How to Pay for In-Home Care
How to Pay for Home Care in New Hampshire
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists New Hampshire-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. New Hampshire's strongest state-specific pathways include the Choices for Independence (CFI) Waiver with Participant Directed and Managed Services (PDMS) and its paid-relative options, PACE through Neighborhood PACE, the developmental disability, in-home support, and acquired brain disorder waivers, the Family Caregiver Support Program through ServiceLink, and MEAD/MOAD and other spend-down financial-eligibility routes, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible New Hampshire veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
New Hampshire Medicaid / LTSS
Choices for Independence (CFI) Waiver
YesHelps pay for: New Hampshire’s primary Medicaid HCBS waiver for adults who otherwise need nursing-facility level care; can authorize a broad package of home and community services.
Who qualifies: Age 18+; Medicaid financial eligibility; nursing-facility clinical level of care; need at least one CFI waiver service and choose community care instead of institutional care.
How to start: Contact DHHS/ServiceLink and request CFI screening and case-management intake.
Good to know: Family caregiver payment: Sometimes
New Hampshire Medicaid / Self-Direction
CFI Participant Directed and Managed Services (PDMS)
YesHelps pay for: Lets a CFI participant direct and manage approved waiver services, choose providers and help control how an authorized participant-directed budget is used.
Who qualifies: Must be CFI eligible; participant or legal representative must be able to direct services. PDMS can apply to CFI waiver services except residential-care-facility services.
How to start: Tell the CFI case manager you want participant-directed services and financial-management support.
Good to know: Family caregiver payment: Yes, subject to worker rules
New Hampshire Medicaid / Paid Family
CFI Family or Friend as Direct Support Worker
YesHelps pay for: Under participant direction, a qualifying relative or friend may potentially be hired for approved services; the participant’s spouse is a legally responsible relative and CFI services furnished by that person are not covered.
Who qualifies: Worker must satisfy applicable qualifications and employment rules; service must be authorized. Spouse is excluded as a paid CFI provider under current rules.
How to start: Identify the proposed worker with the case manager/FMS before hiring.
Good to know: Family caregiver payment: Yes - except spouse
New Hampshire Medicaid / Residential / Family
CFI Adult Family Care (AFC)
Yes / bundledHelps pay for: Combines personal care, homemaking and other supports in a certified private residence; the CFI rules expressly allow the residence to be that of the participant’s relative.
Who qualifies: CFI eligibility; residence/oversight agency must meet AFC certification and program requirements.
How to start: Ask the case manager whether Adult Family Care fits the person-centered plan.
Good to know: Family caregiver payment: Potentially, through approved AFC arrangement
New Hampshire Medicaid / Personal Care
CFI Personal Care Services
YesHelps pay for: Pays hands-on assistance with ADLs/IADLs, cueing, medication self-administration support, light housekeeping and community accompaniment when authorized.
Who qualifies: CFI eligibility and documented need in the comprehensive care plan; provider/worker requirements apply.
How to start: Request personal-care authorization through the CFI case manager.
Good to know: Family caregiver payment: Possible under PDMS
New Hampshire Medicaid / In-Home Services
CFI In-Home Care
YesHelps pay for: Covers nonmedical supervision, socialization and selected household/errand supports for isolated participants to help prevent institutionalization.
Who qualifies: CFI eligibility; assessed need; not separately covered while receiving residential-care-facility services.
How to start: Ask the case manager to assess in-home-care needs.
Good to know: Family caregiver payment: Possible under PDMS
New Hampshire Medicaid / Homemaker
CFI Homemaker Services
YesHelps pay for: Can cover light housekeeping, laundry, meal/snack preparation and errands that support safe community living.
Who qualifies: CFI eligibility and authorized need in the person-centered plan.
How to start: Request homemaker services through the CFI case manager.
Good to know: Family caregiver payment: Possible under PDMS
New Hampshire Medicaid / Home Health Aide
CFI Home Health Aide Services
YesHelps pay for: Can cover non-acute home-health-aide services from a licensed nursing assistant, including certain personal-care tasks when clinically indicated.
Who qualifies: CFI eligibility; services must be in the plan and meet aide/provider requirements.
How to start: Ask the case manager/clinical team about home-health-aide authorization.
Good to know: Family caregiver payment: Generally provider workforce
New Hampshire Medicaid / Respite
CFI Respite Services
Yes - respiteHelps pay for: Can provide temporary relief for an unpaid primary caregiver through authorized respite services.
Who qualifies: CFI eligibility; respite must address an assessed need and be authorized.
How to start: Ask the CFI case manager to add respite to the comprehensive care plan.
