WHAT YOU NEED TO KNOW:
- The Open Enrollment Period in New Hampshire is November 1 to December. This is when you can sign up, renew or change your health insurance plan.
- You can enroll online at healthcare.gov for an Affordable Care Act (ACA) plan through New Hampshire’s Health Insurance Marketplace.
- When you apply online, you’ll find out if you also qualify for other programs or assistance.
- The average monthly premium in 2020 for an ACA plan for a 40-year-old ranges from $303 to $456, but tax credits and subsidies could lower your premiums and out-of-pocket costs.
With 1.3 million residents, New Hampshire is the fifth smallest state in the U.S.,1 but residents have access to the full range of health insurance options: employer-provided plans; Affordable Care Act (ACA) individual and family plans purchased through the federal Health Insurance Marketplace or directly from insurance companies; or government-assisted plans such as Medicare, Medicaid and the state’s Children’s Health Insurance Program (CHIP).
Three out of five Granite State residents get their coverage through their work. Another one in six receives it through both Medicaid and Medicare, while the ACA (aka Obamacare) covers fewer than one in every 20 residents.2
New Hampshire expanded Medicaid coverage shortly after the ACA passed into law. In August 2014, Medicaid expansion began covering adults 19 to 64 with incomes up to 133% of the federal poverty level (FPL). By October 2019, Medicaid covered an additional 57,000 New Hampshire residents.3
Between Obamacare and the state’s Medicaid expansion, the two programs helped drop New Hampshire’s uninsured rates from 11% in 2013 to 5% in 2018.4
Here you’ll find an overview of New Hampshire’s health insurance landscape and get help navigating your options to choose the plan that’s right for you.
When Is the Open Enrollment Period in New Hampshire?
The Open Enrollment Period (OEP) in New Hampshire runs from November 1 to December 15 each year for coverage that starts the following January 1.
If you don’t enroll at that time, you’ll have to wait until next year’s OEP to apply. One exception is if you have what’s called a “qualifying life event.” That could be something that changes the size of your family or leaves you uninsured, such as having a baby or losing your job. A qualifying life event will trigger a 60-day window called a Special Enrollment Period during which you can get insurance.5
Enrollment in New Hampshire’s ACA Marketplace started at 40,000 in 2014, rose to a peak of about 55,000 in 2016, and then dropped to around 44,000 in 2020.6
How Do I Enroll in New Hampshire’s Health Insurance Marketplace?
Under the ACA, Granite Staters can purchase federally regulated coverage and possibly qualify for subsidies through the federal government’s healthcare.gov website, which runs the state’s Health Insurance Marketplace (also called an “exchange”). Remember that if you choose to buy your coverage through an agent or broker, you will give up access to subsidies, which, if you qualify, will help you pay your monthly premiums.
Every ACA plan has to provide 10 “essential health benefits,” including things like coverage of preexisting conditions, preventive care and prescription drugs.
How Much Does Marketplace Health Insurance Cost in New Hampshire?
Different levels of cost-sharing between you and your insurance carrier are used to structure the individual plans that are available on and off the Marketplace. These are called “metal” tiers of gold, silver and bronze, where the more valuable the “metal,” the more coverage you get.
The average cost of premiums for New Hampshire Marketplace plans all fell from 2018 to 2020. Bronze plans fell by over 22%, silver by 15% and gold by 13%. Here are the average monthly costs for a 40-year-old New Hampshire resident for bronze, silver and gold plans sold through the state’s Marketplace:7
Average Premiums for New Hampshire Marketplace Plans (for a 40-year-old person)
|Lowest-Cost Bronze Plan||$391||$302||$303|
|Lowest-Cost Silver Plan||$457||$373||$390|
|Lowest-Cost Gold Plan||$524||$444||$456|
The federal government uses a “benchmark” silver plan — the second-lowest-cost silver premium for a 40-year-old8 — to calculate subsidies. From 2018 to 2020, this benchmark went from $475 to $405, a decrease of nearly 15%.
Which Companies Offer Individual Health Insurance Plans in New Hampshire?
In 2020, three health insurance companies sell individual policies to New Hampshire residents through healthcare.gov:9
- Celtic Insurance Company
- Harvard Pilgrim Health Care of NE
- Matthew Thornton Health Plan (Anthem BCBS)
What Are My Coverage Options in New Hampshire If I’m Low-Income?
