them one at a time, and that is how this guide walks through them.

In This Guide

What Are New Hampshire Medicaid HCBS Waivers?

Home and Community-Based Services (HCBS) is the Medicaid umbrella for long-term care delivered outside an institution, in your own home, a family member's home, an assisted-living residence, or another community setting, rather than in a nursing home. Federal Medicaid law lets states run these programs through a section 1915(c) HCBS waiver, which is the authority New Hampshire uses for its Choices for Independence program.

The word "waiver" points to how these programs are built. To offer care in the community instead of an institution, a state asks the federal government to waive certain standard Medicaid rules, and in exchange the state agrees to serve people who would otherwise qualify for institutional care. That trade has one consequence worth understanding up front: because a 1915(c) waiver is tied to a nursing-facility level of care, federal law requires the state to run a level-of-care evaluation as part of deciding whether you are eligible, on top of the usual financial review.

So when people ask whether New Hampshire Medicaid HCBS waivers can pay for a parent to stay at home, the answer runs through one program, and the rest of this guide is about that program in detail.

Choices for Independence: New Hampshire's CFI Waiver Up Close

Choices for Independence is New Hampshire's primary Medicaid HCBS waiver for older adults and adults with chronic illness. It is administered by the New Hampshire Department of Health and Human Services (DHHS) through its Bureau of Adult and Aging Services, the office that administers CFI.

The purpose of CFI is straightforward. It exists so that a person who would otherwise need nursing-home care can instead receive that care at home or in a community setting, including an assisted-living or residential-care facility. The care is meant to match what a nursing facility would provide, just delivered where the person lives.

On the federal side, CFI is a section 1915(c) waiver that also operates with concurrent 1915(b)(1) and 1915(b)(4) authority. Those extra authorities are the mechanics that let the state manage how services are delivered and who provides them. For a family, the practical takeaway is simpler: CFI is the door to Medicaid-paid home and community care in New Hampshire, and it is run by the state rather than by a county or a private plan you have to shop for.

Who Qualifies for New Hampshire's CFI Waiver?

Eligibility for CFI comes down to two separate tests, and you have to clear both. One is medical, and one is financial.

The medical test is a nursing-facility level of care. Because CFI is a federal 1915(c) waiver, the state must evaluate whether you need the level of care a nursing facility provides, and only people who meet that bar can enroll. In plain terms, the waiver is for people whose needs are serious enough that a nursing home would otherwise be on the table, not for someone who needs only light help around the house.

The financial test uses New Hampshire's Medicaid long-term-care rules. For 2026, the monthly income cap for a single applicant is $2,982, a figure that equals 300% of the federal Supplemental Security Income (SSI) benefit rate, which New Hampshire adopts. An applicant who qualifies through this special income limit is treated as a household of one, even if a spouse lives in the same home. There is also a Medicaid resource, or asset, test that applies alongside the income limit; confirm the current asset figure with DHHS when you apply, since it is set separately from the income cap.

If you enroll in CFI and your income is above the level that would let Medicaid cover your full cost, you keep a monthly Personal Needs Allowance (PNA) and the rest of your income goes toward the cost of your care. New Hampshire sets that Personal Needs Allowance at $90 per month. That is above the federal floor: federal law requires states to leave an institutionalized individual at least $30 a month, and New Hampshire sets its amount well above that minimum.

What New Hampshire Medicaid HCBS Waivers Cover

The CFI service menu is broad, which is what makes it possible to replace nursing-home care at home. The waiver covers, among other services:

  • Personal care, home health aide, and homemaker services
  • Adult day services and respite for family caregivers
  • Home-delivered meals and non-medical transportation
  • Skilled nursing and specialized medical equipment services
  • A Personal Emergency Response System (PERS), the button-and-monitor service that summons help if you fall or have an emergency at home
  • Environmental accessibility services, such as home modifications for safety and access
  • Adult family care, residential care facility services, and supportive housing services
  • Participant-directed and managed services, plus financial management services that support self-direction
  • Supported employment, community transition services, and in-home services

Because the list reaches into assisted-living and residential-care settings, CFI can follow a person as their needs change, rather than only paying for care inside a private home. The services a given person actually receives are set through their care plan, based on what the level-of-care assessment shows they need.

