New Hampshire residents have access to a strong set of health coverage options under the Affordable Care Act (ACA). Whether you are looking for subsidized Marketplace insurance, Medicaid through the Granite Advantage Health Care Program, or coverage for your children, the state offers multiple pathways to affordable care. In fact, New Hampshire consistently ranks among the states with the most competitive and affordable ACA premiums in the country, and more than 70% of Marketplace enrollees qualify for premium subsidies that reduce their monthly costs by an average of $338 per month.
This guide covers everything you need to know about New Hampshire ACA benefits and coverage, from eligibility and income limits to step-by-step enrollment instructions.
Not sure which programs you qualify for? Check your eligibility in minutes with our free screener to see all the benefits available to you. You can also visit our New Hampshire Benefits Overview for a full list of assistance programs in the state.
What the ACA Covers in New Hampshire
All ACA Marketplace plans in New Hampshire must include 10 categories of essential health benefits:
- Ambulatory (outpatient) care including doctor visits and specialist appointments
- Emergency services with no prior authorization required
- Hospitalization for surgeries and overnight stays
- Maternity and newborn care before and after birth
- Mental health and substance use disorder services including counseling and rehab
- Prescription drugs with formulary coverage
- Rehabilitative and habilitative services including physical therapy and devices
- Laboratory services such as blood tests and imaging
- Preventive and wellness services including vaccinations and screenings at no extra cost
- Pediatric services including dental and vision care for children
All plans must also cover pre-existing conditions, and insurers cannot charge you more based on your health history.
New Hampshire Marketplace Plans and Carriers
New Hampshire uses the federal Healthcare.gov marketplace. For 2025 and 2026 coverage, four insurance carriers offer plans:
| Carrier | Plan Types | Network Notes |
|---|---|---|
| Anthem | Bronze, Silver, Gold | Broad provider network across NH |
| Ambetter (NH Healthy Families) | Bronze, Silver, Gold | Growing network, competitive pricing |
| WellSense | Bronze, Silver, Gold | Strong in southern NH |
| Harvard Pilgrim Health Care | Bronze, Silver, Gold | Well-established New England carrier |
Plans are organized into metal tiers based on how costs are shared between you and the insurer:
- Bronze: Lowest premiums, highest out-of-pocket costs (covers about 60% of costs)
- Silver: Moderate premiums and costs (covers about 70%). Eligible for extra cost-sharing reductions if your income is between 100% and 250% FPL
- Gold: Higher premiums, lower out-of-pocket costs (covers about 80%)
Income Limits and Financial Assistance
Your household income determines what type of help you can get. The table below shows 2025 Federal Poverty Level (FPL) guidelines used for eligibility:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 150% FPL | 250% FPL | 400% FPL |
|---|---|---|---|---|---|
| 1 | $15,650 | $21,597 | $23,475 | $39,125 | $62,600 |
| 2 | $21,150 | $29,187 | $31,725 | $52,875 | $84,600 |
| 3 | $26,650 | $36,777 | $39,975 | $66,625 | $106,600 |
| 4 | $32,150 | $44,367 | $48,225 | $80,375 | $128,600 |
| 5 | $37,650 | $51,957 | $56,475 | $94,125 | $150,600 |
| 6 | $43,150 | $59,547 | $64,725 | $107,875 | $172,600 |
What You Qualify For Based on Income
Medicaid (Granite Advantage Health Care Program): If your income is at or below 138% FPL, you likely qualify for Medicaid coverage through New Hampshire's expansion program. This provides comprehensive health coverage with minimal cost sharing.
Premium Tax Credits: If your income is between 100% and 400% FPL, you may qualify for monthly tax credits that lower your Marketplace insurance premiums. These credits are applied directly to your monthly bill.
Cost-Sharing Reductions (CSR): If your income is between 100% and 250% FPL and you choose a Silver plan, you can get extra savings on deductibles, copays, and coinsurance.
Important Note for 2026: The enhanced premium tax credits that were expanded under the Inflation Reduction Act expired on December 31, 2025. This means subsidies have returned to pre-2021 levels, and some households earning above 400% FPL may no longer qualify for assistance. Check your specific eligibility using our free screener.
Granite Advantage Health Care Program (Medicaid Expansion)
New Hampshire expanded Medicaid in 2014 through the Granite Advantage Health Care Program. This program covers adults aged 19 to 64 with household incomes up to 138% of the federal poverty level.
