New Hampshire Health Insurance: Find Affordable Plans

If you’re looking for affordable health insurance in New Hampshire, you have several options. These options include employer coverage, individual or family plans purchased on New Hampshire’s Health Insurance Marketplace at Healthcare.gov, off-exchange insurance, Medicaid, Medicare, and short-term policies.

This guide explains each of these options, potential costs (if any), and how to enroll, join, or purchase an affordable health insurance plan in New Hampshire.

• Marketplace plans: Individuals and families interested in purchasing Affordable Care Act (ACA) health insurance plans can do so using New Hampshire’s Health Insurance Marketplace at Healthcare.gov. You can also purchase health insurance from a broker, insurance agent, or insurance company. Cost-sharing plans and short-term insurance plans are also available in New Hampshire.
• Open enrollment: For 2023, open enrollment runs from November 1, 2022 to January 15, 2023. If you fail to sign up during this period, you need a qualifying event to enroll. Qualifying events include getting married, getting divorced, having or adopting a baby, becoming a U.S. citizen or permanent resident, and moving to New Hampshire.
• Health Insurance Marketplace: New Hampshire uses the federal government’s Healthcare.gov platform to offer residents ACA plans. All these plans offer affordable, quality health care coverage. Many plans also offer special tax benefits and discounts.
• Off-market plans: If you do not wish to use the federal Health Insurance Marketplace, plans are available to purchase outside of the exchange. However, under the ACA, all qualifying health insurance plans must offer coverage of pre-existing conditions, mental health care, and other essential benefits. You can purchase off-exchange plans through a broker, an insurance agent, or directly from a health insurance company.
• Coverage types: Most (just over 56%) residents of New Hampshire receive health insurance through an employer. Medicare comprises the next largest group at 17.7%, followed by Medicaid at 13.2%. Non-group insurance plans cover 5.3%, while the military ensures 1.2% of the state’s residents. Currently, 6.4% of people in New Hampshire are uninsured.

New Hampshire’s Health Insurance Marketplace uses the federal Healthcare.gov platform to enroll residents in ACA plans.

Your first step is to create an account. You’ll be asked for certain personal information such as household size, your income and age, and the ages of people in your household, your address, etc.

Once you enter this information, Healthcare.gov will be able to match you with plans that you’re eligible for, or tell you if you qualify for Medicaid or Medicare. You’ll be able to look at several plans simultaneously to find a plan that provides the best health coverage for your family and works with your budget.

Three companies offer plans on the New Hampshire section of Healthcare.gov:

• Ambetter
• Anthem Blue Cross and Blue Shield
• Harvard Pilgrim

Before you purchase a health insurance plan, you’ll need to determine your or your family’s health care needs. This will help you find the most affordable health insurance plan.

Insurance for individuals in New Hampshire

When selecting an insurance plan for yourself, much will depend upon your state of health. If you’re a healthy individual with minimal health concerns, you may be better off selecting a cheap health insurance plan that offers a low monthly premium and higher deductibles. These deductibles only kick in when you use medical services, so if you’re healthy, this kind of plan can keep your monthly health care costs to a minimum.

If you have a health condition that requires regular medical attention or numerous prescriptions, you may want to consider a plan that has a higher monthly premium but lower deductibles. This will help reduce your overall out-of-pocket expenses.

You can choose from different types of plans including.

• Health Maintenance Organization (HMO) plans, which are the least expensive plans available. One reason these plans are less expensive is there are more restrictions. You’ll need to select a primary care physician, obtain referrals to see a specialist, and you can only use the plan’s in-network medical providers.
• Preferred Provider Organization (PPO) plans, which are more expensive. But in exchange for that higher cost, you’ll face fewer restrictions. You aren’t limited to in-network medical providers. You don’t need to name a primary care physician nor obtain a referral to see a specialist.
• Point of Service (POS) plans allow you to use out-of-network providers. However, when you want to see a specialist, you’ll still need to get a referral.

Insurance for families in New Hampshire

When looking for an insurance plan that will work for your whole family, you’ll need to balance the health needs of several individuals against how much you can afford in your budget. For instance, you may have a chronic health issue like hypertension or high blood pressure. Your children may be healthy, or one may have to deal with asthma or a mental health condition. These conditions can drastically change your health insurance needs and impact what kind of plan you should look for.

