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NH Department of Health and Human Services (DHHS) Division of Family Assistance (DFA) www.dhhs.nh.gov/dfa/index.htm DFA Form 800 06/16 APPLICATION FOR ASSISTANCE Welcome to the Department of Health.

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Who is eligible for New Hampshire Medicaid? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows

To request disenrollment from your plan, call or write to NH DHHS. Contact the NH DHHS Customer Service Center at 1-844-ASK-DHHS (1-844-275-3447) (TDD Access Relay: 1-800-735-2964), Monday through Friday, 8 a.m. – 4 p.m. ET.

Service authorization requests for Medicaid Fee for Service recipients can be found on the MMIS online portal. All service authorizations should be submitted via secure email at ServiceAuthorizationFFS@dhhs.nh.gov.

Questions? Contact the DHHS Customer Service Center toll-free at 1-844-ASK-DHHS (1-844-275-3447) (TDD Relay Access: 1-800-735-2964), Monday through Friday, 8:00 a.m. to 4:00 p.m. ET.

NH Healthy Families provides the same benefits as Medicaid, plus more.

If you are required to report changes (check the reporting requirements handout, DFA Form. 215, for more information), you can do 1 of 2 things: 1) Log into your NH EASY account and report your change online; or. 2) Call your Local District Office and follow the instructions below:

They must have limited income, limited assets, and a medical need for care. In 2023, a single individual applying for Nursing Home Medicaid in NH must meet the following criteria: 1) Have income under $2,742 / month 2) Have assets under $2,500 3) Require the level of care provided in a nursing home facility.

Contact the DHHS Customer Service Center toll-free at 1-844-ASK-DHHS (1-844-275-3447) (TDD Relay Access: 1-800-735-2964), Monday through Friday, 8:00 a.m. to 4:00 p.m. ET. Contact your local District Office.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Nheasy
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