Good to know: Family caregiver payment: No continuous wage
New Hampshire Medicaid / Adult Day
CFI Adult Day Services
Offsets care cost / day careHelps pay for: Pays licensed adult-day services such as supervision, personal care and health-related supports, potentially reducing in-home supervision hours.
Who qualifies: CFI eligibility and service authorization; cannot be separately covered in certain residential/AFC settings.
How to start: Ask the CFI case manager about adult-day options.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Nutrition
CFI Home-Delivered Meals
Offsets care costHelps pay for: Can cover prepared meals delivered to the home when included in the authorized care plan.
Who qualifies: CFI eligibility; assessed nutrition need; cannot duplicate meals supplied through certain other settings.
How to start: Ask the case manager about home-delivered meal authorization.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Safety
CFI Personal Emergency Response System (PERS)
Offsets care costHelps pay for: Can cover a 24/7 emergency-response device for participants at risk of institutionalization who would otherwise need more supervision.
Who qualifies: CFI eligibility; must meet plan-based risk/need criteria.
How to start: Ask the CFI case manager about PERS.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Home Modification
CFI Environmental Accessibility Services
Offsets care costHelps pay for: Can fund approved ramps, grab bars, doorway widening, electronic aids and other home/vehicle adaptations necessary for health and safety.
Who qualifies: CFI eligibility; modification must have direct medical/remedial benefit and be authorized.
How to start: Discuss accessibility barriers with the case manager before purchasing or modifying.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Equipment
CFI Specialized Medical Equipment
Offsets care costHelps pay for: Can cover approved devices, controls, appliances, supplies and equipment not otherwise available under the Medicaid state plan when needed for functional limitations.
Who qualifies: CFI eligibility; item must be necessary, in the care plan and authorized.
How to start: Ask the case manager/clinical team to document equipment need before purchase.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Transportation
CFI Non-Medical Transportation
Offsets care costHelps pay for: Can cover transportation needed to access the community when personal-care assistance is required and public transportation cannot meet the need.
Who qualifies: CFI eligibility; destination and need must be documented in the care plan; not for medical appointments.
How to start: Ask the case manager about authorized non-medical transportation.
Good to know: Family caregiver payment: No
Medicaid Non-Emergency Medical Transportation (NEMT)
Offsets household/care costHelps pay for: Can provide or reimburse eligible transportation to covered medical appointments, reducing caregiver driving and transportation expense.
Who qualifies: Medicaid eligibility; ride must be for a covered medical service and comply with scheduling/transportation rules.
How to start: Use the Medicaid plan/transportation contact shown on the member card or ask DHHS.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Transition
CFI Community Transition Services
Offsets care costHelps pay for: Can pay certain one-time, reasonable costs that help a participant move from an institutional/provider-operated setting to a private residence.
Who qualifies: CFI eligibility and transition criteria; service must be necessary and approved through person-centered planning.
How to start: Ask the facility social worker and CFI case manager about transition supports before discharge.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Skilled Care
CFI Skilled Nursing Services
Yes - skilled careHelps pay for: Can cover skilled nursing included in the CFI comprehensive care plan for participants who need nursing services at home.
Who qualifies: CFI eligibility, clinical need and service authorization; nursing scope/provider rules apply.
How to start: Ask the CFI case manager and treating clinician about skilled nursing.
Good to know: Family caregiver payment: No
New Hampshire Medicaid + Medicare / Integrated Care
PACE - Neighborhood PACE
YesHelps pay for: Integrated medical and long-term-care program that can arrange personal care, home care, nursing, therapies, meals, transportation and other services needed to remain in the community.
Who qualifies: Generally age 55+; nursing-home level of care; live in the PACE service area; able to live safely in the community with PACE services.
How to start: Check ZIP-code/service-area availability and request an eligibility conversation with Neighborhood PACE.
Good to know: Family caregiver payment: No direct cash
New Hampshire Medicaid / State Plan
Medicaid Home Health
Yes - skilled/home healthHelps pay for: Can cover medically necessary skilled nursing, therapies, home-health-aide and related services under New Hampshire Medicaid home-health rules.
Who qualifies: Medicaid eligibility; medical necessity, practitioner order/plan of care and provider requirements apply.
How to start: Ask the treating clinician and Medicaid plan/provider for a home-health referral.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Skilled Nursing
Private Duty Nursing (PDN)
Yes - skilled careHelps pay for: Can pay medically necessary individualized nursing for Medicaid beneficiaries who need more continuous skilled nursing than ordinary visiting-nurse services.
Who qualifies: Medicaid eligibility; intensive skilled-nursing need; authorization and provider requirements apply.
