Granite Advantage, New Hampshire's Medicaid expansion program, covers adults ages 19 to 64 with household income up to 138% of the Federal Poverty Level in 2026, and the New Hampshire Department of Health and Human Services (NH DHHS) runs it alongside the state's children's Medicaid and CHIP coverage. Medicaid in New Hampshire can end for several reasons: income rose above the 2026 limit, a renewal form or verification request went unanswered, a notice went to an old mailing address, or household size changed. Whatever the reason, losing Medicaid is a qualifying life event. HealthCare.gov, the platform New Hampshire residents use, gives people who lose Medicaid or CHIP a 90-day Marketplace Special Enrollment Period (SEP), longer than the standard 60-day loss-of-coverage window. The temporary unwinding SEP ended July 31, 2024, so the 90-day rule is the one that applies in 2026. Acting early matters: coverage from a plan you pick starts the first of the month after you choose it, and there is no retroactive Marketplace coverage. The ACA enhanced premium tax credits expired January 1, 2026, so the 400% FPL subsidy cliff is back for 2026 plans.
New Hampshire expanded Medicaid in 2014, one of the 40 states plus DC that use ACA expansion, so no coverage gap exists in 2026 for adults below 100% FPL. For 2026, 138% FPL equals $22,025 for one person and $45,540 for a family of four, based on HHS ASPE 2026 Poverty Guidelines. Adults above that line can qualify for premium tax credits on HealthCare.gov up to 400% FPL ($63,840 single, $132,000 for four in 2026). Children and teens are treated differently: New Hampshire's children's Medicaid and CHIP coverage reaches 323% FPL in 2026, and enrollment is open year-round. New Hampshire also has changes ahead for Granite Advantage members: federal law requires work or community engagement reporting for expansion adults beginning around January 1, 2027, and eligibility reviews every six months, and NH DHHS has scheduled monthly premiums for members at 100% to 138% FPL in 2026. Check your notice for the exact reason before choosing a path. This guide covers reapplying through NH EASY, appealing, children's coverage, and Marketplace enrollment. Use the Medicaid income limits and ACA income limits pages below to test your numbers first.
6 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The costliest mistakes New Hampshire residents make after losing Medicaid in 2026:
- Ignoring a procedural termination. Coverage lost over an unreturned renewal or missing verification can often be restored by submitting the paperwork or appealing with NH DHHS within the date on your notice. Appeal first, and keep your Marketplace SEP in reserve.
- Waiting past the 90-day window. The Marketplace SEP for loss of Medicaid runs 90 days from your coverage end date. After that, the next chance is Open Enrollment from November 1, 2026, with coverage starting no earlier than January 1, 2027.
- Reporting 2025 income to HealthCare.gov. Premium tax credits use your projected 2026 income. If your income dropped, reporting last year's higher figure shrinks your credit and raises your monthly premium.
- Skipping coverage for the kids. New Hampshire's children's Medicaid and CHIP coverage reaches 323% FPL in 2026 and takes applications year-round, so children can stay covered even when the adults move to a Marketplace plan.
- Missing mail from NH DHHS. Renewal and verification requests go to the address on file, so an outdated address in NH EASY is a leading reason coverage ends. Update your address and check your NH EASY account regularly.
Granite Advantage vs Marketplace vs Children's Coverage: Which Path Fits Your New Hampshire Household in 2026?
Granite Advantage is the right first move for any New Hampshire adult whose 2026 income is at or below 138% FPL ($22,025 for one person, $45,540 for a family of four, per HHS ASPE 2026 Poverty Guidelines). Reapplying through NH EASY costs nothing to try, enrollment is year-round, and a procedural termination can often be reversed. Marketplace coverage on HealthCare.gov fits adults whose 2026 income runs from 139% to 400% FPL, where premium tax credits cut the monthly cost of the benchmark Silver plan, and Silver plans with cost-sharing reductions add lower deductibles for incomes up to 250% FPL. Children's Medicaid and CHIP coverage reaches 323% FPL in 2026 and runs on its own year-round clock, so a household can split: adults on a Marketplace plan, children on New Hampshire coverage. COBRA applies only when job-based coverage ended too, and it costs 102% of the full group premium, typically $400 to $900 per month for one person in 2026. New Hampshire also has state continuation rights under RSA 415:18 for some small-employer plans. COBRA rarely beats a subsidized Marketplace plan, though it can bridge a gap to keep a specialist or a met deductible. Medicaid loss itself does not create COBRA rights. In 2026 the sequence for most New Hampshire households is: confirm the termination reason, appeal or reapply if the reason is procedural, enroll children in New Hampshire coverage, and pick a subsidized HealthCare.gov plan for adults above 138% FPL in 2026 before the 90-day window closes.