If your family is healthy overall, you may want to consider an HMO plan. These plans offer lower costs if you and your family are comfortable with the necessary restrictions. If you, your spouse, or any of your children have a chronic health concern, and you need to see doctors or specialists regularly, a PPO or a POS plan may provide you with the coverage you need.

Healthcare.gov organizes its plans into metal tiers: Bronze, Silver, Gold, and Platinum. Selecting a Silver plan rather than a Gold or a Platinum plan does not mean you’ll receive an inferior level of coverage. All plans sold on Healthcare.gov offer affordable health insurance. The difference in the metal tiers is in how costs are divided between you and your insurer.

• Bronze plans have low monthly premiums but high deductibles, with coinsurance fees of 40%. Bronze plans work best for healthy people who don’t require much health care but want to have affordable health insurance coverage in case they fall ill or suffer an injury. The most affordable bronze plan in New Hampshire costs $266 a month.
• Silver plans are more expensive than bronze plans, but you’ll have lower deductibles and a lower coinsurance payment of 30%. What makes silver plans attractive is that they offer the most tax credits and benefits, such as CSRs. If your family is eligible, you’ll often be able to purchase a silver plan for less than a bronze plan. The most affordable silver plan in New Hampshire, before considering any tax credits or benefits, is $317 a month.
• Gold and platinum plans are designed for people who have chronic health issues. Gold and platinum plans have the lowest deductibles as well as the lowest coinsurance fees — 20% for a gold plan and 10% for a platinum plan. This helps reduce your out-of-pocket costs. The expense of a gold or a platinum plan is a result of heftier monthly premiums. Currently, the most affordable gold plan in New Hampshire costs $359 a month.

New Hampshire expanded its Medicare coverage to low-income adults in 2014 and in 2019, began the Granite Advantage Health Care Program. The state no longer buys individual plans on the Health Insurance Marketplace for adults included in the Medicaid expansion. Instead, they’re enrolled in the Granite Advantage Health Care Program.

In August 2022, there were 242,584 individuals enrolled in Medicaid and CHIP (the Children’s Health Insurance Program) in the state. This is a net increase of 90.89% since the Open Enrollment period in October 2013.

Medicaid in New Hampshire

You are eligible for Medicaid in New Hampshire if you’re a state resident, a U. S. citizen, national, permanent resident, or legal alien and you need health care or insurance assistance, and your financial situation can be described as low income or very low income. You also need to be fit into one of the following categories:

• Pregnant
• Blind
• Have responsibility for a child (or children) 18 years of age or younger
• Have a disability or have a member of your household with a disability
• Be at least 65 years of age

Individuals or families whose household income is at or below 133% of the FPL are eligible for Medicaid under the Granite Advantage Healthcare Program.

Each category of individuals or families eligible for Medicaid or the Granite Advantage Health Care Program has different income and resource requirements. For instance, medically needy individuals applying for Medicaid face resource limits of $2,500 for an individual, $4,000 for a couple, with an additional $100 for each additional person in your household. Your house, appliances, and one car are excluded when calculating this total.

New Hampshire Children’s Health Insurance Program (CHIP)

This program extends health benefits to uninsured children and teens under the age of 19 whose families are ineligible for Medicaid but meet CHIP income eligibility requirements. Medical and dental services are provided, including hospitalizations, doctor’s visits, mental health care, immunizations, vision care, and dental care.

Medicare is the federal government’s health insurance program for those aged 65 and older or younger people with qualifying disabilities.

