Skilled nursing at home (private duty nurse) costs in New Hampshire
Here is the middle of the price range in New Hampshire, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.
The New Hampshire median
$195.00 an hour
- Works out to, monthly
- $37,180
- Works out to, yearly
- $446,160
Our arithmetic, not the survey's. The survey reports this one by the hour, so the monthly and yearly figures assume a schedule: $195.00 an hour × 44 hours a week × 52 weeks ÷ 12 months. Fewer hours, smaller bill — the schedule is the biggest lever you have.
That is about 117% higher than the national median of $90.00 an hour. Within New Hampshire the spread is usually wider still: a city costs more than a rural county, often by a great deal.
A licensed practical nurse or registered nurse who comes to the house for medical care such as wound care, injections, IV therapy, catheters, feeding tubes and medication management.
What this number is, and what it is not.
It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.
A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.
Where New Hampshire sits
$195.00 an hour ranks New Hampshire 2nd of the 46 states priced for skilled nursing at home (private duty nurse): 1 charge more, 44 charge less.
Wyoming is the next state up, at $207.00; Iowa the next down, at $180.00.
The national median is $90.00, so New Hampshire runs $105.00 above it — 117% more, or $240,240 a year ($105.00 × 44 hours a week × 52 weeks).
The column runs $43.00 (Mississippi) to $207.00 (Wyoming). New Hampshire sits 93% up it, 4.53× the lowest, with 2 other within a tenth of it.
Of the 6 kinds of care New Hampshire was priced for, this is its 1st dearest standing: at best 2nd of 46 for skilled nursing at home (private duty nurse), at worst 26th of 45 for adult day health care.
What $37,180 a month becomes
Our multiplication, holding the New Hampshire median flat — no real bill does — with the same span of the state's least costly priced care beside it:
Six months
$223,080
$12,090 of adult day health care
One year
$446,160
$24,180 of adult day health care
Two years
$892,320
$48,360 of adult day health care
Three years
$1,338,480
$72,540 of adult day health care
Five years
$2,230,800
$120,900 of adult day health care
Care is bought in years, not months, and $37,180 a month is $446,160 a year.
Five years at the national median would be $1,029,600: $1,201,200 less than five years in New Hampshire.
Inside New Hampshire, five years of adult day health care runs $120,900 and five of nursing home, private room $806,640; this page's $2,230,800 sits 100% between them. Most families pay for more than one of these in sequence.
Against other care in New Hampshire
Converted to a month on our schedule, set beside this page's $37,180:
Nursing home, private room
$13,444 a month
$23,736 a month less, $284,832 a year, 0.36× this page. New Hampshire places 16th of 49 for it, 14 below its 2nd here.
Nursing home, semi-private room
$12,243 a month
$24,937 a month less, $299,244 a year, 0.33× this page. New Hampshire places 14th of 50 for it, 12 below its 2nd here.
Assisted living community
$8,025 a month
$29,155 a month less, $349,860 a year, 0.22× this page. New Hampshire places 8th of 50 for it, 6 below its 2nd here.
In-home care (non-medical caregiver)
$7,627 a month
$29,553 a month less, $354,640 a year, 0.21× this page. New Hampshire places 10th of 50 for it, 8 below its 2nd here.
Adult day health care
$2,015 a month
$35,165 a month less, $421,980 a year, 0.05× this page. New Hampshire places 26th of 45 for it, 24 below its 2nd here.
On the same monthly footing, skilled nursing at home (private duty nurse) is the 1st costliest of the 6 kinds of care priced in New Hampshire, at $37,180. The conversions are ours; the medians are the survey's.
44 hours a week of in-home care in New Hampshire is $7,627 a month against $8,025 for assisted living — 5% more. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.
Who actually pays for this
This is the part most cost pages leave out, and it is the part that changes what a family does next.
Medicare does not pay for long-term care
Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.
Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.
Medicaid may pay — after a spend-down
Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits New Hampshire sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.
Veterans: Aid and Attendance may help
A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.
Otherwise: savings, family, and long-term care insurance
Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.
Working out which of these applies to one particular family is exactly what a free New Hampshire counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 ↗ will connect you to the area agency on aging for your county.
Who to ask in New Hampshire
New Hampshire's free counseling program is New Hampshire State Health Insurance Assistance Program (SHIP) – ServiceLink Resource Center, on 1-866-634-9412. It is grant-funded and sells nothing.
the New Hampshire Department of Health and Human Services decides Medicaid long-term care here — not a facility, and not us. New Hampshire runs it as Nursing facility (institutional) Medicaid, Home and community based services waiver and Old Age Assistance and Aid to the Permanently and Totally Disabled Medicaid, with a 60-month look-back on gifts and transfers.
Beside $37,180 a month — our comparison, its limits — that is what "spend-down" means: a single applicant's monthly income may not top $2,982, which this bill clears 12.5 times over, countable assets may not top $2,500, or about 2 days of skilled nursing at home (private duty nurse) at this rate and an at-home spouse may keep up to $162,660, or about 4 months of it.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against New Hampshire Department of Health and Human Services, Bureau of Family Assistance Program Fact Sheet (07/2026), with the Bureau's Standard of Need release and New Hampshire administrative rules He-W 800 (effective 2026-01-01)
Common questions
- Does Medicare pay for skilled nursing at home (private duty nurse) in New Hampshire?
- No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
- Is skilled nursing at home (private duty nurse) dearer in New Hampshire than in other states?
- $195.00 an hour places New Hampshire 2nd of the 46 states the survey priced for it: 1 charge more and 44 charge less. The national median is $90.00. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
- Is this the price I will be quoted in New Hampshire?
- No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
- Who can help me work out how to pay for it?
- New Hampshire runs its free counseling program as New Hampshire State Health Insurance Assistance Program (SHIP) – ServiceLink Resource Center, on 1-866-634-9412. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.