How to Get Help with Hospital and Medical Bills in New Hampshire.
If you are a resident of New Hampshire struggling with high hospital costs or past-due medical debt, the state offers several unique, state-specific programs to help you. Unlike many other states, New Hampshire has specific laws requiring nonprofit hospitals to provide charity care, as well as a collaborative network of hospitals that share a common application for financial assistance.
Whether you are uninsured, underinsured, or facing a "catastrophic" medical bill that exceeds your ability to pay, use the resources below to reduce or eliminate your New Hampshire hospital bills.
New Hampshire State Law: The 150% Charity Care Rule
Under New Hampshire law (RSA 7:32-d through l), all "health care charitable trusts" (nonprofit hospitals) are required to provide free care to uninsured patients whose household income is at or below 150% of the Federal Poverty Level (FPL). Hospitals are also required to publicly post information about their assistance policies and allow patients to apply for help.
Patients should contact the hospital’s billing department or financial counseling office and request a Financial Assistance Application or Charity Care Application. Hospitals are required to review applications and make a determination of eligibility.
- Key Protection: If you fall under this income limit, the hospital must waive the bill. While the law allows for a small copayment of up to $100, this must also be waived if it creates a financial hardship.
- How to use it: Ask the hospital’s financial counseling department for their "Charity Care Policy" or "Financial Assistance Application." Mention that you are applying based on the state’s charity care requirements.
The New Hampshire Health Access Network (NHHAN)
One of the most effective ways to get help in New Hampshire is through the NH Health Access Network (website: https://healthynh.org/initiatives/access-to-care/nh-health-access-network/). This is a voluntary collaboration between 26 hospitals and dozens of physician practices and community health centers across the state. If you qualify for NHHAN, you receive a membership card that allows you to get free or discounted care at any participating facility in the network.
This is a voluntary collaboration between hospitals, physician groups, and community health centers that work together to improve access to care for residents without adequate health insurance. Through this program, patients who qualify can receive free or reduced-cost medical services at participating facilities throughout the state.
- Eligibility: Generally available to uninsured or underinsured New Hampshire residents with incomes up to 200% or 300% of the FPL (depending on the specific hospital's policy).
- The Common Application: Instead of filling out 10 different forms for 10 different doctors, you can use the NHHAN Common Application. Once approved at one hospital, your status is often recognized by other participating providers.
- Contact: Call your local NH hospital and ask for a "NH Health Access Network Coordinator."
NH Medicaid and State-Specific Programs
New Hampshire has expanded Medicaid, making it easier for low-income adults to get coverage that can sometimes be applied retroactively to unpaid bills. If someone qualifies for the program, Medicaid may pay medical bills incurred up to three months prior to the application date, as long as the person would have met eligibility requirements during those months.
- The Granite Advantage Health Care Program is New Hampshire’s Medicaid expansion program for adults aged 19–64.
- Income Limit: Roughly 133% of the FPL (plus a 5% disregard, effectively 138%).
- Retroactive Coverage: If you are approved, Medicaid may cover medical bills incurred up to three months before the month you applied, provided you were eligible during those months.
- "In and Out" Medical Assistance (Spenddown) is an option. If your income is slightly too high for regular Medicaid, New Hampshire offers a "Spenddown" program. This program allows patients to deduct their medical expenses from their income when determining eligibility. Learn more at https://www.dhhs.nh.gov/mam_htm/html/625_in_and_out_medical_assistance_mam.htm.
- How it works: If you have high medical bills, the state allows you to "spend down" your income by subtracting your medical expenses. Once your remaining income hits the Medicaid limit, the state will pay the rest of your medical bills for that period.
- Health Insurance Premium Program (HIPP): If you have access to health insurance through your job but can't afford the premiums, the NH HIPP program may pay your portion of the premium for you. This ensures you keep your private insurance while Medicaid acts as a backup to cover deductibles and co-pays.