How to start: Ask the treating clinician/Medicaid plan to evaluate PDN eligibility.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Children
Home Care for Children with Severe Disabilities (HC-CSD)
Yes / medical supportsHelps pay for: Medicaid pathway that can allow a qualifying child with severe disability to receive family-centered community-based medical assistance at home rather than institutional care; parental income deeming is not applied under the specified rules.
Who qualifies: Child must meet statutory/program medical, level-of-care, home-safety and cost-effectiveness criteria.
How to start: Apply through NH DHHS/NH EASY and ask specifically about HC-CSD eligibility.
Good to know: Family caregiver payment: Family remains primary caregiver; payment rules vary by service
New Hampshire Medicaid / Developmental Disabilities
Developmental Disabilities (DD) Waiver
Yes / habilitationHelps pay for: HCBS waiver for eligible people with intellectual/developmental disabilities; services include residential habilitation, community participation, respite, service coordination, supported employment and other supports.
Who qualifies: Medicaid eligibility; qualifying developmental disability and ICF/IID level-of-care requirements; current waiver authorization/availability applies.
How to start: Contact the local Area Agency/Bureau of Developmental Services for eligibility and waiver intake.
Good to know: Family caregiver payment: Sometimes
New Hampshire Medicaid / DD / Self-Direction
DD Waiver Participant-Directed Services
YesHelps pay for: Allows eligible DD waiver participants to direct specified services and select workers within program rules.
Who qualifies: Service-specific worker rules apply; spouse and parent-of-minor restrictions generally apply, with limited exceptions under the rules.
How to start: Ask the service coordinator about participant-directed options and worker eligibility before hiring.
Good to know: Family caregiver payment: Yes, subject to restrictions
New Hampshire Medicaid / DD / Respite
DD Waiver Respite
Yes - respiteHelps pay for: Can fund respite to temporarily relieve unpaid caregivers of eligible waiver participants.
Who qualifies: DD waiver eligibility, assessed need and authorization.
How to start: Ask the service coordinator to include respite in the individual service agreement.
Good to know: Family caregiver payment: No continuous wage
New Hampshire Medicaid / DD / Accessibility
DD Waiver Assistive Technology & Environmental/Vehicle Modifications
Offsets care costHelps pay for: Can fund approved assistive technology and environmental/vehicle modifications that support independence and community living.
Who qualifies: DD waiver eligibility; item/modification must be authorized and meet waiver requirements.
How to start: Document the functional barrier with the service coordinator before purchase or construction.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Children / DD
In Home Supports (IHS) Waiver for Children with Developmental Disabilities
Yes / habilitationHelps pay for: 1915(c) waiver for eligible children/young adults with developmental disabilities who meet ICF/IID level of care and can be supported at home.
Who qualifies: Generally ages 0-21; Medicaid and waiver clinical eligibility; service authorization and availability apply.
How to start: Contact the local Area Agency/BDS and ask about the IHS waiver.
Good to know: Family caregiver payment: Sometimes
New Hampshire Medicaid / IHS / Habilitation
IHS In-Home Residential Habilitation
YesHelps pay for: Can fund habilitation/support delivered in the family home to build or maintain skills and safely support the participant at home.
Who qualifies: IHS waiver eligibility; service must be authorized in the individual plan and meet provider/worker requirements.
How to start: Ask the Area Agency/service coordinator about in-home residential habilitation.
Good to know: Family caregiver payment: May allow qualifying workers under program rules
New Hampshire Medicaid / IHS / Respite
IHS Respite
Yes - respiteHelps pay for: Can provide authorized respite for families caring for an eligible child/young adult with developmental disabilities.
Who qualifies: IHS waiver eligibility; assessed caregiver need and authorization.
How to start: Request respite through the service coordinator.
Good to know: Family caregiver payment: No continuous wage
New Hampshire Medicaid / IHS / Accessibility
IHS Assistive Technology, Home/Vehicle Modifications & Transportation
Offsets care costHelps pay for: Can cover approved assistive technology, environmental/vehicle modifications and non-medical transportation under the waiver.
Who qualifies: IHS eligibility; service/item must meet waiver criteria and be authorized.
How to start: Discuss safety, access and transportation barriers with the service coordinator.
Good to know: Family caregiver payment: No
New Hampshire Medicaid / Brain Injury
Acquired Brain Disorder (ABD) Waiver
Yes / habilitationHelps pay for: HCBS waiver for eligible adults with acquired brain disorder who meet nursing-facility level of care; includes residential habilitation, community participation, respite, service coordination and other supports.
