New Hampshire Medicaid Fees in 2026: Premiums, Copays & What to Expect

Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against Medicaid.gov and NH DHHS official guidelines | Last Updated: May 2026

New Hampshire Medicaid Fees in 2026: What You Need to Know

New Hampshire Medicaid is adding new monthly premiums and higher copays starting in 2026. If you are currently enrolled — or thinking about applying — these changes may affect how much you pay out of pocket.

This guide covers every fee change in plain language, including who pays, how much, and what comes next.

Quick Summary:

• NH Medicaid is adding monthly premiums for the first time starting July 2026
• Adults in Granite Advantage (Medicaid expansion) earning ≥100% FPL will pay $60–$100/month
• Prescription drug copays are rising from $1–$2 to $4 per prescription
• Nursing home reimbursement rates also changed as of January 2026
• Two bills (SB 484 and HB 1760) are actively trying to roll back these fees
• 👉 Check your eligibility with our free Medicaid Eligibility Calculator in 2026

What Is New Hampshire Medicaid?

New Hampshire Medicaid is a state and federally funded health insurance program. It provides free or low-cost coverage to people with low incomes.

The program is run by the NH Department of Health and Human Services (DHHS). It covers medical visits, prescriptions, hospital care, and more.

Granite Advantage Health Care Program

Granite Advantage is NH’s Medicaid expansion program under the Affordable Care Act (ACA). It covers adults aged 19–64 who earn up to 138% of the Federal Poverty Level (FPL).

This program currently serves tens of thousands of New Hampshire residents. It is managed care, meaning enrollees choose a health plan for their coverage.

Other NH Medicaid Programs

NH Medicaid also covers children through CHIP, pregnant women, seniors, and people with disabilities. Each group has its own income limits and rules.

To see how NH compares to other states, visit our guide on Medicaid income limits by state in 2026.

Who Qualifies for New Hampshire Medicaid in 2026?

NH Medicaid covers several groups of people. Your eligibility depends on your income, household size, and life situation.

Here is a quick look at who may qualify:

Income is measured using Modified Adjusted Gross Income (MAGI) for most groups. Seniors and people with disabilities may also face asset limits.

What Counts as Income?

Countable income includes wages, self-employment, and Social Security benefits. Some income is exempt, like certain disability payments.

Your household size affects your income limit. A larger household can earn more and still qualify.

Do I Still Qualify If I Work?

Yes. Many working adults in NH qualify for Medicaid. If you earn below 138% FPL as a single adult, you likely qualify for Granite Advantage.

Use our Medicaid eligibility guide in 2026 to learn more about what counts toward your household income.

New Hampshire Medicaid Income Limits 2026

Here are the monthly income limits for Granite Advantage based on household size. These are based on 138% of the Federal Poverty Level.

Source: Medicaid.gov / 2026 FPL guidelines

These limits are based on MAGI rules. If your income is close to the limit, you may still qualify — it is worth checking.

New Hampshire Medicaid Fees in 2026: What Is Changing

This is the most important section if you are already enrolled. NH Medicaid has no history of charging monthly premiums — but that is changing in 2026.

These changes were approved as part of the NH 2026–27 state budget. Here is a full breakdown.

New Monthly Premiums Starting July 2026

For the first time, NH Medicaid will charge monthly premiums to some enrollees. These apply to adults in Granite Advantage earning at or above 100% FPL ($15,650/year for a single person).

Granite Advantage Adults (≥100% FPL):

Families with Children (≥255% FPL):

Source: NHPR, July 2025

Important: NH DHHS is currently seeking guidance from the Centers for Medicare & Medicaid Services (CMS) on whether these premiums require a federal waiver. Final implementation for July 2026 has not been confirmed.

Prescription Drug Copay Increase

Pharmacy copays are rising significantly in 2026. Previously, enrollees paid $1–$2 per prescription. The new amount is $4 per prescription for all Medicaid enrollees.

This applies across the board — generic and brand-name drugs alike. If you take multiple medications, this change could add up quickly.

What If I Cannot Afford the New Fees?

Federal law limits how much states can charge Medicaid enrollees. If you cannot pay a premium, contact NH DHHS right away.

Losing coverage due to unpaid premiums could leave you uninsured. It is important to act before any deadline.

What Does New Hampshire Medicaid Cover?

