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Medicare in New Hampshire

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Overview of Medicare coverage options in New Hampshire

In 2018 , 286,980 New Hampshire residents received Medicare coverage in one form or another, according to the Centers for Medicare & Medicaid Services (CMS). If you’re a beneficiary in New Hampshire, you may have a variety of options for your Medicare coverage. These options may include the following:

Original Medicare (Part A and Part B) is the federal health insurance program for certain United States citizens and legal residents age 65 and older, as well as younger beneficiaries who qualify by disability or through having certain conditions. In all states, you must be either a United States citizen or a legal permanent resident who has lived in the country for at least five continuous years.

Original Medicare includes Part A and Part B.

  • Medicare Part A covers inpatient hospital, skilled nursing facility, and hospice care, as well as some home health services.
  • Medicare Part B covers outpatient services, including doctor visits, lab tests, preventive care, and some home health care.

While many people get Medicare Part A without a premium if they’ve worked at least 10 years (40 quarters) under Medicare-covered employment, you’ll typically pay a premium for Medicare Part B. In addition, Original Medicare comes with other out-of-pocket costs, which may include deductibles, copayments, and coinsurance costs for covered Medicare Part A and Part B services.

New Hampshire beneficiaries should keep in mind that Original Medicare does not pay for all health-care services you may need. For instance, prescription drug coverage is limited to medications you get during a covered inpatient hospital or skilled nursing facility stay, as well as medications you may get in an outpatient setting, which are usually not the type of prescription drugs you give yourself, such as infusion drugs or chemotherapy medications. For coverage of most other prescription drugs, you’ll need to enroll in a stand-alone Medicare Prescription Drug Plan.

In addition, Original Medicare doesn’t cover costs like health coverage outside of the country, routine dental or vision, or custodial care (for example, help with bathing or going to the bathroom).

As mentioned, New Hampshire beneficiaries enrolled in Original Medicare have the option to enroll in a Medicare Part D Prescription Drug Plan (PDP) for help with prescription drug costs. These plans provide coverage that works alongside your Original Medicare coverage, and you’ll need to be enrolled in either Medicare Part A and/or Part B and live in the service area of a plan. Medicare Prescription Drug Plans are available from Medicare-approved private insurance companies in New Hampshire.

Medigap (Medicare Supplement) insurance plans are also offered by private insurance companies. These plans help with certain out-of-pocket costs and work alongside your Original Medicare coverage.

If you’re interested in getting coverage beyond Original Medicare, you may want to consider a Medicare Advantage plan in New Hampshire. As an alternative to the federally administered program, Medicare Advantage plans are offered by private insurance companies that contract with CMS and must provide at least the same level of coverage as Original Medicare (except for hospice care, which is paid by Medicare Part A).

Also known as Medicare Part C, many Medicare Advantage plans also include extra benefits such as routine dental and vision care, hearing, or wellness programs. For New Hampshire residents who want the convenience of having all of their Medicare coverage administered through a single plan, Medicare Advantage Prescription Drug (MA-PD) plans cover Medicare medical and prescription drug benefits.

One key difference between Original Medicare and Medicare Part C is that Medicare Advantage plans are required include a yearly out-of-pocket spending limit. Once your health-care spending for covered services reaches this limit (including the deductible), your Medicare Advantage plan covers 100% of covered medical costs for the rest of the year. In contrast, Original Medicare doesn’t include a maximum spending cap on your health-care costs.

To be eligible for Medicare Part C, you must have Medicare Part A and Part B and live in the Medicare Advantage plan’s service area. In addition, you generally can’t enroll in a Medicare Advantage plan if you have end-stage renal disease (with some exceptions). Remember, you’ll need to keep paying your Medicare Part B premium, in addition to any plan premium required by your Medicare Advantage plan.

If you’re ready to research Medicare plan options, eHealth’s plan finder tool makes it easy to view coverage choices in your service area. You can get started by inputting your zip code into the plan finder tool on this page. Or, if you prefer, you can also give us a call to get personalized assistance from a licensed insurance agent.

Medicare resources in New Hampshire

Bureau of Elderly and Adult Services: This state office operates under the oversight of the New Hampshire Department of Health and Human Services, and provides a range of support and services to seniors living in the state. To ensure all of the residents in New Hampshire can access the programs offered by the bureau, a number of district offices have been placed in various regions of the state. In addition to services involving meals, housing and long-term care, the Bureau of Elderly and Adult Services also offers the following programs:

  • Prescription Drug Assistance – This program offers resources for New Hampshire Medicare beneficiaries interested in prescription drug coverage. Although the web page primarily provides a list of links, there are a few helpful tips for seniors taking prescription drugs as well.
  • Medicare Savings Programs – This program is designed to help low-income seniors in the state afford health care. Those having difficulty paying Medicare premiums and deductibles may be able to find assistance through this program if they fall within certain income levels.

Service Link Aging and Disability Resource Center: ServiceLink is a statewide network established in 2000 that helps New Hampshire Medicare beneficiaries learn more about their health-care coverage. The network currently offers 13 office locations for residents to contact in person or by phone. There is also plenty of accessible information about Medicare benefits on the program’s website. Every resource center in the state is equipped with a Medicare Learning Center that offers workshops and other educational resources to beneficiaries. In addition, this office oversees the state’s Medicare Patrol, which educates beneficiaries on benefit fraud protection and how to report errors on their claims.

New Hampshire Insurance Department: The New Hampshire Insurance Department is the agency responsible for overseeing the insurance industry for the state. As part of its services, the Insurance Department also provides beneficiaries with information about their health-care coverage options. Much of the information included on this website is in the form of links to other state and local offices. However, there are a number of resources available, and all of the PDF files can be downloaded directly from the Insurance Department’s website. In addition, the New Hampshire Insurance Department offers a wide range of information on other areas of insurance in the state.

Medicare statistical trends in New Hampshire

Listed below are facts about Medicare coverage in New Hampshire that may be of interest as you consider your Medicare coverage options.

As of January 2018 –

  • 286,980 New Hampshire residents were enrolled in the Medicare program; 249,295 individuals had Original Medicare, Part A and/or Part B and 37,685 had Medicare Advantage and other Health plans.
  • 192,806 Medicare beneficiaries also had Medicare Part D prescription drug coverage; 162,662 individuals enrolled in a stand-alone Medicare Prescription Drug Plan to provide their Part D coverage.

In 2018, Medicare coverage in New Hampshire features –

  • 100% of New Hampshire residents with Medicare have access to a Medicare Advantage plan.
  • 24 Medicare Advantage plans are available in New Hampshire.
  • 24Medicare Prescription Drug Plans are available in New Hampshire.
  • 79% of people with Medicare Part D have access to a plan with a lower premium than what they paid in 2017.
  • 23% of people with Medicare Part D are eligible for Extra Help (also called the Low-Income Subsidy, or LIS).
  • $12.60 is the lowest monthly premium for coverage through a stand-alone Medicare Prescription Drug plan (premiums may be lower for individuals who qualify for Extra Help or higher for individuals who owe a late-enrollment penalty)

Statistical data from the Centers for Medicare & Medicaid Services, “Medicare Enrollment Dashboard ” and “2018 MA Part D Landscape State-by-State Fact Sheet”.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.
Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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