• Original Medicare is the basic form of Medicare, which is composed of Part A (hospitalizations, home health care, hospice, skilled nursing care) and Part B (medical services, durable health equipment, ambulance services). Part A can cost as much as $473 a month depending upon how much you’ve paid in Medicare taxes in the past, while Part B always includes a $170.10 monthly premium. Original Medicare does not cover prescription drugs, so you’ll need a Medicare Part D plan, which is a Medicare prescription drug plan. Original Medicare has no out-of-pocket limits for deductibles, copays, or coinsurance.  The Medicare Part A deductible for inpatient hospital stays is $1,600 in 2023. Medicare Part B enrollees pay a standard monthly premium of $226 for 2023.
• A Medicare Advantage Plan is an alternative to Original Medicare, also known as Part C. These are private insurance plans which have been approved by Medicare and offer dental, vision, and hearing coverage. Fitness memberships and prescription drug coverage can also be included in many Medicare Advantage Plans. There are four types of Medicare Advantage Plan: HMO, PPO, Private Fee-For-Service, and Special Needs. As of 2023, there are 43 Medicare Advantage Plans available in the state, however, you can only select a plan that’s available in your county.

Medicare Supplement Insurance plans are designed to help cover out-of-pocket expenses that occur with Original Medicare. These plans won’t help you with the cost of vision, dental, hearing, or long-term care. If you’re traveling out of the country, however, a Medicare Supplement Insurance Plan can provide you with health coverage. Medicare Supplement Insurance Plans do not work with a Medicare Advantage Plan.

Eligibility

To qualify for Medicare, you must be at least 65 years old or have a qualifying disability. In most cases, a qualifying disability is a condition that makes you eligible for at least 24 months of payments from the Social Security Disability Insurance program or Railroad Retirement Board. You may be able to qualify sooner if you have end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease).

Enrollment

If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

• Initial enrollment: Your initial enrollment period starts three months before your 65th birthday and ends three months after your 65th birthday. If you’ve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
• General enrollment: Choose this enrollment period if you missed your initial enrollment period. The Medicare general enrollment period is January 1 to March 31. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D.
• Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from January 1 to March 31.
• Open enrollment: You can join, switch plans, or drop your coverage from October 15 to December 7 each year.
• Special enrollment periods: You may qualify for a special enrollment period if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

Medicare Resources

The New Hampshire State Health Insurance Assistance Program (SHIP) provides Medicare beneficiaries, their families, or their caregivers with free, unbiased, and confidential advice and counseling on their Medicare options in New Hampshire. This includes providing information about Original Medicare, Medicare Advantage Plans, Medicare Part D, and other aspects of Medicare. These trained and certified counselors can also help you with other health insurance questions and will never try to sell you a plan.

Yes, short-term policies can offer cheap health insurance, but these plans are limited to six months and cannot be renewed. Residents of New Hampshire also cannot buy a short-term plan if they have been covered by one for more than 540 days in the past 24 months. You can apply for a new short-term plan after the first one ends, but it must be a separate plan with new out-of-pocket expenses.

Short-term plans do not cover pre-existing conditions or mental health care. These plans are designed for people who are unemployed and need coverage until a new plan is available, missed the Open Enrollment period for Healthcare.gov, or only need a health insurance plan for a short period of time.

• Benefits.gov | New Hampshire Medicaid | Last accessed December 21, 2022
• Healthcare.gov | Cost-Sharing Reduction | Last accessed December 21, 2022
• HealthCare.gov | Deductible | Last accessed December 21, 2022
• HealthCare.gov | Health Maintenance Organization (HMO | Last accessed December 21, 2022
• HealthCare.gov | Point of Service (POS) Plan | Last accessed December 21, 2022
• HealthCare.gov | Preferred Provider Organization (PPO | Last accessed December 21, 2022
• Healthcare.gov | Premium Tax Credit | Last accessed December 21, 2022
• HealthCare.gov | The ‘metal’ categories: Bronze, Silver, Gold & Platinum | Last accessed December 21, 2022
• KFF | Health Insurance Coverage of the Total Population | Last accessed December 21, 2022
• Medicare.gov | Medicare Advantage Plans | Last accessed December 21, 2022
• National Academy for State Health Policy | New Hampshire CHIP Fact Sheet | Last accessed December 21, 2022
• New Hampshire Department of Health and Human Services | Eligibility-Non-MAGI Programs for Adults | Last accessed December 21, 2022
• New Hampshire Department of Health and Human Services | Granite Advantage Health Care Program | Last accessed December 21, 2022
• New Hampshire Department of Health and Human Services| Health Coverage For Children Under Age 19 | Last accessed December 21, 2022