New Hampshire Medicaid Spousal Impoverishment 2026 Guide

New Hampshire Medicaid spousal impoverishment rules exist so that when one spouse enters a nursing home and the other stays home, the couple does not have to spend down to nothing. The spouse who stays home keeps a protected share of the couple's savings and can receive a monthly income allowance before New Hampshire Medicaid pays for nursing-facility care. In 2026 the standard calculation protects up to $162,660 in savings and sets the income allowance's standard at up to $4,067 a month, and an appeal or a court order can set more than either figure.1

In This Guide

• How New Hampshire Medicaid Spousal Impoverishment Works
• The Protected Resource Amount
• The Monthly Income Allowance
• When the Standard Allowance Isn't Enough
• What the Applicant Spouse Can Keep
• How to Apply in New Hampshire
• Frequently Asked Questions
• Learn More

How New Hampshire Medicaid Spousal Impoverishment Works

When a married person needs nursing-facility care through Medicaid, New Hampshire looks at both spouses' finances together. That is the moment many families panic, assuming every dollar must go toward care. It does not. Federal spousal impoverishment law, at 42 U.S.C. 1396r-5, protects the spouse who stays home by reserving a share of the couple's assets and a minimum monthly income before Medicaid begins paying.4

Two terms do the heavy lifting. The spouse who needs care is the institutionalized spouse; the spouse who stays home is the community spouse. New Hampshire shields the community spouse's assets through what it calls the protected resource amount (the federal Community Spouse Resource Allowance) and shields their income through the Minimum Monthly Maintenance Needs Allowance.1

One thing to know up front, because it settles a common worry: New Hampshire's 2026 standards equal the federal ones. It does not shrink the protections, and it does not add a state enhancement on top of them. What is genuinely local is the vocabulary, the way the income allowance is calculated, and the appeal path if the standard result leaves the at-home spouse short.1

One scope limit matters before you read further. New Hampshire's income-allocation rules described in this guide apply when the spouse who needs care lives in a hospital, skilled nursing facility, or intermediate care facility and is expected to stay 30 consecutive days or longer.1 If the spouse who needs care will get home care through the Choices for Independence (CFI) waiver instead, ask New Hampshire DHHS directly what applies to the community spouse before assuming the figures below carry over.2

The Protected Resource Amount

New Hampshire takes a snapshot of the couple's combined countable resources as of the date the institutionalized spouse's continuous care began. The protected resource amount the community spouse keeps is the highest of these figures:1

• Half of the couple's combined countable resources, up to a maximum of $162,660.1
• A minimum of $32,532, if half the couple's resources falls below that floor.1
• A larger amount set by a court support order or by New Hampshire's Administrative Appeals Unit.1

New Hampshire's $32,532 and $162,660 equal the federal 2026 standards, and its own rule sets the state spousal resource standard at the federal minimum, so New Hampshire is not one of the states that protects the maximum for every community spouse. Those two figures are standards, not a ceiling on what the at-home spouse may keep. The eligibility worker sets the protected amount within that band even if the couple says it causes hardship, and either spouse who disagrees can appeal through the administrative appeals process or go to court.1

The Monthly Income Allowance

The Minimum Monthly Maintenance Needs Allowance sets the community spouse's monthly needs standard, so the at-home spouse is not pushed into poverty because their partner's income now goes toward care. In New Hampshire the standard is built from a base and a shelter add-on:1

• The base is $2,705 a month.1
• On top of the base, the community spouse can add their excess shelter costs, meaning the amount by which their shelter expenses run above $812 a month.1
• The total is capped at $4,067 a month, or a higher amount set by an Administrative Appeals Officer for significant financial duress or by a court support order.1

Two of those figures are rounded in New Hampshire's own manual. The federal 2026 standards are $4,066.50 for the cap and, in every state except Alaska and Hawaii, $811.50 for the shelter threshold, and New Hampshire's Medical Assistance Manual states them as $4,067 and $812.4 The difference is 50 cents and will not change your outcome, but it explains why you may see slightly different numbers on a New Hampshire notice and a federal one.1

New Hampshire figures the utility part of shelter costs using the state's SNAP Standard Utility Allowance rather than your actual monthly bills, which keeps the calculation consistent from case to case.1

That total is a needs standard, not a payment. The community spouse's own income is subtracted first, so a spouse whose own income already reaches the standard gets no allocation. If it falls short, part of the institutionalized spouse's income can be redirected to make up the gap, but only as much as that spouse has available to allocate.1

In New Hampshire, allocation is also voluntary. The institutionalized spouse has to agree to it and may refuse to allocate some or all of their income; the state's stated remedy for a refusal is for the community spouse to get a court support order.1

When the Standard Allowance Isn't Enough

Sometimes the standard math still leaves the at-home spouse short of what it actually costs them to live. New Hampshire provides two routes to a higher allowance, and the eligibility worker can't use either one at intake. An Administrative Appeals Officer can set a larger income allowance based on exceptional circumstances resulting in significant financial duress, and a court support order can set a higher income amount.1

Savings can be raised the same two ways. A court support order can transfer more to the community spouse, and the Administrative Appeals Unit can set a larger protected resource amount, enough to raise the community spouse's income to the maximum maintenance allowance. That appeal route opens only after the institutionalized spouse has allocated the maximum income available for allocation.1

Both routes ask you to document the real numbers, so keep records of the community spouse's actual shelter costs, medical expenses, and income. If the standard allowance does not cover reasonable living expenses, that documentation is what supports a request for more.

What the Applicant Spouse Can Keep

The protections above are for the community spouse. The institutionalized spouse, the one applying for Medicaid, has their own limits.

In 2026 New Hampshire's nursing facility income cap is $2,982 a month for the applicant. Income above the cap isn't an automatic bar: an applicant over it can still qualify for nursing-facility care as medically needy when their net income is at or below the monthly Medicaid nursing facility rate.2 Separately, an applicant with a spouse at home is resource-eligible when the couple's combined resources are at or below the protected resource amount plus $2,500.3

That $2,500 is a base, not the most the applicant may hold. For applicants 18 or older seeking nursing-facility care or long-term-care waiver services, New Hampshire disregards resources between the base standard and $7,500, a rule in effect since September 20, 2025.3 These rules sit alongside the spousal protections rather than replacing them: the couple's resources are split at the snapshot, the community spouse keeps the protected amount, and the applicant spends down only what is left above their own limit before Medicaid pays.1,3

How to Apply in New Hampshire

Learn More

Find personalized help protecting an at-home spouse under New Hampshire Medicaid 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.