Enrollment and Slots: What to Know Before You Apply

One structural point matters before you apply. CFI is a waiver, not an open-ended entitlement, which means it operates with a limited number of enrollment slots rather than serving everyone who qualifies the moment they qualify. That is a normal feature of a 1915(c) waiver, and it is the trade the state made to offer community care in the first place.

What that means for you in practice is worth planning around. Meeting the medical and financial tests makes you eligible, but eligibility and an open slot are two different things, so it is worth asking DHHS about current availability at the same time you apply. If you are weighing this against a nursing-home stay, start the CFI conversation early rather than waiting until care is urgent.

How to Apply for the CFI Waiver in New Hampshire

You apply through New Hampshire DHHS. Under federal Medicaid rules, the state has to let you apply through several channels, so you can start online through the state's Medicaid portal, by phone, by mail, or in person at a local office, whichever fits your situation.

1
Step 1

Contact DHHS and ask about CFI

Reach out to the Department of Health and Human Services (DHHS) to say you are seeking the Choices for Independence waiver, and ask both about applying for Medicaid and about current waiver availability.

2
Step 2

Complete the level-of-care evaluation

Because CFI is a 1915(c) waiver, the state arranges an assessment to confirm you meet a nursing-facility level of care.

3
Step 3

Submit the financial application

The state reviews your income against the 2026 cap of $2,982 for a single applicant, along with the separate asset test.

4
Step 4

Wait for the decision, then enroll

Once you are found eligible and a slot is available, the state sets up your care plan and services begin.

Federal rules also put a clock on the decision. The state generally has to decide a Medicaid application within 45 calendar days, and within 90 calendar days if you are applying on the basis of disability. Knowing that window helps you tell the difference between a normal wait and a delay worth following up on.

Frequently Asked Questions

Is there a waiting list for Choices for Independence?

Choices for Independence (CFI) is a waiver, which means it runs with a limited number of enrollment slots rather than serving everyone the moment they qualify. Meeting the eligibility tests and having an open slot are two separate things, so the most reliable step is to ask the Department of Health and Human Services (DHHS) about current availability when you apply, rather than assuming a slot is or is not open.

Can I direct my own care or choose my own workers under CFI?

CFI includes participant-directed and managed services, along with financial management services that support self-direction. That structure is designed to give participants a say in how their services are arranged. The exact rules for who you can hire and how self-direction works are set through your care plan, so ask DHHS to walk you through the participant-directed option when you enroll.

How is the CFI waiver different from nursing-home Medicaid?

The core difference is setting, not the level of care. CFI is built for people who medically qualify for a nursing-facility level of care but receive that care at home or in a community setting instead. The financial rules track New Hampshire's Medicaid long-term-care standards, the same single-applicant income cap and asset test described earlier in this guide, so the money side looks much the same whether care happens at home or in a facility.

How do I apply, and how long does a decision take?

You apply through DHHS, and federal rules require the state to accept applications online, by phone, by mail, or in person. The state generally has to decide within 45 calendar days, or within 90 calendar days if you are applying on the basis of disability. Keep in mind that a decision on Medicaid eligibility is separate from an open waiver slot.

Learn More

MedicaidNew Hampshire Medicaid Long-Term 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 HCBS Waivers by StateMedicaid HCBS waivers pay for care at home instead of a nursing facility. How 1915(c) waivers work, who qualifies, why waitlists happen, and your state's guide. 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 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. MedicaidNew Hampshire Medicaid Personal Needs AllowanceThe New Hampshire Medicaid personal needs allowance is $90 a month for nursing-home, residential-care, and home-care residents. Here's how it works.

Find personalized help understanding New Hampshire Medicaid HCBS waivers and the Choices for Independence program 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.