Who qualifies: Generally age 22+; Medicaid eligibility, qualifying acquired brain disorder and nursing-facility level-of-care criteria.
How to start: Contact the local Area Agency/BDS about ABD waiver eligibility.
Good to know: Family caregiver payment: Sometimes
New Hampshire Medicaid / ABD / Self-Direction
ABD Waiver Participant-Directed Services
YesHelps pay for: Allows eligible ABD waiver participants to direct specified supports and choose workers within program rules.
Who qualifies: Service-specific worker qualifications and legally responsible-relative rules apply.
How to start: Ask the service coordinator about participant direction before hiring a worker.
Good to know: Family caregiver payment: Yes, subject to restrictions
New Hampshire Medicaid / ABD / Respite
ABD Waiver Respite
Yes - respiteHelps pay for: Can provide respite for unpaid caregivers supporting an eligible person with acquired brain disorder.
Who qualifies: ABD waiver eligibility, assessed need and authorization.
How to start: Ask the service coordinator to include respite in the plan.
Good to know: Family caregiver payment: No continuous wage
New Hampshire Medicaid / ABD / Accessibility
ABD Assistive Technology, Modifications & Transportation
Offsets care costHelps pay for: Can fund approved assistive technology, environmental/vehicle modifications, PERS and non-medical transportation that support community living.
Who qualifies: ABD waiver eligibility; item/service must be authorized and meet waiver criteria.
How to start: Discuss access and safety needs with the service coordinator before purchase.
Good to know: Family caregiver payment: No
New Hampshire Developmental Services / Family Support
Family Support Services
Partial / supportiveHelps pay for: Area-agency developmental services can provide family support, information, service coordination and flexible supports intended to help people with developmental disabilities remain with family/community.
Who qualifies: Developmental-services eligibility and local funding/service-plan rules apply.
How to start: Contact the local Area Agency and ask for family-support assessment.
Good to know: Family caregiver payment: Sometimes / program-specific
New Hampshire Developmental Services / Respite
Developmental Services Respite
Yes - respiteHelps pay for: State developmental-services rules provide for respite supports for eligible individuals/families, helping reduce unpaid caregiver burden.
Who qualifies: Developmental-services eligibility, local assessment and funding/authorization.
How to start: Ask the local Area Agency about respite availability.
Good to know: Family caregiver payment: No continuous wage
New Hampshire Medicaid / Working Disability
Medicaid for Employed Adults with Disabilities (MEAD)
Enables Medicaid coverageHelps pay for: Allows many working adults with disabilities to maintain Medicaid coverage at substantially higher earnings than ordinary Medicaid limits, preserving access to Medicaid-funded home and community services when otherwise eligible.
Who qualifies: Generally ages 18-64, working, meet disability/blindness criteria and program financial rules; current rules use an income ceiling tied to the federal poverty level.
How to start: Apply through NH EASY/DHHS and ask for MEAD eligibility screening.
Good to know: Family caregiver payment: No direct caregiver wage
New Hampshire Medicaid / Working Older Adult
Medicaid for Employed Older Adults with Disabilities (MOAD)
Enables Medicaid coverageHelps pay for: Work-incentive Medicaid category for qualifying employed adults age 65+ with disabilities, which may preserve Medicaid access while working.
Who qualifies: Must meet MOAD statutory/rule requirements, employment and financial criteria.
How to start: Apply through NH EASY/DHHS and ask whether MOAD applies.
Good to know: Family caregiver payment: No direct caregiver wage
New Hampshire Medicaid / Financial Eligibility
Medically Needy / Spenddown
Enables Medicaid coverageHelps pay for: Some people above ordinary Medicaid income limits may qualify after applying allowable medical expenses toward a spenddown, potentially opening access to covered medical/home-health services.
Who qualifies: Category, income/resource and spenddown rules apply; not every LTSS pathway uses the same financial methodology.
How to start: Request a full Medicaid eligibility determination rather than assuming income is too high.
Good to know: Family caregiver payment: No
New Hampshire Aging / In-Home Services
Title III Adult In-Home Care
Yes / subsidizedHelps pay for: Older Americans Act/state aging services can support nonmedical in-home supervision and assistance for eligible older adults, helping them remain at home.
Who qualifies: Generally older adults with priority to those in greatest social/economic need; local assessment and funding availability apply.
How to start: Contact ServiceLink for referral to the local aging provider.
Good to know: Family caregiver payment: No
New Hampshire Aging / Homemaker
Title III Homemaker Services
Yes / subsidizedHelps pay for: Can subsidize household-management help such as light cleaning, laundry, meal preparation and errands for eligible older adults.
Who qualifies: Local assessment, age/program criteria and funding availability apply.
