If you live in New Hampshire and need health insurance, the Affordable Care Act (ACA) offers several pathways to coverage. Whether you qualify for Medicaid through the Granite Advantage Health Care Program or for subsidized Marketplace plans on Healthcare.gov, your eligibility depends on your household size, income, and a few other factors. This guide breaks down everything Granite Staters need to know about ACA eligibility for 2026, including current income limits, available subsidies, and step-by-step instructions for enrolling.
How ACA Eligibility Works in New Hampshire
New Hampshire uses the federal Health Insurance Marketplace at Healthcare.gov for ACA plan enrollment. The state has also expanded Medicaid under the ACA through the Granite Advantage Health Care Program, which covers adults aged 19 to 64 with incomes up to 138% of the federal poverty level (FPL).
Your eligibility for ACA coverage in New Hampshire falls into one of three main categories:
- Medicaid (Granite Advantage) for individuals and families earning up to 138% FPL
- Subsidized Marketplace plans with premium tax credits for households earning between 100% and 400% FPL
- Unsubsidized Marketplace plans available to anyone regardless of income
Because New Hampshire expanded Medicaid, there is no coverage gap in the state. If your income is too low for Marketplace subsidies, you will likely qualify for Granite Advantage coverage instead.
2026 Income Limits for ACA Coverage in New Hampshire
ACA Marketplace subsidy eligibility for 2026 coverage is based on the 2025 federal poverty guidelines. Here are the income thresholds that determine which type of coverage you may qualify for:
Medicaid (Granite Advantage) Income Limits: Up to 138% FPL
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $21,597 | $1,800 |
| 2 | $29,187 | $2,432 |
| 3 | $36,777 | $3,065 |
| 4 | $44,367 | $3,697 |
| 5 | $51,957 | $4,330 |
| 6 | $59,547 | $4,962 |
ACA Premium Tax Credit Eligibility: 100% to 400% FPL
| Household Size | Minimum Income (100% FPL) | Maximum Income (400% FPL) |
|---|---|---|
| 1 | $15,650 | $62,600 |
| 2 | $21,150 | $84,600 |
| 3 | $26,650 | $106,600 |
| 4 | $32,150 | $128,600 |
| 5 | $37,650 | $150,600 |
| 6 | $43,150 | $172,600 |
Important note about 2026 subsidies: The enhanced premium tax credits that were in effect from 2021 through 2025 under the American Rescue Plan and Inflation Reduction Act have expired as of January 1, 2026. This means the income cap for premium tax credit eligibility has returned to 400% FPL. Households earning above that threshold no longer qualify for subsidies unless Congress passes new legislation. If you earned above 400% FPL and previously received subsidies, check your current options carefully. Congress may still take action to extend or modify these credits.
What Coverage Options Are Available?
Granite Advantage Health Care Program (Medicaid Expansion)
If your household income falls at or below 138% FPL, you likely qualify for the Granite Advantage Health Care Program. This is New Hampshire's Medicaid expansion program, which has been in place since 2014 and covers more than 96,000 Granite Staters.
Key details about Granite Advantage:
- No monthly premiums for most enrollees (those above 100% FPL may pay $60 to $100 per month depending on family size)
- No enrollment period required. You can apply any time of year
- Covers doctor visits, hospital stays, prescriptions, mental health services, and more
- Managed care plans include AmeriHealth Caritas, NH Healthy Families, and Well Sense Health Plan
- No work requirement is currently in effect
- No asset test for the expansion population
ACA Marketplace Plans
For those earning between 100% and 400% FPL who do not qualify for Medicaid, the ACA Marketplace offers subsidized private health insurance plans. New Hampshire has a competitive marketplace with five insurance companies offering plans for 2026:
- Anthem Health Plans of New Hampshire
- Matthew Thornton Health Plan
- Ambetter from NH Healthy Families
- Harvard Pilgrim Health Care
- WellSense Health Plan
The New Hampshire Insurance Department has noted that the state consistently has one of the most affordable and competitive health insurance markets in the nation.
Premium Tax Credits and Cost-Sharing Reductions
If you qualify for ACA subsidies, you can receive:
- Premium Tax Credits (PTCs): Lower your monthly premium. The amount depends on your income, age, and the cost of the benchmark Silver plan in your area. For 2026, you must earn between 100% and 400% FPL to qualify.
- Cost-Sharing Reductions (CSRs): Available if you earn between 100% and 250% FPL and choose a Silver plan. These reduce your deductibles, copays, and out-of-pocket maximums.
Children's Coverage
New Hampshire provides generous coverage for children:
- Medicaid for children: Up to 318% FPL
- CHIP: Up to 300% FPL
- Children may qualify for coverage even if parents do not
Enrollment Periods and Deadlines
Open Enrollment for 2026 Coverage
The open enrollment period for 2026 Marketplace plans ran from November 1, 2025, through January 15, 2026. If you missed this window, you cannot currently sign up for a standard Marketplace plan unless you qualify for a Special Enrollment Period.
The next open enrollment period for 2027 coverage will run from November 1, 2026, through December 15, 2026. Note that this is a shorter window than previous years due to a federal rule change finalized in 2025.
Special Enrollment Periods
You may qualify for a Special Enrollment Period (SEP) if you have experienced a qualifying life event within the past 60 days, such as:
- Losing existing health coverage (job loss, aging off a parent's plan, etc.)
- Getting married or divorced
- Having a baby or adopting a child
- Moving to a new state or county
- Experiencing a change in income that affects eligibility
- Losing Medicaid or CHIP coverage
If you qualify for a SEP, you can enroll through Healthcare.gov outside the regular enrollment window.