ACA Marketplace Plans (Obamacare)
If your income is between one and four times the federal poverty level (FPL), that may qualify you for help paying your premiums.10 In 2019, nearly three-quarters of ACA enrollees in New Hampshire received help in the form of subsidies called Advanced Premium Tax Credits (APTC).11 These monthly subsidies averaged $414.12
Here are some examples of cost savings with subsidies:
- A 28-year-old living in Concord who earns $24,000 a year could get a 2020 silver plan for $122 per month after subsidies.13 The same policy would cost $344 per month without the premium tax credits, which cover 64% of the cost.
- A family of three living in Manchester with an income of $50,000 a year could pay $322 per month after subsidies for a 2020 silver plan.14 This policy would cost them $903 per month without the premium tax credits, which cover 64% of the cost.
You may also qualify for cost-sharing reductions (CSRs) if you earn between 100% and 250% of the FPL, purchase a silver plan on the Marketplace and receive premium tax credits. CSRs cut your out-of-pocket costs even more. In 2019, 40% of enrollees in New Hampshire’s Marketplace plans received CSRs.15
If you go through the Marketplace application process, you’ll find out if you qualify for Medicaid, the Children’s Health Insurance Program (CHIP) or other income-based discounts, too.
Medicaid programs and the Granite Advantage Health Care Program (New Hampshire’s Medicaid extension coverage) are available to you if you have little or no income and you need health coverage. Medicaid programs also cover children, pregnant women and the medically frail.16
To check if you might be eligible for benefits before completing the full application, use the NHEasy quick screening tool.
New Hampshire’s Medicaid Care Management Program offers choices to Medicaid-covered individuals and families for coordinating their healthcare. You can select from three managed-care organizations (MCOs):
- AmeriHealth Caritas New Hampshire
- NH Healthy Families
- Well Sense Health Plan
The health plans cover the same Medicaid services but may have different provider networks and prior authorization requirements.17
New Hampshire’s Medicaid program is administered by the state’s Department of Health and Human Services. Its NHEasy Gateway to Services website allows you to create an account, check eligibility, apply for benefits, search for providers and manage your Medicaid coverage.
As of May 2020, nearly one in seven New Hampshire residents were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).18 Enrollment has increased by 50% since the Affordable Care Act was implemented.19
To qualify, recipients must meet income eligibility requirements as a percentage of the federal poverty level (FPL). The percentages vary for different groups:20
- Parents: 138%
- Childless adults: 138%
- Pregnant women: 201%
- Children: 323%
- Seniors: 74%
- People with disabilities: 74%
The Children’s Health Insurance Program (CHIP) was set up to cover children whose parents earn too much to qualify them for Medicaid but aren’t covered on another health plan. For children under 19, a family of four with a total monthly income at or below $5,763 could qualify for coverage.21
What About Medicare Plans for New Hampshire Seniors and People with Disabilities?
Medicare is the federal health insurance program that helps cover your health costs if you’re over age 65, under 65 with long-term disabilities, or have ALS or end-stage renal disease.
The Open Enrollment Period for Medicare runs from October 15 through December 7 each year. More than one in five New Hampshire residents receive Medicare benefits,22 and about 14% of those are also enrolled in Medicaid.23
Of New Hampshire’s 300,000 Medicare beneficiaries, 88% choose to receive their benefits from Original Medicare (Medicare Parts A and B). The remaining 12% of recipients in the state prefer private Medicare Advantage plans.24 Both types of coverage provide enrollees with Part A (hospital insurance) and Part B (medical insurance), so hospitalization, doctor’s visits and emergency room visits are included.
Medicare Advantage (or Part C) offers additional benefits, such as Part D prescription drug coverage. (With Original Medicare, you would have to purchase a standalone Part D plan to cover medications.) Eight companies in New Hampshire offer Medicare Advantage plans in 2020.25
Nearly 190,000 Granite Staters bought a standalone Medicare Part D drug plan.26In 2020, monthly plan premiums through nine insurers range from $13.20 to $84.10, for an average premium of $37.25.27 Among those with Part D prescription drug plans, more than one-quarter received both low-income premium and cost-sharing subsidies in 2017.28
If you have Original Medicare, you can buy Medicare Supplement Insurance (Medigap policy) from one of 19 insurers in New Hampshire. Medigap policies help pay the portion of your healthcare costs that Medicare doesn’t pay.