How to start: Ask ServiceLink about homemaker/in-home support providers.
Good to know: Family caregiver payment: No
New Hampshire Aging / Essential Services
Essential Services - Chore & Emergency Support
Offsets care cost / partialHelps pay for: Title III essential services can include chore and other limited supports that reduce safety risks and help an older adult remain at home.
Who qualifies: Local eligibility/assessment and funding rules apply.
How to start: Ask ServiceLink about essential/chore services in the county.
Good to know: Family caregiver payment: No
New Hampshire Aging / Caregiver Support
NH Family Caregiver Support Program
Yes - respite / supportsHelps pay for: Provides caregiver information, counseling/support, education/training, short-term respite and limited supplemental services such as chore, assistive equipment, home modifications and transportation.
Who qualifies: Caregiver and care-recipient eligibility follows Older Americans Act/state criteria; respite/supplemental funds are limited.
How to start: Contact ServiceLink and request a caregiver assessment/referral.
Good to know: Family caregiver payment: Not a continuous caregiver wage
New Hampshire Aging / Dementia Caregiver
Alzheimer’s Disease & Related Disorders Caregiver Respite/Support Funds
Yes - respite / supportsHelps pay for: State-supported caregiver funding works alongside the Family Caregiver Support Program to help eligible dementia caregivers obtain respite and supplemental supports when funds are available.
Who qualifies: Dementia/caregiver eligibility, assessment and limited funding apply.
How to start: Ask ServiceLink specifically about ADRD caregiver respite/support funding.
Good to know: Family caregiver payment: Not a continuous caregiver wage
New Hampshire Aging / Nutrition
Home-Delivered Meals
Offsets care costHelps pay for: Older-adult nutrition programs can deliver meals and provide a regular safety contact, reducing food expense and some meal-preparation caregiver time.
Who qualifies: Generally age 60+ and homebound/otherwise eligible under local nutrition program criteria; availability varies.
How to start: Contact ServiceLink or the local senior nutrition provider.
Good to know: Family caregiver payment: No
New Hampshire Aging / Adult Day
Adult Day / Community-Based Day Services
Offsets care cost / day careHelps pay for: Adult-day and community programs can provide daytime supervision, activities, meals and health/social supports, reducing the number of paid in-home hours needed for appropriate participants.
Who qualifies: Program-specific clinical/social eligibility, local availability and payer rules apply.
How to start: Ask ServiceLink and the CFI/PACE care manager about funded adult-day options.
Good to know: Family caregiver payment: No
New Hampshire Aging / Navigation
ServiceLink Aging & Disability Resource Center
Navigation / cost avoidanceHelps pay for: Provides free options counseling and connections to long-term services/supports, Medicaid, caregiver resources and local aging/disability programs; it is often the best first call.
Who qualifies: Available statewide; program-specific eligibility applies to referred benefits.
How to start: Call ServiceLink and describe care needs, payer status and caregiver situation.
Good to know: Family caregiver payment: No
Medicare Counseling
NH SHIP through ServiceLink
Offsets household costHelps pay for: Free, unbiased Medicare counseling can identify Medicare Savings Programs, Extra Help, coverage errors and plan choices that preserve more household income for care.
Who qualifies: Medicare beneficiary/caregiver; underlying assistance programs have financial eligibility rules.
How to start: Call ServiceLink and ask for SHIP counseling.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - qualifying skilled/home healthHelps pay for: Medicare can cover intermittent skilled nursing, therapy and home-health-aide services when all coverage requirements are met; it is not a general long-term custodial-care benefit.
Who qualifies: Must meet Medicare home-health eligibility, including need for skilled services and homebound requirements under current coverage rules.
How to start: Ask the treating clinician for a Medicare-certified home-health evaluation.
Good to know: Family caregiver payment: No
Medicare / Caregiver Support
Medicare Caregiver Training Services
Offsets training/care costHelps pay for: Medicare can cover certain caregiver training when needed to help a caregiver safely carry out a beneficiary’s treatment plan.
Who qualifies: Must meet Medicare coverage requirements and be ordered/provided as covered caregiver-training services.
How to start: Ask the clinician whether caregiver training is medically necessary and billable to Medicare.
Good to know: Family caregiver payment: No wage
Medicare / Dementia
GUIDE Dementia Care Model
Partial / respiteHelps pay for: Participating GUIDE organizations can provide care coordination, caregiver education/support and respite services for eligible people with dementia and their caregivers.
Who qualifies: Traditional Medicare and dementia/model-participant requirements; must use a participating GUIDE organization.
How to start: Use CMS resources or ask the treating health system whether it participates in GUIDE.
