Medicaid in New Hampshire
New Hampshire expanded Medicaid in 2014 under its NH Health Protection Program. The program covers adults aged 19 to 64 with household incomes up to 138% FPL (about $22,025 for a single person, or $45,540 for a family of four, for 2027 coverage). Roughly 55,000 New Hampshire residents are enrolled through expansion.
The state's expansion program has been reauthorized multiple times by the legislature. It uses managed care organizations to deliver benefits, with enrollees choosing from participating health plans. There is no coverage gap in New Hampshire, since Medicaid covers those below 138% FPL and marketplace subsidies are available above that threshold.
Expansion adults now face federal work requirements, which states must start by January 1, 2027 (a state making a good-faith effort can get extra time). Most expansion enrollees ages 19 to 64 will need to show 80 hours a month of work, school, job training, or community service. Parents of children under 14, pregnant people, people who are disabled or medically frail, and some others are exempt. Watch for notices from NH DHHS.
New Hampshire's uninsured rate is approximately 5.1%, one of the lowest in the nation. About 70,000 residents lack coverage. The state has a strong employer-sponsored insurance market, which contributes to the low uninsured rate.
What plans cost in 2027
New Hampshire premiums are still low by New England standards, but they rose sharply for 2027. Here is the benchmark (second-lowest cost Silver) premium for a 40-year-old before subsidies, from HealthCare.gov plan data:
- Hillsborough, Rockingham, Merrimack, and Belknap counties: about $472 per month, up from $388 in 2026
- Grafton and Coos counties: about $531, up from $440
That is roughly a 21% increase. If you get a premium tax credit, your credit grows with the benchmark, so the change in what you pay may be much smaller.
The enhanced subsidies expired after 2025 and were not renewed. For 2027, the subsidy cliff sits at 400% FPL ($63,840 for a single person, $86,560 for a family of two), and people above it pay full price. About 66,000 New Hampshire residents picked a marketplace plan during 2026 open enrollment, according to CMS.
Carriers in New Hampshire (2027)
Three insurers offer individual marketplace plans in New Hampshire for 2027. Ambetter from NH Healthy Families, which sold plans in 2026, left the marketplace, so Ambetter enrollees need to choose a new plan:
- Anthem Blue Cross and Blue Shield offers plans in all 10 counties and has a broad provider network.
- Harvard Pilgrim Health Care (now part of Point32Health after merging with Tufts Health Plan) offers plans in all 10 counties.
- WellSense Health Plan (Boston Medical Center Health Plan) offers plans in five counties for 2027: Belknap, Hillsborough, Merrimack, Rockingham, and Strafford.
Those five counties have three choices. The other five (Carroll, Cheshire, Coos, Grafton, and Sullivan) have two, Anthem and Harvard Pilgrim.
Key regions
Southern New Hampshire (Nashua, Manchester, Concord)
Hillsborough and Merrimack counties are the population centers. Dartmouth Health (formerly Dartmouth-Hitchcock) has a presence here, and Elliot Hospital, Catholic Medical Center (Manchester), and Southern New Hampshire Medical Center (Nashua) are major facilities. All three marketplace insurers sell plans here for 2027. Proximity to the Boston metro area means some residents cross into Massachusetts for specialty care, but out-of-state providers may not be in your plan's network.
Upper Valley and Lakes Region
Dartmouth Health's flagship Dartmouth-Hitchcock Medical Center in Lebanon is the academic medical center for the region and a critical resource for specialty care across northern New England. Grafton County has two insurers for 2027, Anthem and Harvard Pilgrim, and its benchmark premium is about $59 a month higher than in the southern counties.
North Country
Coos and Grafton counties in northern New Hampshire are sparsely populated with limited healthcare infrastructure. Androscoggin Valley Hospital in Berlin and Littleton Regional Healthcare are the key facilities. Access to specialists typically requires travel to Lebanon or even further south. Anthem and Harvard Pilgrim both cover these counties for 2027, but in-network provider choices can be thin.
Estimate your subsidy
Subsidy Estimator
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New Hampshire-specific things to know
No coverage gap, but affordability is still an issue. Medicaid expansion eliminated the coverage gap, but New Hampshire has a relatively high cost of living. For middle-income earners above 400% FPL who get no subsidy help in 2027, full-price premiums of $470 or more per month for a 40-year-old (and much more for older adults) can be a serious burden.
Network differences matter here.With two or three insurers in each county, the practical choice often comes down to whether your preferred doctors and hospitals are in-network. If you had Ambetter in 2026, check that your doctors are in the new plan you pick. Always check the carrier's provider directory before enrolling, and enroll by December 15, 2026 for coverage that starts January 1, 2027.
Free enrollment help is available. New Hampshire has certified navigators and community-based enrollment assisters. Community health centers across the state offer free help with marketplace applications and Medicaid enrollment.
Resources
- HealthCare.gov for marketplace enrollment (New Hampshire uses the federal marketplace)
- NH DHHS Medicaid for Medicaid eligibility and enrollment
- NH HealthCost for price transparency and healthcare cost information