New Hampshire covers children under age 19 through two overlapping Medicaid tracks, and together those tracks reach one of the highest income ceilings in the country. A family of four earning up to roughly $104,940 per year can still get their kids covered at no cost. That ceiling sits at 318% of the federal poverty level (FPL), placing New Hampshire well above the 200% to 250% FPL used by most states. This guide explains exactly how the income tiers work, shows the full 2026 income limit chart by household size, and walks through the steps to apply through NH EASY.
How NH Children's Medicaid Is Structured
New Hampshire does not run a separate CHIP program. Instead, it funnels all children's coverage through a single Medicaid framework with two income tiers:
Children's Medicaid (CM): Covers children under 19 with household income at or below 196% FPL. Benefits are fully Medicaid-funded and include medical and dental coverage.
Expanded Children's Medicaid (Expanded CM): Covers children under 19 with household income above 196% FPL and up to 318% FPL. This tier is funded through the federal Children's Health Insurance Program (CHIP) but is administered identically to standard Medicaid. Families do not apply separately for it.
In practice, you apply once and the state determines which tier applies. The benefits package is the same under both.
A note on the 318% vs 323% figure: You may see 323% FPL cited in some sources. The official state policy ceiling is 318% FPL. The 323% figure reflects that NH also applies a standard 5% MAGI income disregard when calculating eligibility, which effectively allows children from households with income slightly above 318% to still qualify. For practical purposes, both numbers point to the same program.
2026 Income Limit Chart: Children's Medicaid (196% FPL)
The table below shows the maximum monthly and annual income for the standard Children's Medicaid tier. Income is based on Modified Adjusted Gross Income (MAGI), using IRS household definitions.
| Household Size | Monthly Limit | Annual Limit |
|---|
| 1 person | $2,607 | $31,282 |
| 2 persons | $3,531 | $42,374 |
| 3 persons | $4,456 | $53,467 |
| 4 persons | $5,390 | $64,680 |
| 5 persons | $6,318 | $75,811 |
| 6 persons | $7,246 | $86,946 |
| 7 persons | $8,173 | $98,078 |
| 8 persons | $9,101 | $109,211 |
For households larger than 8, add approximately $5,680 per additional person per year to the annual limit, or roughly $473 per month.
2026 Income Limit Chart: Expanded Children's Medicaid (318% FPL)
If your household income falls above the table above but below the limits here, your child qualifies for Expanded CM. The benefits are identical.
| Household Size | Monthly Limit | Annual Limit |
|---|
| 1 person | $4,229 | $50,753 |
| 2 persons | $5,735 | $68,815 |
| 3 persons | $7,240 | $86,878 |
| 4 persons | $8,745 | $104,940 |
| 5 persons | $10,247 | $122,962 |
| 6 persons | $11,755 | $141,065 |
| 7 persons | $13,261 | $159,127 |
| 8 persons | $14,766 | $177,190 |
For households larger than 8, add approximately $18,060 per additional person per year to the Expanded CM annual limit.
These figures are based on the 2026 federal poverty guidelines ($33,000 for a family of 4) and the state's stated 318% FPL ceiling.
What Does "Income" Mean Under MAGI Rules?
NH uses Modified Adjusted Gross Income to determine eligibility for children's coverage. This follows federal Medicaid rules and aligns closely with how income is reported on a federal tax return. Key points:
- Counted income: Wages, salaries, self-employment earnings, Social Security benefits (if taxable), unemployment compensation, and most investment income.
- Not counted: Child support received, most gifts, and money borrowed (loans).
- Household size: Defined by who is included on the federal tax return. If a child is claimed as a dependent, the parent's income is counted. If the child files their own return, only the child's income counts.
- 5% disregard: The state subtracts 5% of the FPL from the calculated household income before comparing it to the limit. This is a federal requirement under 42 CFR 435.603(d)(4) and gives households a small buffer above the stated threshold.
There is no asset test for children's Medicaid in New Hampshire. Savings accounts, vehicles, and home equity are not counted.
Who Qualifies Beyond Income
Income is the main factor, but children must also meet these basic requirements:
- Under age 19
- A resident of New Hampshire
- A U.S. citizen or qualifying immigrant (certain immigration statuses qualify; lawful permanent residents typically qualify)
- Not enrolled in other comprehensive coverage that meets minimum value requirements
Children who have access to employer-sponsored insurance are still eligible if that coverage costs more than a certain share of household income. The state evaluates cost-effectiveness on a case-by-case basis.
What's Covered
Both CM and Expanded CM cover the same set of services:
- Well-child visits and preventive care
- Immunizations
- Doctor and specialist visits
- Emergency room care
- Hospital stays (inpatient and outpatient)
- Mental health and substance use services
- Prescription drugs
- Dental care (cleanings, fillings, extractions, orthodontia in some cases)
- Vision care (exams and glasses)
- Physical therapy and occupational therapy
- Speech therapy
There are no premiums and no copays for most services under Children's Medicaid. Expanded CM may have modest cost-sharing for families with higher incomes, but these are minimal.