Good to know: Family caregiver payment: No continuous wage
Medicare Cost Reduction
Medicare Savings Programs (MSP)
Offsets household costHelps pay for: Can help eligible Medicare beneficiaries pay Part A/Part B premiums and, depending on category, deductibles and coinsurance, freeing household income for care.
Who qualifies: Income/resource rules and category requirements apply.
How to start: Apply through NH Medicaid/DHHS; SHIP can help screen.
Good to know: Family caregiver payment: No
Prescription Cost Reduction
Extra Help / Part D Low-Income Subsidy
Offsets household costHelps pay for: Reduces Medicare Part D premiums, deductibles and prescription copays for qualifying beneficiaries, preserving cash for home care.
Who qualifies: Medicare and income/resource or automatic-eligibility criteria apply.
How to start: Apply through Social Security or ask SHIP for help.
Good to know: Family caregiver payment: No
Food Cost Reduction
SNAP
Offsets household costHelps pay for: Monthly food benefits can reduce grocery spending for eligible households, preserving income for home-care costs.
Who qualifies: Federal/state SNAP income, household and other eligibility rules apply.
How to start: Apply through NH EASY or contact DHHS.
Good to know: Family caregiver payment: No
Energy Cost Reduction
New Hampshire Fuel Assistance Program (LIHEAP)
Offsets household costHelps pay for: Provides grant assistance with heating costs and can help with qualifying heating emergencies, reducing household expenses available for care.
Who qualifies: Income/household/energy-burden rules and annual funding apply; renters and homeowners may qualify.
How to start: Apply through the local Community Action Agency; homebound applicants can ask about phone/home interview options.
Good to know: Family caregiver payment: No
Utility Cost Reduction
New Hampshire Electric Assistance Program (EAP)
Offsets household costHelps pay for: Provides eligible customers of participating utilities a tiered discount on monthly electric bills, preserving funds for care.
Who qualifies: Income eligibility, participating utility and program-funding rules apply.
How to start: Apply through a local Community Action Agency.
Good to know: Family caregiver payment: No
Home Energy / Cost Reduction
Weatherization Assistance Program
Offsets household costHelps pay for: Can provide energy audits and efficiency measures such as insulation, air sealing and related improvements for income-eligible households, lowering ongoing heating costs.
Who qualifies: Income and program-priority rules; funding/wait lists vary.
How to start: Apply through the local Community Action Agency; the Fuel Assistance application is used to determine eligibility.
Good to know: Family caregiver payment: No
Property Tax / Cost Reduction
Low & Moderate Income Homeowners Property Tax Relief
Offsets household costHelps pay for: Annual state program can provide property-tax relief to qualifying New Hampshire homeowners, preserving cash for care.
Who qualifies: Current income, homestead, residency, assessed-value and filing-window requirements apply; rules can change annually.
How to start: Review current DRA eligibility and file Form DP-8/Granite Tax Connect during the statutory filing period.
Good to know: Family caregiver payment: No
Property Tax / Senior / Veteran Cost Offset
Municipal Elderly/Disabled Exemptions & Veterans Tax Credits
Offsets household costHelps pay for: New Hampshire municipalities may offer elderly/disabled exemptions and veterans’ property-tax credits that reduce annual housing costs.
Who qualifies: Availability and amounts vary by municipality; statutory and local requirements apply.
How to start: Contact the local assessor and review DRA exemption/credit information before deadlines.
Good to know: Family caregiver payment: No
Private Insurance
Long-Term Care Insurance
Yes, if policy covers itHelps pay for: A private LTC insurance policy may reimburse or pay for covered home care, personal care, respite or other long-term services according to the contract.
Who qualifies: Policy trigger, elimination period, daily/monthly benefit, covered provider and inflation rules vary.
How to start: Request the policy’s schedule of benefits and open a claim before arranging major ongoing care.
Good to know: Family caregiver payment: Sometimes / policy-specific
Home Equity
Reverse Mortgage / HECM
Cash / indirectHelps pay for: Eligible homeowners age 62+ may convert home equity to cash that can be used for care, although fees, interest and occupancy/property obligations make this a major financial decision.
Who qualifies: Age/equity/property/occupancy requirements; HECM requires HUD-approved counseling; loan becomes due under specified events.
How to start: Compare alternatives and complete independent counseling before signing.
Good to know: Family caregiver payment: Yes, indirectly
Private Pay / Family Arrangement
Personal Care Agreement / Private Family Payment
Yes - private fundsHelps pay for: A written, market-rate personal-care agreement can formalize private payment to a relative for caregiving when no public program pays the caregiver.
