Health Insurance in New Hampshire

Health insurance is an indispensable alternative that we cannot do without. Even though, buying suitable health insurance coverage for your family is expensive, it needs a comprehensive evaluation of all future risks and its effect on your finances. More than 47 million Americans are uninsured, majority of whom are the working families. These families often expose themselves to the crushing medical expenses of the lack of proper health coverage. However, for those families who are not covered under their employers’ group plan, there are low-cost state sponsored health insurance programs.

According to the America’s 2008 Health Rankings, New Hampshire is the 3rd healthiest state to live in and obtain better healthcare services. The state continues to maintain its place in the top five healthiest states list; the state was at 4th and 3rd spot in 2007 and 2006 respectively. The moderate prevalence of binge drinking, moderate public health funding, decline in the prevalence of smoking and the decrease in the percentage of children under 18 in poverty have led to a robust health care system in the state. New Hampshire, having the population of more than one million citizens, boasts of both private-market and public health insurance alternatives. The private-market health insurance comprises of numerous types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide low-priced health coverage to the uninsurable residents of New Hampshire who meet specific eligibility requirements.

The New Hampshire Insurance Department is in charge for regulating all types of insurance sold in the state of New Hampshire including health insurance policies offered by private-market health insurers or public health coverage programs. However, despite all positive health features of the state, approximately 11% of the population remains uninsured. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, approximately 48.5% uninsured New Hampshire residents come under the above 200% FPL category.

Choosing a health plan is not as simple as it was before. Before buying a particular health policy, consult with a licensed health insurance agent/broker to avail the appropriate health insurance alternatives.

Individual/Family Health Insurance

Below is the guidelines for applying for and obtaining individual health insurance in the state of New Hampshire. These regulations apply to all insurance companies offering individual or family health insurance in New Hampshire:

Medical Underwriting
Pre-Existing Condition Exclusion Period
9 months
Look Back Period
6 months
Look Back Standard
Mandatory Benefits
Cancer screening for women including breast cancer screening, reconstructive surgery after mastectomy, direct access to OB/GYNs, eating disorder parity, maternity care
Market Rate Restrictions
Guaranteed Issue Options
Small Group Health Insurance

Below is the guidelines for small group health insurance in the state of New Hampshire. These regulations apply to all insurance companies offering small group health insurance in New Hampshire:

Small Group Size
Employee Qualifications
Two employees must be present for half of the preceding calendar quarter and
work 20 hrs/week
Guaranteed Issue
Premium Rating Factors
Adjusted Community Rating
Rate Adjustment Factors
Modified Community Rate
Look-Back Period
3 months
Pre-existing condition exclusionary period
9 months
Mandatory Benefits
Same as individual
State Cobra Variations for Small Groups

Below are the COBRA guidelines for small groups in the state of New Hampshire. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:

Mini-Cobra Option
Eligible Group Sizes
Extension of Benefits Period – Standard
18 months
Extension of Benefits Period – Disabled
18 months
Maximum Premium Increase
State Legislation Reference
Additional Notes
Certain qualified individuals may qualify for an additional 18 months of coverage.
State Sponsored Health Insurance Programs

There are several state sponsored health insurance programs in the State of New Hampshire to assist those without insurance in obtaining adequate coverage.

High-Risk Pools

Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of New Hampshire is summarized in the chart below:

Plan Name
New Hampshire Health Plan (5NHHP)
Phone Number
877-888-NHHP (56447)
HIPPA Eligibility Required?
Available Carriers
Benefit Management Inc.
Pre-Existing Condition Waiting Period
9 months
Enrollment Periods
No Current Enrollment Waiting Periods
Premium Limits
No more than 150% of the standard rate
Lifetime Maximum Benefit
$2.5 million
Special Notes
To be eligible for the coverage, you must be a resident of New Hampshire; you have applied for individual health insurance within the last 6 months; you were denied for health reasons or, you were quoted a premium rate higher than a substantially similar NHHP plan; you are federally eligible and have exhausted any COBRA coverage offered.
Children’s Health Insurance Program

Through shared funding from the federal government, the State of New Hampshire provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:

Program Name
New Hampshire Healthy Kids
Phone Number
Apply Online
Age Limits
Under 19
Insurance Carrier
Harvard Pilgrim
Length of Coverage
12 months
Residency Requirements
New Hampshire resident and U.S. citizen, refugee, asylee, permanent resident who has been in the U.S. for at least five years
Other Eligibility Requirements
Children should not be eligible for Medicaid
Pre-Existing Condition Exclusions
$0 for Gold Program. Monthly premium for Silver Program is based on family size and household income.

Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of New Hampshire:

Governing Agency
Department of Health and Human Services
Phone Number
800-852-3345 ex 5254, 603-271-5254
Residency Requirements
New Hampshire resident and U.S. citizen
Federal Poverty Line Income Limits
Infant: 300% FPL
Child Age 1-19: 185% FPL
Pregnant woman: 185% FPL
Non-working parents: 49% FPL
Working parent: 61% FPL
Medically needy individual: 76% FPL
Medically needy couple: 70% FPL
Additional Resources

New Hampshire Health Care Options Matrix™ Guide
Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines New Hampshire’s public and private health care choices for individuals and groups with various demographic profiles.
Family Health Insurance Guide by
The guide created by provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.
New Hampshire: At-A-Glance
Provides all-inclusive health data of New Hampshire. is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.