How to Apply: Step-by-Step
Step 1: Gather Documents
Before you start, pull together the following:
- Social Security numbers for the child and any parent or guardian in the household
- Proof of New Hampshire residency (utility bill, lease, or bank statement)
- Proof of income for all household members (pay stubs, tax returns, or a letter from an employer)
- Proof of citizenship or immigration status for the child
- Information on any current health insurance coverage
Step 2: Apply Online Through NH EASY
Go to nheasy.nh.gov and create an account if you do not have one. Select "Apply for Benefits" and choose health coverage. The online application is available 24 hours a day and typically takes 20 to 30 minutes to complete.
After submitting, you can log back in to check your application status, upload additional documents, and manage your benefits once approved.
Step 3: Apply by Phone (Optional)
If you prefer to apply over the phone, call the DHHS Customer Service Center at 1-844-ASK-DHHS (1-844-275-3447), Monday through Friday, 8:00 a.m. to 4:00 p.m. ET. A representative can take your application and answer questions.
Step 4: Apply by Mail or In Person (Optional)
Download and print the application from the DHHS website, complete it, and mail it to your local DHHS district office. You can also bring it in person. Find your nearest office at dhhs.nh.gov.
Step 5: Respond to Any Requests for Information
After submitting, DHHS may contact you to verify income or other details. Respond promptly to avoid delays. Processing typically takes up to 45 days from the date of a complete application.
Step 6: Receive Your Decision
If approved, you will receive a Medicaid card and a notice explaining which tier your child qualifies for. Coverage is usually retroactive to the first day of the month you applied.
If denied, you have the right to appeal the decision. The denial notice will include instructions on how to request a fair hearing.
Renewing Coverage
Children's Medicaid must be renewed every 12 months. DHHS will send a renewal notice before your child's coverage expires. You can renew online through NH EASY, by phone, or by mail. If your household income has changed, update it at renewal time so the state can reassess which tier applies.
What If Your Income Is Too High for Expanded CM?
If your household income exceeds 318% FPL (approximately $104,940 for a family of 4), your child will not qualify for either children's Medicaid tier. At that income level, consider:
- Marketplace health insurance: Coverage through the ACA marketplace may be available with premium tax credits if household income falls between 100% and 400% FPL (or higher with the extended subsidies currently in effect). Plans cover children comprehensively.
- NH's marketplace: New Hampshire uses the federal marketplace at healthcare.gov for plan enrollment.
Use the Benefits Navigator screener to check eligibility across all programs at once, including Medicaid, marketplace subsidies, SNAP, and more.
How NH Compares to Other States
New Hampshire's 318% FPL ceiling for children is among the highest in the country. The national minimum under federal law is 100% FPL. Most states exceed that, with the median around 200% to 250% FPL. New Hampshire, Massachusetts, New Jersey, and a handful of others have pushed their limits to 300% FPL or above.
That means a middle-income family in New Hampshire that would not qualify for children's coverage in most other states can still get their kids covered here.
Frequently Asked Questions
What is the income limit for a family of 4 for NH children's Medicaid in 2026?
A family of 4 can earn up to $104,940 per year (about $8,745 per month) and still have their children covered under Expanded Children's Medicaid at 318% FPL. The standard Children's Medicaid tier cuts off at $64,680 per year (about $5,390 per month) for a family of 4, which is 196% FPL.
Do both parents' incomes count?
Yes. MAGI rules count the income of all household members whose income is included on the federal tax return. If both parents file jointly, both incomes are counted toward the household total.
Is there an asset test for children's Medicaid in NH?
No. New Hampshire does not apply an asset test to children's Medicaid. Bank accounts, vehicles, retirement savings, and home equity are not considered in the eligibility determination.
What is the difference between Children's Medicaid and Expanded Children's Medicaid?
Both programs provide the same benefits. The difference is the funding source and the income range they cover. Standard Children's Medicaid covers households up to 196% FPL and is funded entirely by Medicaid. Expanded Children's Medicaid covers households from 196% to 318% FPL and is funded through CHIP. Families apply once and do not need to know which program they end up in.
Can an undocumented child qualify for Medicaid in New Hampshire?
Children who are undocumented are not eligible for full Medicaid in New Hampshire. However, federal law requires that emergency Medicaid be available regardless of immigration status. Some children in mixed-status families with qualifying immigration statuses may be eligible. Contact DHHS directly to discuss a specific situation.
How long does the application take?
Most decisions come within 45 days of a complete application. If you applied based on a disability, it may take up to 90 days. Submitting all required documents upfront reduces delays significantly.
Does the child need to see a specific doctor?
New Hampshire uses managed care organizations (MCOs) to deliver Medicaid services. When your child is enrolled, you will choose or be assigned to an MCO. The MCO maintains a network of participating providers. You can usually change your MCO or primary care provider if needed.
What happens if my income goes up during the year?
Report income changes promptly through NH EASY or by calling DHHS. If your income rises above the applicable limit, coverage will end at the next renewal period. You will have time to find other coverage.
Can I apply for my child even if they are enrolled in school?
Yes. School enrollment has no effect on Medicaid eligibility. Students at any grade level are eligible as long as they meet the age, residency, and income requirements.
Where do I find my local DHHS office?
The New Hampshire DHHS website at dhhs.nh.gov has a district office locator. You can also call 1-844-ASK-DHHS for the address and hours of the office closest to you.
For a quick check across all programs your household might qualify for, use the free Benefits Navigator screener. It covers Medicaid, SNAP, ACA subsidies, WIC, LIHEAP, and more, and takes about three minutes. See the New Hampshire benefits guide for a full overview of all programs available in the state.