Who qualifies: Use prospective written terms, reasonable compensation, time records and professional legal/tax/Medicaid-planning advice; gifts can affect Medicaid eligibility.
How to start: Consult an elder-law attorney/CPA before transferring money or assets.
Good to know: Family caregiver payment: Yes
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply.
How to start: Ask the VA primary-care team/social worker for assessment and authorization.
Good to know: Family caregiver payment: No
Veteran-Directed Care (VDC)
YesHelps pay for: Provides a flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors subject to local program rules.
Who qualifies: Enrolled Veteran; clinical/community-care eligibility and local VDC availability.
How to start: Ask the VA social worker whether VDC is available through the local VA/aging-network partnership.
Good to know: Family caregiver payment: Yes
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional pension payment for qualifying Veterans/survivors who need help with daily activities or meet other criteria; cash can be used toward care.
Who qualifies: Must first qualify for VA pension plus Aid & Attendance medical/financial criteria.
How to start: Apply through VA or an accredited representative.
Good to know: Family caregiver payment: Yes, indirectly
VA Homemaker & Home Health Aide
YesHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care (VDC)
YesHelps pay for: Provides a flexible self-directed budget for eligible Veterans who need personal care and help with daily activities; workers may include family or neighbors under local program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical need and local VDC availability. Ask the VA social worker whether VDC is available through the local VA/AAA partnership.
How to start: Ask the VA social worker or care team about Veteran-Directed Care (VDC).
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from community providers for eligible Veterans.
Who qualifies: Clinical need, VA eligibility and authorization/local availability. Ask the VA care team for skilled home-health assessment/referral.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may arrange in-home, adult-day or nursing-home respite to give eligible caregivers a break.
Who qualifies: Clinical need, enrollment and local availability; community-care authorization may apply. Ask the VA caregiver support coordinator/social worker.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No
VA Aid & Attendance
Cash / indirectHelps pay for: Extra pension amount for a qualifying Veteran/survivor who needs help with ADLs, is bedridden, has severe vision impairment or meets other criteria.
Who qualifies: Must qualify for VA pension and Aid & Attendance medical/financial criteria. Apply through VA or an accredited representative.
How to start: Ask the VA social worker or care team about VA Aid & Attendance.
Good to know: Family caregiver payment: Yes, indirectly
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Direct caregiver stipendHelps pay for: Monthly stipend and additional supports for an approved primary family caregiver of an eligible Veteran.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment. Apply jointly through VA Caregiver Support.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes
VA Community Care Network - Region 1
Pays authorized providerHelps pay for: VA-authorized community care can include home health and other approved services. New Hampshire is in CCN Region 1, administered by Optum.
Who qualifies: VA referral/authorization and community-care eligibility generally apply. Do not assume reimbursement after privately hiring care. Obtain VA authorization before routine community care; use emergency/urgent-care rules when applicable.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 1.
Good to know: Family caregiver payment: No
VA Pension
Cash / indirectHelps pay for: Needs-based monthly cash benefit for qualifying wartime Veterans or survivors; can be used toward living and care expenses.
Who qualifies: Wartime service plus age/disability and net-worth/income rules. Apply through VA or an accredited representative.
How to start: Ask the VA social worker or care team about VA Pension.
Good to know: Family caregiver payment: Yes, indirectly
Housebound Pension Add-On
Cash / indirectHelps pay for: Additional pension amount for some pension-eligible Veterans substantially confined to the home because of permanent disability.
Who qualifies: Must qualify for pension plus housebound criteria; cannot generally receive both A&A and housebound add-ons. Apply with pension/A&A-housebound forms and medical evidence.
How to start: Ask the VA social worker or care team about Housebound Pension Add-On.
Good to know: Family caregiver payment: Yes, indirectly
Home Improvements and Structural Alterations (HISA)
Offsets care costHelps pay for: Grant for medically necessary home improvements/structural alterations such as accessibility changes.
Who qualifies: Veteran must meet HISA clinical/eligibility rules; prescribed improvement and approval required. Ask VA prosthetics/rehabilitation or care team before starting work.
How to start: Ask the VA social worker or care team about Home Improvements and Structural Alterations (HISA).
Good to know: Family caregiver payment: No
VA Adult Day Health Care
Offsets care cost / day careHelps pay for: Therapeutic daytime health, rehabilitation and social services can reduce in-home supervision needs for eligible Veterans.
Who qualifies: Clinical need, enrollment/eligibility and local availability. Ask the VA social worker about adult day health care.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
VA Hospice Care
Yes - hospiceHelps pay for: VA can arrange hospice/palliative services, often including home-based support, for eligible Veterans with advanced illness.