Key features of Granite Advantage:
- No asset test for the expansion population
- Coverage through managed care plans: AmeriHealth Caritas, NH Healthy Families, or Well Sense Health Plan
- Small monthly premiums may apply ($10/month for income up to 100% FPL, up to $25/month for income between 101% and 138% FPL)
- No work requirement currently in effect
- Covers doctor visits, hospital stays, prescriptions, mental health services, and more
Children's coverage is available through Medicaid for families with incomes up to 318% FPL, and CHIP coverage extends to 300% FPL. Pregnant women qualify with incomes up to 196% FPL.
How to Enroll in New Hampshire ACA Coverage
For Marketplace Plans (Healthcare.gov)
Step 1: Determine your eligibility. Use our free benefits screener to see what programs you may qualify for, or visit Healthcare.gov directly.
Step 2: Gather your documents. You will need:
- Social Security numbers for everyone in your household
- Immigration documents (if applicable)
- Employer and income information (pay stubs, W-2s, tax returns)
- Information about any current health coverage
Step 3: Create an account at Healthcare.gov. Go to Healthcare.gov and create a Marketplace account if you do not already have one.
Step 4: Complete your application. Answer questions about your household size, income, and coverage needs. The system will determine your eligibility for premium tax credits and cost-sharing reductions.
Step 5: Compare and choose a plan. Review available plans from Anthem, Ambetter, WellSense, and Harvard Pilgrim. Compare premiums, deductibles, provider networks, and prescription drug coverage.
Step 6: Enroll and pay your first premium. Select your plan and make your first monthly payment to activate coverage.
Open Enrollment for 2026: November 1, 2025 through December 15, 2025. Outside of open enrollment, you can still enroll if you have a qualifying life event such as losing other coverage, getting married, having a baby, or moving to New Hampshire.
For Medicaid (Granite Advantage)
Step 1: Apply online at NH EASY
Step 2: Or call 1-800-852-3345, ext. 9700
Step 3: You can also apply by fax at (603) 271-8604 or visit your local District Office
Medicaid applications are accepted year-round with no enrollment period restrictions.
Getting Help With Enrollment
New Hampshire offers several free resources to help you enroll:
- Covering New Hampshire: Visit coveringnewhampshire.org for local enrollment assistance and navigator services
- NH Insurance Department: Call 1-800-852-3416 or email consumerservices@ins.nh.gov for questions about your coverage options
- ServiceLink Resource Centers: Call 1-866-634-9412 for Medicare-related questions and counseling
- Healthcare.gov Help Center: Call 1-800-318-2596 (available 24/7)
Frequently Asked Questions
What is the difference between Medicaid and ACA Marketplace coverage in New Hampshire?
Medicaid (through the Granite Advantage Health Care Program) is a government-funded program for lower-income residents with incomes up to 138% FPL. It offers comprehensive coverage with very low or no cost sharing. ACA Marketplace plans are private insurance plans available through Healthcare.gov, often with premium tax credits to make them more affordable. Generally, if your income qualifies you for Medicaid, that will be your most affordable option.
Can I enroll in an ACA plan outside of open enrollment?
Yes, but only if you experience a qualifying life event (QLE). Examples include losing employer coverage, getting married or divorced, having a baby, adopting a child, or moving to a new state. You typically have 60 days from the event to enroll in a new plan.
Does New Hampshire have its own state health insurance exchange?
No. New Hampshire uses the federal marketplace at Healthcare.gov. However, the state provides resources through Covering New Hampshire and the NH Insurance Department to help residents navigate their options.
How much will my ACA plan cost?
Your cost depends on your income, household size, age, and the plan you choose. Many New Hampshire residents qualify for premium tax credits that significantly reduce monthly premiums. During the 2025 enrollment period, subsidized enrollees saved an average of $338 per month. Use our free screener to estimate your potential savings.
Are pre-existing conditions covered under New Hampshire ACA plans?
Yes. Under the ACA, all Marketplace plans must cover pre-existing conditions. Insurers cannot deny you coverage or charge you higher premiums based on your health status.
What happens if my income changes during the year?
If your income increases or decreases, you should update your Marketplace application as soon as possible. A significant income change could affect your subsidy amount or make you eligible for Medicaid instead. Failing to report changes could result in owing money at tax time or missing out on additional savings.
Is dental coverage included in ACA plans?
Pediatric dental coverage is included as an essential health benefit in all Marketplace plans. Adult dental coverage is not required but may be available as a standalone dental plan through the Marketplace or your chosen carrier.
Take the Next Step
Finding the right health coverage in New Hampshire does not have to be complicated. Start by checking your eligibility with our free screener to see which programs you qualify for based on your income and household size. In just a few minutes, you can discover potential savings on health insurance, Medicaid, and other assistance programs available in the Granite State.
For a complete overview of all benefits programs available to New Hampshire residents, visit our New Hampshire Benefits Overview.