- Contact: Call NH DHHS at 1-844-ASK-DHHS (1-844-275-3447)
Specific Financial Assistance Policies at NH Hospitals
Major hospitals in New Hampshire often have financial assistance policies (FAPs) that go far beyond the state’s 150% minimum requirement.
Dartmouth Health (Dartmouth-Hitchcock): As the state's largest healthcare provider, Dartmouth Health (including Lebanon, Concord, Manchester, and Nashua clinics) has an extensive policy. Some patients may qualify for presumptive eligibility, meaning the hospital may automatically approve assistance if the patient already participates in programs such as SNAP (food stamps), WIC, or other public assistance programs.
- Income Limits: They provide assistance for patients with household incomes up to 350% of the FPL.
- Presumptive Eligibility: They may automatically qualify you for 100% assistance if you are already enrolled in programs like SNAP (Food Stamps) or WIC.
- Contact: Patient Advocates at (844) 647-6436.
Catholic Medical Center (Manchester): CMC offers a "Charity Discount Policy" for both uninsured and underinsured patients. Up to 100% bill forgiveness for households with income up to 250% of the Federal Poverty Level. Additional hardship discounts for families with income up to 400% of the Federal Poverty Level if a medical bill exceeds about $1,500 and creates financial hardship.
- Income Limits: 100% discount for those up to 250% of the FPL.
- Catastrophic Help: They may offer discounts to families with incomes up to 400% of the FPL if the medical bill balance exceeds $1,500 and creates a hardship.
- Contact: (603) 663-6922.
Southern New Hampshire Health (Nashua): Income Limits: Financial assistance is available for those at or below 225% of the FPL.
- Prescription Help: They offer a unique Prescription Assistance Program for long-term medications for patients of Southern NH Health or St. Joseph Hospital.
- Contact: Financial Advocates at (603) 281-6630.
Elliot Health System (Manchester): Elliot provides discounts on a sliding scale. Patients with income under 200% FPL typically receive a 100% waiver, while those up to 300% or higher may receive partial discounts.
Community Health Centers with Sliding Fee Clinics
For residents who need ongoing medical care but cannot afford traditional hospital services, Federally Qualified Health Centers (FQHCs) provide affordable care throughout New Hampshire. These clinics receive federal funding and are legally required to offer a sliding fee scale based on income and family size. Patients without insurance can often receive primary care, dental services, behavioral health care, and prescription assistance at reduced cost. Examples of community health centers in the state include:
- Ammonoosuc Community Health Services (Littleton, Franconia, Woodsville)
- Amoskeag Health (Manchester)
- Coös County Family Health Services (Berlin and Gorham)
- Mid-State Health Center (Plymouth and Bristol)
- Lamprey Health Care (Newmarket, Raymond, and Nashua)
These clinics can be a lower-cost alternative for primary care and ongoing medical needs. We also have additional NH clinics listed on our site.
Legal and Debt Advocacy in New Hampshire
If a hospital has turned your bill over to collections or is threatening a lawsuit, do not ignore it. New Hampshire has specific legal resources for medical debt:
- New Hampshire Legal Assistance (NHLA): New Hampshire Legal Assistance (NHLA) provides free legal services to qualifying low-income residents. Attorneys may be able to help patients challenge improper medical debt collection practices or ensure that hospitals followed their charity care policies before pursuing legal action. They can help ensure the hospital followed the "150% Rule" before suing you. Call 1-800-921-1115 or read more about legal aid in New Hampshire.
- 603 Legal Aid: This is a centralized point for all pro-bono (free) legal services in the state. They can help you navigate bankruptcy or negotiate a settlement with a hospital. They may help patients negotiate with hospitals or collection agencies or resolve medical debt disputes. If needed, get help to explore bankruptcy options when appropriate. Call (603) 224-3333.
- NH Bureau of Family Assistance (BFA): They can help you apply for the various state programs mentioned above. You can apply online via the NH EASY website.
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