Who qualifies: Clinical eligibility and VA/hospice authorization requirements. Ask VA care team for hospice/palliative consultation.
How to start: Ask the VA social worker or care team about VA Hospice Care.
Good to know: Family caregiver payment: No
Where New Hampshire Families Can Start
Not sure where to begin? Match your situation to a contact below.
Best statewide first stop for LTSS options, CFI navigation, caregiver support, meals, local aging/disability programs and SHIP
ServiceLink Aging & Disability Resource Center
Medicaid eligibility, CFI/HCBS, HC-CSD and general benefits questions
NH Department of Health and Human Services
Online applications, renewals and case access for Medicaid, SNAP and other DHHS benefits
NH EASY
Choices for Independence screening, clinical eligibility, case management and waiver questions
CFI / Bureau of Adult & Aging Services
PACE eligibility and service-area screening for integrated medical/LTSS care
Neighborhood PACE
DD, IHS and ABD waiver eligibility, service coordination, respite and participant-directed supports
NH Developmental Services / Local Area Agencies
Caregiver assessment, counseling, training, short-term respite and supplemental supports
NH Family Caregiver Support Program
Free Medicare, Medicare Savings Program and insurance counseling
NH SHIP through ServiceLink
Fuel Assistance, Electric Assistance and Weatherization applications
New Hampshire Community Action Agencies
Low/Moderate property-tax relief and property-tax forms/questions
NH Department of Revenue Administration
Medicare home health, caregiver training, GUIDE and coverage questions
Medicare
VA health benefits, caregiver/home-care programs and general VA assistance
U.S. Department of Veterans Affairs
Before You Rely on Any Payment Source
Planning Point
Why It Matters
CFI is the main Medicaid LTSS pathway for older adults and adults with physical/chronic needs
CFI serves Medicaid-eligible adults age 18+ who meet nursing-facility clinical level of care and choose community services. It is the first Medicaid waiver to screen for when ongoing personal care or broad HCBS is needed.
CFI PDMS can enable paid relatives - but not the spouse
Current CFI rules define the participant’s spouse as the legally responsible relative and exclude services furnished by a legally responsible relative. Other relatives/friends may be considered under participant direction when worker and service rules are met.
Adult Family Care is a separate CFI route worth screening
CFI defines Adult Family Care as a combination of personal care, homemaking and other services in an approved private residence, and the residence may be that of the participant’s relative. This is different from simply hiring an hourly personal-care worker.
DD, IHS and ABD waivers serve different populations
DD is for qualifying intellectual/developmental disability populations, IHS is specifically for eligible children/young adults through age 21, and ABD is for eligible adults with acquired brain disorder. Each has its own level-of-care and service-planning rules.
Participant-direction family rules differ outside CFI
Developmental-services participant-directed programs have service-specific restrictions, including spouse/parent-of-minor limits with narrow exceptions. Families should clear a proposed worker with the Area Agency/service coordinator before assuming payment is allowed.
HC-CSD is a critical Medicaid pathway for children with severe disabilities
New Hampshire law allows qualifying children who meet institutional-level criteria to receive family-centered home care and specifies that parental income deeming does not apply under the cited program criteria.
ServiceLink is the best statewide navigation call
ServiceLink functions as New Hampshire’s Aging & Disability Resource Center and SHIP access point. It can connect families to CFI, caregiver supports, aging services, meals, Medicare counseling and local providers.
The Family Caregiver Support Program is respite/support - not a salary program
NHFCSP can fund limited short-term respite and supplemental supports, but it should not be confused with an ongoing wage for the primary unpaid caregiver.
MEAD, MOAD and spenddown can change Medicaid eligibility
Working people with disabilities and people with significant medical expenses should request a formal Medicaid eligibility review rather than assuming they are over income. Different LTSS categories can use different financial rules.
Medicare is not a general custodial home-care benefit
Medicare home health is tied to qualifying skilled/intermittent needs and other rules. GUIDE and caregiver training add targeted support, but ongoing custodial assistance usually requires Medicaid, VA, LTC insurance or private pay.
Energy and property-tax programs can preserve meaningful care dollars
Fuel Assistance, Electric Assistance, Weatherization and property-tax relief do not usually pay a caregiver directly, but they can materially reduce recurring household expenses and stretch a home-care budget.
New Hampshire home-care costs vary by market
CareScout’s 2025 statewide median is $91,520 for 44 hours/week of non-medical caregiving. Southern New Hampshire, Seacoast, rural areas and high-need schedules can differ substantially, so use local agency quotes for planning.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in New Hampshire to help you navigate the application process.
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