Medicaid Enrollment
Unlike Marketplace plans, Medicaid (Granite Advantage) has no enrollment period. You can apply at any time of year. If you qualify, coverage can begin as early as the first day of the month you apply.
How to Apply for ACA Coverage in New Hampshire
Step 1: Check Your Eligibility
Use our free eligibility screener to find out which programs you may qualify for based on your income, household size, and location. This takes just a few minutes and covers ACA, Medicaid, and other assistance programs.
Step 2: Gather Your Documents
Before applying, have the following ready:
- Social Security numbers for all household members
- Immigration documents (if applicable)
- Employer and income information (pay stubs, W-2 forms, tax returns)
- Information about any current health coverage
- Policy numbers from any current insurance
Step 3: Apply Through Healthcare.gov
For Marketplace plans:
- Visit Healthcare.gov and create an account
- Complete the application with your household and income information
- Review your eligibility results, which will show whether you qualify for Medicaid, premium tax credits, or both
- Compare available plans and select one that fits your needs and budget
- Enroll and pay your first premium to activate coverage
Step 4: Apply for Medicaid (If Eligible)
If your application shows you qualify for Granite Advantage:
- Your application will be forwarded to NH DHHS for processing
- You can also apply directly through NH EASY, the state's online benefits portal
- Call 1-800-852-3345, ext. 9700 for phone assistance
- Choose a managed care plan (AmeriHealth Caritas, NH Healthy Families, or Well Sense)
Step 5: Get Free Help
New Hampshire offers several resources for free enrollment assistance:
- Covering New Hampshire (coveringnewhampshire.org): Find local navigators and certified application counselors
- Healthcare.gov Help Center: Call 1-800-318-2596 (TTY: 1-855-889-4325)
- NH Insurance Department: Visit insurance.nh.gov for consumer resources
Additional Programs You May Qualify For
If you qualify for ACA coverage or Medicaid in New Hampshire, you may also be eligible for other assistance programs. Use our free screener to check your eligibility for programs like:
- SNAP (food assistance): Up to 200% FPL in New Hampshire (BBCE state)
- LIHEAP (fuel assistance): Up to 60% of state median income
- WIC: Up to 185% FPL for pregnant women, new mothers, and children under 5
- Childcare Scholarship Program: Up to 85% of state median income
- TANF (Financial Assistance for Needy Families): Up to 60% FPL
Visit our New Hampshire Benefits Overview for a complete guide to all available programs in the Granite State.
What Changed for 2026
Several important changes affect ACA eligibility and affordability for 2026:
Enhanced subsidies expired. The American Rescue Plan's enhanced premium tax credits, which eliminated the income cap for subsidies and reduced premiums across the board, expired on December 31, 2025. For 2026, the 400% FPL income cap is back in effect, and premium contributions are based on the original ACA formula. Congress may still act to extend or reinstate enhanced subsidies, so check Healthcare.gov or coveringnewhampshire.org for the latest updates.
Shorter open enrollment for 2027. The next open enrollment window (for 2027 coverage) will be six weeks shorter than recent years, running November 1 through December 15, 2026, rather than extending into January.
Updated poverty guidelines. The 2026 FPL is $15,960 per year for an individual and $33,000 for a family of four. While Marketplace subsidy eligibility for 2026 coverage uses the 2025 FPL ($15,650 individual, $32,150 family of four), Medicaid eligibility determinations will transition to the 2026 numbers by spring 2026.
Frequently Asked Questions
Can I still get ACA coverage in New Hampshire if I missed open enrollment?
You can only enroll in a Marketplace plan outside of open enrollment if you qualify for a Special Enrollment Period due to a qualifying life event. However, if you qualify for Medicaid through the Granite Advantage program, you can apply at any time of year with no enrollment deadline.
What if my income is too low for Marketplace subsidies?
Because New Hampshire has expanded Medicaid, you will likely qualify for the Granite Advantage Health Care Program if your income is at or below 138% FPL. There is no coverage gap in New Hampshire.
How do I know if I qualify for Medicaid or Marketplace coverage?
When you apply through Healthcare.gov, the system automatically checks whether you qualify for Medicaid or for Marketplace plans with subsidies. You can also apply for Medicaid directly through NH EASY. For a quick estimate, try our free eligibility screener.
What happens if my income changes during the year?
You are required to report income changes to the Marketplace. If your income goes down, you may qualify for more financial help. If your income goes up, your subsidy may decrease. Failing to report changes could result in owing money at tax time. If your income drops below 138% FPL, you may become eligible for Granite Advantage instead.
Are undocumented immigrants eligible for ACA coverage?
Undocumented immigrants are not eligible for Medicaid or Marketplace coverage. However, lawfully present immigrants can enroll in Marketplace plans and may qualify for subsidies. Children with lawful immigration status may qualify for Medicaid or CHIP regardless of their date of entry.
How much will I pay for a Marketplace plan in New Hampshire?
Your costs depend on your income, age, household size, and the plan you choose. With premium tax credits, many New Hampshire residents can find plans for $100 per month or less. Silver plans may include cost-sharing reductions that further lower out-of-pocket costs. Visit Healthcare.gov to see exact pricing, or start with our eligibility screener for an estimate.
Is the Granite Advantage program the same as Medicaid?
Yes. The Granite Advantage Health Care Program is New Hampshire's name for its Medicaid expansion program. It provides the same type of comprehensive health coverage as traditional Medicaid but is specifically for adults aged 19 to 64 with incomes up to 138% FPL who do not qualify for other Medicaid categories.
This article is for informational purposes only and does not constitute legal, tax, or benefits enrollment advice. Eligibility is determined by the relevant government agencies. Income limits and program details are subject to change. Use our free screener to check your eligibility, and visit Healthcare.gov for official enrollment.