How to Appeal or Reverse a New Hampshire Medicaid Termination in 2026
NH DHHS notices of decision state the reason for the action, the effective date, and how to request a fair hearing. The Department must receive your written appeal request within 30 days of the date on the notice, according to NH DHHS appeal instructions. Continuation of benefits during an appeal has shorter deadlines that depend on the program and the notice, commonly 10 to 15 days or before the effective date, so file as early as possible. Request the appeal in writing, keep a copy, and ask NH DHHS for confirmation. A hearing is held by the Administrative Appeals Unit and lets you present documents and testimony. Evidence for a New Hampshire appeal includes proof that renewal paperwork was submitted, recent pay stubs showing income at or below the 2026 limit, proof of New Hampshire residency, and any NH EASY upload confirmations. Filing an appeal does not close your Marketplace SEP. The 90-day clock on HealthCare.gov runs from your coverage end date, so keep both tracks open: appeal with NH DHHS, and enroll in a HealthCare.gov plan before the window ends if you cannot afford a gap. If the appeal succeeds, coverage is restored and you can cancel the Marketplace plan.
New Hampshire Medicaid Income Limits and Upcoming Granite Advantage Changes for 2026 and 2027
New Hampshire Granite Advantage covers adults 19 to 64 up to 138% FPL, with the 2026 lookup in the table below: $22,025 for a household of 1, $29,863 for 2, $37,702 for 3, and $45,540 for 4. New Hampshire children's Medicaid and CHIP coverage reaches 323% FPL in 2026, and pregnant women qualify at higher limits with 12 months of postpartum coverage. Federal law passed in 2025 requires expansion adults to document 80 hours a month of work, school, or community service starting around January 1, 2027, and moves eligibility reviews to every six months. NH DHHS has also scheduled monthly premiums for members at 100% to 138% FPL beginning July 1, 2026, and says it is awaiting final federal guidance. Confirm the current rules at dhhs.nh.gov or through NH EASY before relying on them. New Hampshire does not use an asset test for Granite Advantage adults, so savings do not affect eligibility under the 2026 income rules. Pregnant members keep 12 months of postpartum coverage, and the Marketplace SEP for loss of Medicaid still applies to anyone who ends up above the 2026 income limit after a review.
New Hampshire Granite Advantage (Medicaid) + ACA Subsidy Income Limits, 2026 (48 contiguous states + DC)| Household size | 138% FPL (Granite Advantage) | 400% FPL (subsidy ceiling) |
|---|
| 1 | $22,025 | $63,840 |
| 2 | $29,863 | $86,560 |
| 3 | $37,702 | $109,280 |
| 4 | $45,540 | $132,000 |
| 5 | $53,378 | $154,720 |
| 6 | $61,217 | $177,440 |
| 7 | $69,055 | $200,160 |
| 8 | $76,894 | $222,880 |
| Each additional | + $7,838 | + $22,720 |
New Hampshire children's Medicaid and CHIP coverage reaches 323% FPL in 2026 (about $69,897 for a household of 2, $88,244 for 3, $106,590 for 4). The 400% FPL subsidy cliff returned for 2026 after enhanced premium tax credits expired January 1, 2026.
Source: HHS ASPE 2026 Poverty Guidelines; dhhs.nh.gov; healthcare.gov
Documents You Need After Losing Medicaid in New Hampshire in 2026
Your NH DHHS notice of decision is the most important document because it proves the qualifying life event and the coverage end date that start your 90-day SEP. Pay stubs or a self-employment estimate establish your projected 2026 MAGI, which sets your premium tax credit. Social Security numbers are needed for every applicant, and immigration documents are needed for non-citizens. A New Hampshire utility bill, lease, or government mail proves residency. If you had a Marketplace plan before, bring last year's Form 1095-A to avoid tax reconciliation problems. Gathering these before you log in to healthcare.gov or NH EASY prevents the processing delays that most often cause coverage gaps. Missing pages from a renewal packet are a common reason NH DHHS sends a verification request, so confirm every page and upload is accepted in NH EASY, and keep screenshots of confirmations for 2026.
