New Hampshire Health Insurance Consumer Guide

In order to sign up for private health coverage through the New Hampshire Marketplace, you must:

• Live in New Hampshire
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

By those rules, the majority of Americans qualify to use the Marketplace.⁵ But a bigger question for most people is financial assistance, and there are a few additional parameters in order to qualify for subsidies in the Marketplace. 

To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must:

• Not have access to affordable health coverage through an employer. If you have access to an employer’s plan but it seems too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.

Beyond those basic parameters, qualifying for Marketplace subsidies depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. (Note that the cost of this plan will vary depending on your age and location)

You can sign up for an ACA-compliant individual or family health plan in New Hampshire between November 1 and January 15, which is the annual open enrollment period.⁶ 

For coverage to take effect on January 1, you need to complete your application by December 15. Applications submitted between December 16 and January 15 will have a February 1 coverage effective date.⁵

Outside of the annual open enrollment window, you may be eligible to enroll if you experience a qualifying life event, such as giving birth or losing other health coverage. And some people can enroll year-round even without a specific qualifying life event.⁷ 

Enrollment in New Hampshire Medicaid/CHIP is available year-round.

To enroll in an ACA Marketplace plan in New Hampshire, you can: 

• Visit HealthCare.gov, New Hampshire’s health insurance Marketplace. HealthCare.gov is an online platform where you can compare plans, see your subsidy eligibility, and enroll in the plan that best meets your needs. 
• Purchase Marketplace coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.⁸

You can reach HealthCare.gov’s call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, except holidays.

Under the Affordable Care Act (ACA), there are income-based subsidies that can help lower your premium payments each month. These subsidies are available to New Hampshire residents who meet the eligibility requirements and enroll in Marketplace coverage.

As of 2023, six out of ten New Hampshire Marketplace enrollees were receiving premium subsidies, and these subsidies reduced their average health insurance premiums by $345/month. After accounting for subsidies, the average enrollee’s premium was about $149/month.⁹

If your household income is below 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR), as long as you select a Silver-level plan. These subsidies are designed to reduce your deductibles and out-of-pocket expenses. As of 2023, 29% of Marketplace enrollees in New Hampshire Marketplace were receiving CSR benefits.¹⁰

You can use both APTC and CSR benefits if you’re eligible for both and you select a Silver-level plan in the Marketplace (APTC can be used with plans at any metal level, but CSR benefits are only available on Silver plans). 

Depending on your income and circumstances, you may be able to enroll in free or low cost health coverage through Medicaid or CHIP. Check to see if you meet the criteria for Medicaid in New Hampshire. 

Source: CMS.gov¹¹

In 2023, there are three private insurers that offer coverage through the New Hampshire Marketplace, and all three plan to continue to offer coverage in 2024.¹² 

In most of New Hampshire, at least three insurers are offering plans.¹³

• Celtic Insurance Company (Ambetter) 
• Harvard Pilgrim Healthcare of New England
• Matthew Thornton Health Plan (Anthem BCBS)

For 2024, the state’s individual market insurers have proposed an overall weighted average rate increase of about 3%.¹⁴ These rates are under review by state regulators and final rates will be made public in the fall, coinciding with the start of open enrollment. 

The following average rate changes have been proposed by the insurers that offer coverage via New Hampshire’s exchange, applicable to full-price premiums (ie, these rate changes are calculated before subsidies are applied, and most exchange enrollees receive subsidies):

The following table highlights each Marketplace insurer’s proposed rate changes for 2024 Marketplace health plans. These rates are subject to the state’s approval and will be finalized in Fall 2023.

Source: New Hampshire Rate Review Submissions¹²

*Anthem Health Plans does not offer an exchange plan on the Marketplace

It’s important to remember that these average rate increases are for full-price plans, and most enrollees do not pay full price: As of 2023, 70% of New Hampshire’s Marketplace enrollees were receiving premium subsidies that reduced their monthly payments.¹⁰

During the open enrollment period for 2023 coverage, 54,557 people selected private plans through the New Hampshire Marketplace.¹⁵ 

Source: 2014,¹⁶  2015, ¹⁷ 2016,¹⁸ 2017,¹⁹ 2018,²⁰ 2019,²¹ 2020,²² 2021,²³ 2022,²⁴ 2023,²⁵ 2024²⁶

HealthCare.gov: This is New Hampshire’s Marketplace. Residents can enroll in individual/family health plans and receive income-based subsidies. You can contact HealthCare.gov at 800-318-2596.

New Hampshire Department of Health and Human Services: The New Hampshire Department of Health and Human Services administers Medicaid and CHIP, as well as other social services programs. You can reach them at 1-844-ASK-DHHS (1-844-275-3447) For TDD Access, use Relay NH 1-800-735-2964

New Hampshire Insurance Department: Regulates the New Hampshire insurance industry, and assists consumers and businesses with insurance-related questions and concerns.  

New Hampshire State Health Insurance Assistance Program: A local service that provides information and assistance with questions related to Medicare eligibility, enrollment, and claims.