NH Medicaid covers a wide range of health services. Here is what most enrollees can access:

• Doctor visits — primary care and specialists
• Hospital care — inpatient and outpatient services
• Emergency services — 24/7 emergency room coverage
• Prescription drugs — covered with a copay
• Mental health care — therapy and counseling
• Substance use treatment — inpatient and outpatient programs
• Dental care — basic services for adults; full coverage for children
• Vision care — eye exams and glasses for children
• Preventive care — screenings, vaccines, and checkups
• Nursing home care — long-term care for qualifying seniors

For more detail on what is covered under your plan, visit Medicaid.gov.

NH Medicaid Fee Schedule 2026: What Providers Need to Know

The NH DHHS publishes all provider reimbursement rates through the NH Medicaid Management Information System (MMIS) portal. As of April 2026, the following fee schedules are active:

• 2026 Fee Schedule – Covered Procedures (effective 04-01-2026)
• 2026 Fee Schedule – Manually Priced Items (effective 04-01-2026)
• 2026 Fee Schedule – Covered Dental Procedures (effective 01-01-2026, v2)
• DRG Pricing Memo FFY26 (updated)

Source: NH MMIS Health Enterprise Portal — nhmmis.nh.gov

For a broader national comparison, see our guide to the Medicaid fee schedule in 2026.

Nursing Home Rate Changes (January 2026)

Nursing home reimbursement rates saw significant changes at the start of 2026. A planned average rate cut of 3.91% — equal to $10.36 per resident, per day — was partially offset by a state budget surplus.

The final result was an average increase of just two cents per resident, per day. However, individual facilities saw much larger cuts. Some lost as much as $46 per resident, per day.

Rates are based on each facility’s Case Mix Index (CMI) from August 31, 2025. The state also rebased its system to state fiscal year 2024 data.

Hospital Reimbursement (July 2025–June 2026)

CMS approved a renewal for NH’s inpatient and outpatient hospital fee-for-service payments. This covers July 1, 2025 through June 30, 2026 and includes a uniform price increase for Medicaid discharges and outpatient visits.

Source: Medicaid.gov — NH Fee IPH/OPH Renewal document

How to Apply for Medicaid in New Hampshire

Applying is free and takes about 30 minutes. Here are your options:

1. Online: Apply at NH Easy — the NH DHHS self-service portal
2. By phone: Call NH DHHS at 1-844-ASK-DHHS (1-844-275-3447)
3. In person: Visit your local District Office
4. By mail: Download and mail the paper application from the NH DHHS website

What you will need:

• Proof of identity (driver’s license or state ID)
• Proof of NH residency
• Social Security numbers for all household members
• Proof of income (pay stubs, tax returns)
• Immigration documents (if applicable)

Coverage can start as early as the first day of the month you apply. In some cases, Medicaid may cover medical bills from up to 3 months before your application date.

What Happens After You Apply?

After you submit your application, here is what to expect:

Step 1 — Review (up to 45 days): NH DHHS reviews your application. Most decisions come within 45 days. Disability-based cases may take up to 90 days.

Step 2 — Verification: You may be asked for additional documents. Respond quickly to avoid delays.

Step 3 — Approval or Denial: You will receive a letter with the decision. If approved, your Medicaid card will arrive in the mail.

Step 4 — Choose a Health Plan: Granite Advantage enrollees must select a managed care plan. You will have a limited window to choose.

Step 5 — Annual Renewal: You must renew your Medicaid coverage each year. NH DHHS will send you a renewal notice.

Active Bills That Could Change 2026 NH Medicaid Fees

Two bills are currently working through the NH Legislature that could reverse the new fees:

• SB 484 — Would eliminate monthly premiums for CHIP and Granite Advantage, and cap cost-sharing at $5 per service for Granite Advantage adults
• HB 1760 — Would roll back both the premium increases and the prescription copay increases approved in the 2026–27 budget

Source: NH Needs Medicaid — nhneedsmedicaid.com/current-legislation

These bills are still in progress as of May 2026. The final outcome could change what enrollees pay starting July 2026.

Frequently Asked Questions

Sources & Disclaimer

Sources:

• Medicaid.gov — Official Medicaid Program Information
• Healthcare.gov — Medicaid & CHIP Overview
• NH MMIS Health Enterprise Portal — nhmmis.nh.gov
• NH Health Care Association — nhhca.org
• NHPR — nhpr.org
• NH Needs Medicaid — nhneedsmedicaid.com

Last Updated: May 2026

CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official eligibility information, contact your state Medicaid office or visit Medicaid.gov.