Private insurance companies offer 10 standardized Medigap policies, meaning they must follow federal and state laws. Each plan’s benefits are the same no matter which insurance company you select, but premiums vary widely by company, so it pays to compare pricing.
New Hampshire’s Service Link Resource Center offers help through the State Health Insurance Assistance Program (SHIP). Call (866) 634-9412 for information about Medicare plans.
If you can’t afford your insurance payments, ask SHIP if you qualify for one of New Hampshire’s Medicare Savings Programs: Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB 120 and 135) or Qualified Disabled and Working Individuals (QDWI). Monthly income and asset limits apply.29
Can I Buy Short-Term Health Insurance in New Hampshire?
Short-term health coverage (also called temporary health insurance) can be an affordable alternative to an ACA Marketplace plan, but keep in mind that these policies aren’t required to cover all of ACA’s 10 “essential health benefits.” Be sure to read your policy carefully to see what coverage is guaranteed and what isn’t.
If you’re a Granite State resident between jobs or otherwise without a long-term insurance plan, a short-term health insurance policy may be what you need to fill a temporary gap. In New Hampshire, these policies are limited to six months and cannot be renewed.
You can apply for a completely new short-term plan as long as you haven’t had more than 540 days of short-term coverage in the past 24 months. (This limitation means you won’t be able to string policies together back-to-back.) In effect, as long as you’re residing in New Hampshire, you can have up to three short-term plans; then, you’d have to take a break before buying another one.30
The New Hampshire Insurance Department has licensed the Independence American Insurance Company to sell short-term, limited-duration health insurance in the state.31
1. Kaiser Family Foundation. “Population Distribution by Age.” kff.org (accessed August 28, 2020).
2. Kaiser Family Foundation. “Health Insurance Coverage of the Total Population.” kff.org (accessed August 28, 2020).
5. New Hampshire Insurance Department. “New Hampshire’s Federally Facilitated Health Insurance Marketplace (HealthCare.gov).” nh.gov (accessed August 28, 2020).
6. Kaiser Family Foundation. “Marketplace Enrollment, 2014-2020.” kff.org (accessed August 28, 2020).
7. Kaiser Family Foundation. “ Average Marketplace Premiums by Metal Tier, 2018-2020.”
10. U.S. Government Website for the Federal Health Insurance Marketplace. “Federal Poverty Level (FPL).” healthcare.gov (accessed August 28, 2020).
11. Kaiser Family Foundation. “State Health Care Snapshots: New Hampshire.” kff.org (accessed August 28, 2020).
12. Kaiser Family Foundation. “Estimated Total Premium Tax Credits Received by Marketplace Enrollees.” kff.org (accessed August 28, 2020).
13. Kaiser Family Foundation. “Health Insurance Marketplace Calculator.” kff.org (accessed August 28, 2020).
15. Centers for Medicare & Medicaid Services. ”Early 2019 Effectuated Enrollment Snapshot.” cms.gov (accessed August 28, 2020).
18. U.S. Government Website for Medicaid. “May 2020 Medicaid & CHIP Enrollment Data Highlights.” medicaid.gov (accessed August 28, 2020).
19. Kaiser Family Foundation. “Total Monthly Medicaid and CHIP Enrollment.” kff.org (accessed August 28, 2020).
20. Kaiser Family Foundation. “Medicaid in New Hampshire.” kff.org (accessed August 28, 2020).
22. Kaiser Family Foundation. “Medicare Beneficiaries as a Percent of Total Population.” kff.org (accessed August 28, 2020).
25. Centers for Medicare & Medicaid Services. “Prescription Drug Coverage – General Information.” cms.gov (accessed August 28, 2020).
26. Cubanski, Juliette; Damico, Anthony and Neuman, Tricia. Medicare Part D in 2018: The Latest on Enrollment, Premiums and Cost Sharing, May 17, 2018. Kaiser Family Foundation. (accessed August 28, 2020).