New Hampshire Medicaid Personal Needs Allowance (2026)

The New Hampshire Medicaid personal needs allowance is $90 a month. It's the amount of a resident's own income that Medicaid lets them keep for personal spending when the program is paying for their long-term care, while the rest goes toward the cost of that care.1

In This Guide

• What the New Hampshire Medicaid Personal Needs Allowance Is
• New Hampshire Medicaid Personal Needs Allowance vs. the Federal Floor
• How the Money Is Held: The Resident Trust Fund
• Where the Allowance Fits: Cost of Care
• What the Facility Must Provide Free
• If Your Loved One Is a Veteran
• Frequently Asked Questions
• Learn More

What the New Hampshire Medicaid Personal Needs Allowance Is

When someone needs long-term care and Medicaid pays the bill, they don't hand the facility a rent check. Instead, most of their monthly income (Social Security, a pension, an annuity) flows toward the cost of their care, and Medicaid covers the gap. That arrangement would leave the resident with nothing of their own, so both federal and state rules carve out a small protected amount they get to keep. That amount is the Personal Needs Allowance, or PNA.

The allowance is meant for the small, personal things care doesn't supply: a preferred brand of shampoo, a haircut, a magazine subscription, a phone bill, snacks, a birthday card for a grandchild, clothing. It isn't much, but it's the difference between a resident having a little money of their own and having none at all.

New Hampshire's version is a little broader than many states'. The New Hampshire Department of Health and Human Services applies the $90 allowance not only to nursing-facility residents but also to people living in community residences and residential care facilities, and to people receiving care at home through the Choices for Independence (CFI) waiver, the state's home- and community-based services program for older adults and adults with disabilities.1 Wherever Medicaid is paying for the care, the resident keeps the same $90 for personal needs.

New Hampshire Medicaid Personal Needs Allowance vs. the Federal Floor

Here's the number that matters. In 2026, a New Hampshire Medicaid resident keeps a Personal Needs Allowance of $90 a month. The state raised it from $74 to $90 effective July 1, 2025, an increase written into state law under RSA 167:27-b.1

New Hampshire's $90 is three times the federal floor. Under federal Medicaid law, a state must let an institutionalized individual keep at least $30 a month for personal needs (and at least $60 a month for a couple when both spouses are in a facility), and those minimums have been fixed since 1988.3 States are free to set the allowance higher, and New Hampshire is one of the more generous, sitting toward the upper end of the range states use in 2026, where nursing-facility allowances commonly run from the $30 floor up to roughly $200.3

Even at $90, the allowance doesn't stretch far against the price of clothing, personal-care items, or a phone plan.1 Families often help with those costs directly, and it helps to think of the allowance as a floor for the resident's own spending money rather than a ceiling on what they can have.

How the Money Is Held: The Resident Trust Fund

A resident doesn't have to manage the allowance out of a wallet in a nightstand. Federal law gives every nursing-home resident the right to manage their own money, and if they ask the facility to hold it for them, the facility takes on strict fiduciary duties.2

A facility that manages a resident's funds must keep money over a set threshold in an interest-bearing account separate from the facility's own operating accounts, never commingle the two, give the resident (or their representative) a statement at least quarterly and access to the account on request, and purchase a surety bond to protect the funds. When a resident dies, the balance is conveyed to their estate within a set period.2 The point of all this is simple: the $90 is the resident's money, and the trust-fund rules exist so it stays that way and can be accounted for.

Where the Allowance Fits: Cost of Care

The allowance makes the most sense once you see the monthly calculation it sits inside. When Medicaid pays for someone's care, the resident still contributes most of their own income toward the cost, keeping only the protected amounts. That contribution is often called the cost of care or patient liability.

The order runs roughly like this. Start with the resident's total monthly income, usually Social Security plus any pension. Subtract the $90 Personal Needs Allowance.1 If a spouse is still living in the community, a monthly income allowance for that spouse may be subtracted too, so they aren't left short.4 Whatever is left is what the resident pays toward care each month, and New Hampshire Medicaid pays the rest.

So the allowance isn't spending money the state hands out. It's the one piece of a resident's income the calculation protects before the rest is applied to care.

What the Facility Must Provide Free

A common worry is that the $90 will vanish into charges the facility tacks on. Federal law limits that. During a Medicaid-covered nursing-facility stay, the facility must provide certain routine items and services as part of its daily rate and may not bill them to the resident or charge them against the Personal Needs Allowance.5

Those covered items include nursing care, dietary services, activities, room and bed maintenance, and routine personal-hygiene items and services. A facility that tries to charge a resident's personal funds for something in that category is not allowed to.5 If you see a charge against a resident's account for something that looks routine, that's worth questioning, because the $90 is meant for the resident's own choices, not for services the daily rate already covers.

If Your Loved One Is a Veteran

There's a specific federal rule worth knowing if the resident is a veteran. When a veteran with no spouse and no dependent child is receiving Medicaid-covered nursing-home care, the U.S. Department of Veterans Affairs (VA) reduces their VA pension to $90 a month, and that $90 is protected for the veteran's personal use.6

This is a federal rule that operates alongside New Hampshire's own $90 personal needs allowance, and the two can interact in ways that depend on the veteran's exact benefits and household. If your loved one is a veteran, a County Veterans Service Officer and their Medicaid caseworker can confirm how the VA pension and the state allowance apply in their situation.6

Learn More

Find personalized help understanding the New Hampshire Medicaid personal needs allowance 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.