How to Apply for the Medicare Savings Program in New Hampshire
Three Ways to Apply
New Hampshire DHHS gives you three application channels. All three lead to the same Bureau of Family Assistance intake process — the choice comes down to what works best for your situation.
Online through NH EASY (nheasy.nh.gov): Create an account, select "Medicare Savings Programs" under medical assistance, fill out the intake questionnaire, and upload document scans or clear photos. The portal lets you track case status in real time. One warning: NH EASY automatically deletes unsubmitted applications at midnight, so finish in one session or save your progress.
Paper using Form 800: Download Form 800 (Application for Assistance) from the DHHS website or pick one up at any District Office. Mail it or hand-deliver it to your nearest DHHS office. This is the best option when the applicant has no internet access or is uncomfortable with online forms.
Phone at 1-844-275-3447 (1-844-ASK-DHHS): A DHHS staff member walks through the application over the phone and records a verbal signature. Free language interpreter services are available. Phone applications are a solid option for seniors in rural northern counties where the nearest District Office might be a long drive.
Documents You'll Need
Gather these before starting the application:
- Medicare card showing your Medicare Beneficiary Identifier (MBI) and Part A/B effective dates
- Photo ID — driver's license, state ID, or passport
- Proof of NH residence — utility bill, lease, or property tax document
- Income verification — Social Security benefit statement (SSA-1099 or current award letter), pension statements, pay stubs if working
- Asset documentation — complete bank, savings, CD, and investment account statements for the full calendar month before the application date
- Life insurance — proof of cash surrender value for policies with face value over $1,500
If an adult child is helping, submit Form 77a (Authorized Representative Declaration) alongside the application. This authorizes DHHS to share case details and send duplicate notices to the representative. A Power of Attorney or court-ordered Guardianship also works.
What Happens After You Apply
- Intake: DHHS logs the application into the New HEIGHTS system and runs automated cross-matches with federal databases.
- Verification request: Within a few days to weeks, you'll receive a Verification Checklist with a 10-day deadline to provide any missing documents. This is the step that derails the most applications — have bank statements ready before you apply, not after.
- Processing: DHHS has 45 calendar days from the filing date to issue a decision.
- Notice of Decision: You'll receive a written approval or denial. Approval triggers an electronic buy-in record sent to CMS and Social Security to stop Part B premium deductions from the beneficiary's check.
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When Coverage Starts
The start date depends on which tier DHHS approves:
- QMB: Coverage begins the first day of the month after approval. Not retroactive.
- SLMB and SLMB135: Can reimburse Part B premiums retroactively for up to three months before the application month, as long as the person was eligible during those months.
The lag between DHHS approval and the actual Social Security check adjustment can take 60 to 90 days. During that time, $202.90 may still be deducted from the monthly check. Those deductions get refunded — but it helps to know it's coming so nobody panics.
Tips for a Smoother Application
Use NH EASY's document upload even if you applied by paper or phone. Uploading scans creates a timestamped digital record, which matters if documents get lost in the Centralized Scanning Unit pipeline. Label each upload with the specific document type rather than a generic category.
Apply early in the month. QMB coverage starts the first of the following month, so applying on October 3 vs. October 28 doesn't change the coverage start date if approval takes a few weeks — but it gives you more breathing room for the 10-day verification window.
Keep copies of everything. DHHS notices include a 30-day Fair Hearing appeal window. If something goes wrong, having your own paper trail makes the appeal straightforward.
Our New Hampshire Medicare Savings Programs & Extra Help Guide includes a pre-application document checklist, NH EASY walkthrough, and scripts for calling the DHHS customer service line — designed to keep the process on track from first login to approval notice.
Get Your Free New Hampshire — Medicare Savings Program Eligibility Checklist
Download the New Hampshire — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.