Frequently Asked Questions
How long do I have to get new coverage after losing New Hampshire Medicaid?
Loss of Medicaid or CHIP opens a 90-day Marketplace Special Enrollment Period on HealthCare.gov, counted from your coverage end date, per healthcare.gov. If your Granite Advantage coverage ends October 31, 2026, the window runs through January 29, 2027. You can also apply up to 60 days before coverage ends, starting September 1, 2026 in that example, so a new plan starts without a gap. Coverage from a plan you pick starts the first of the month after selection. If you miss the window, Open Enrollment for 2027 plans runs November 1, 2026 to January 15, 2027, with a December 15 deadline for January 1 coverage.
What documents do I need to enroll after losing New Hampshire Medicaid?
The NH DHHS notice of decision is the key document because it proves the loss and the end date that start the 90-day SEP. You also need proof of projected 2026 income such as pay stubs, Social Security numbers for everyone applying, and a New Hampshire utility bill or lease for residency. Add immigration documents for non-citizens and birth certificates when enrolling children. If HealthCare.gov asks for proof of the qualifying life event, upload the notice in your account. Gathering these first prevents the verification delays that commonly cause coverage gaps.
What if I miss the 90-day SEP window after losing New Hampshire Medicaid?
Missing the window without another qualifying life event means waiting for Open Enrollment, which runs November 1, 2026 to January 15, 2027 for 2027 coverage, and you have no Marketplace coverage until a plan starts. Medicaid remains open year-round, so if your 2026 income is at or below 138% FPL you can reapply through NH EASY at any time. Children can enroll in New Hampshire's children's Medicaid and CHIP coverage year-round as well. Another qualifying life event, such as a move or the birth of a child, can open a new 60-day SEP.
Can I get retroactive coverage after losing New Hampshire Medicaid?
Marketplace plans have no retroactive coverage: a plan starts the first of the month after you select it, so applying up to 60 days before Medicaid ends is the way to avoid a gap. Medicaid can sometimes cover medical bills from months before an application, but federal law shortens that retroactive period for applications beginning January 1, 2027, and NH DHHS applies its own rules. If a procedural termination is reversed on appeal, coverage is typically restored back to the termination date. Ask NH DHHS how retroactive coverage applies to your case.
What is the difference between COBRA and Marketplace coverage after losing Medicaid?
COBRA applies only to job-based coverage, so losing Medicaid alone creates no COBRA rights. If both ended, COBRA keeps your old plan at 102% of the full premium, roughly $400 to $900 per month for one person in 2026, with a 60-day election window. A HealthCare.gov plan with premium tax credits often costs far less, roughly $60 to $280 per month for a benchmark Silver plan at 139% to 250% FPL in 2026. COBRA suits short-term needs, such as keeping a specialist or a met deductible, while Marketplace coverage suits most households.
What New Hampshire state rules apply after losing Medicaid in 2026?
New Hampshire runs Granite Advantage for adults up to 138% FPL and children's Medicaid and CHIP coverage up to 323% FPL in 2026, with applications through NH EASY year-round. Appeals must reach NH DHHS within 30 days of the notice date. New Hampshire uses HealthCare.gov for Marketplace plans. Federal law adds work or community engagement reporting for expansion adults starting around January 1, 2027, plus six-month eligibility reviews, and NH DHHS has scheduled premiums for members at 100% to 138% FPL, so confirm current terms at dhhs.nh.gov.
Do I qualify for Medicaid again after losing it in New Hampshire?
Adults qualify for Granite Advantage when 2026 household income is at or below 138% FPL: $22,025 for one person, $29,863 for two, $37,702 for three, and $45,540 for four. Reapplication is open year-round through NH EASY at nheasy.nh.gov or by phone at 1-844-275-3447. If you lost coverage for a procedural reason, submit the missing paperwork or appeal first. Adults above 138% FPL generally move to a subsidized Marketplace plan, which is available up to 400% FPL ($63,840 for one person in 2026).
What happens to my children's coverage if I lose Medicaid in New Hampshire?
Children's coverage runs separately from adult coverage. New Hampshire's children's Medicaid and CHIP coverage reaches 323% FPL in 2026, which is about $106,590 for a family of four, and applications are accepted year-round with no Special Enrollment Period. A child can keep or regain coverage even when the parents move to a Marketplace plan. Apply for each child through NH EASY and include birth certificates or Social Security numbers if requested. Children covered through New Hampshire programs generally do not need a Marketplace plan.
