New Hampshire Health Insurance Marketplace 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 ⁹

By those rules, the majority of Americans qualify to use the Marketplace.¹⁰ But a bigger question for most people is financial assistance, and there are a few additional parameters 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.
• Not be eligible for premium-free Medicare Part A. ¹¹
• If married, file a joint tax return.¹²
• Not be able to be claimed by someone else as a tax dependent.¹²

Beyond those basic parameters, qualifying for Marketplace subsidies depends on your household income.

In New Hampshire, the open enrollment period to sign up for 2027 ACA-compliant individual and family health plans is expected to run from November 1, 2026 to January 15, 2027.

Under a rule change that HHS finalized in 2025 open enrollment would have been shortened, ending in mid-December. But that change was overturned by a judge in June 2026. However, HHS appealed the judge’s ruling in July 2026.¹³ So as of early August 2026, there was still some uncertainty regarding the open enrollment schedule for 2027 coverage

But consumers should plan to enroll by December 15, regardless of the outcome of the appeal. Even if open enrollment continues until mid-January, December 15 will be the final day to pick a plan with a January 1 effective date.

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. Native Americans can enroll year-round with a qualifying life event.

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.
• Enroll via an approved enhanced direct enrollment entity.¹⁴ (Confirm that you’re enrolling in Marketplace coverage, as that’s the only way you can take advantage of financial assistance if you’re eligible for it.)

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.

During the open enrollment period for 2026 coverage, more than 55% of New Hampshire Marketplace enrollees qualified for premium subsidies. These subsidies reduced their health insurance premiums by an average of $378/month. After accounting for subsidies, the average subsidy-eligible enrollee’s premium was about $200/month.¹⁵

(As noted below in the section about premium changes for 2026, the expiration of federal subsidy enhancements at the end of 2025 resulted in significantly higher after-subsidy premiums for 2026.)

Source: CMS.gov¹⁵

For individual/family market enrollees who aren’t eligible for premium subsidies, the state’s reinsurance program, which took effect in 2021, keeps full-price premiums lower than they would otherwise be.¹⁶

If your household income isn’t more than 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 early 2025, nearly a third of Marketplace enrollees in New Hampshire Marketplace were receiving CSR benefits.¹⁷

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). 

New Hampshire has expanded Medicaid eligibility under the Affordable Care Act, so adults under age 65 are eligible for Medicaid with household incomes up to 138% of the poverty level. From 2014 through 2018, New Hampshire purchased private Marketplace plans for people who were eligible for expanded Medicaid. However, the state opted to transition to regular Medicaid managed care starting in 2019,¹⁸ so the program now functions much the way it does in most other states.

Three private insurers will offer coverage through the New Hampshire Marketplace for 2027:

• Harvard Pilgrim Health Care of NE
• Matthew Thornton Health Plan (Anthem BCBS)
• Boston Medical Center Health Plan (WellSense)

There were four participating insurers in 2026, but Celtic/Ambetter is exiting the New Hampshire Marketplace at the end of 2026. Nearly 12,000 Celtic/Ambetter enrollees will need to select new coverage during the open enrollment period that begins November 1, 2026.¹⁹

(Another carrier, Anthem Health Plans of New Hampshire, offers coverage only outside the exchange. But a separate Anthem entity, Matthew Thornton Health Plans, offers coverage in the New Hampshire Marketplace.)²⁰

New Hampshire has among the lowest Marketplace premiums (before subsidies) in the country in 2026.²¹

The following average rate changes, calculated before Marketplace subsidies are applied, have been proposed for 2027 by the insurers that offer Marketplace coverage in New Hampshire, amounting to a weighted average proposed rate increase of about 18.4%:²² 

Source: Federal rate review database²⁰ 

Normally, subsidies grow to keep pace with the cost of the benchmark (second-lowest-cost Silver plan) in each area. But because Congress did not extend the federal subsidy enhancements that expired at the end of 2025, subsidies no longer cover as much of enrollees’ premiums in 2026, and enrollees with household income over 400% of the federal poverty level lost their subsidies altogether. The result is sharply higher net premiums for 2026 Marketplace coverage.

For 2027, the loss of the federal subsidy enhancements is already “baked in,” so enrollees won’t experience the level of sticker shock they had for 2026. For most enrollees, subsidies will grow to offset some or all of the rate increases.

Here’s an overview of how average full-price (pre-subsidy) premiums have changed in New Hampshire’s individual/family health insurance market over the years:

• 2015: Average increase of 0.5%²³ (accounting for four new insurers)
• 2016: Average increase of 6.2%²⁴
• 2017: Average increase of 8.8%²⁵(insurer participation down to four)
• 2018: Average increase of 52%²⁶(insurer participation down to three)²⁴
• 2019: Average decrease of 14.4%²⁷ (Medicaid Premium Assistance Program no longer in use)
• 2020: Average decrease of 0.8%²⁸
• 2021: Average decrease of 15.6%¹⁶ (reinsurance program took effect)
• 2022: Average increase of 3.3%²⁹
• 2023: Average increase of 4.8%³⁰
• 2024: Average increase of 0.7%³¹
• 2025: Average increase of 4.8%³²
• 2026: Average increase of 17.3%³³

New Hampshire’s 2026 Marketplace enrollment declined in 2026 (as was the case in nearly all states), with 66,024 people enrolling in plans during the open enrollment period.¹⁵

The decline happened as a result of the expiration of federal subsidy enhancements, which resulted in sharply higher net premiums for most enrollees.

As illustrated below, New Hampshire Marketplace enrollment had been climbing since 2021, largely due to the American Rescue Plan’s enhancement of the ACA’s premium subsidies. The Inflation Reduction Act extended these subsidy enhancements through 2025, but affordability was greatly reduced in 2026 after the subsidy enhancements expired.

The enrollment growth in 2024 and 2025 was also due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. CMS reported that nearly 20,000 New Hampshire residents transitioned from Medicaid to a Marketplace plan during the unwinding process.³⁴

Source: 2014,³⁵ 2015,³⁶ 2016,³⁷ 2017,³⁸ 2018,³⁹ 2019,⁴⁰ 2020,⁴¹ 2021,⁴² 2022,⁴³ 2023,⁴⁴ 2024,⁴⁵ 2025⁴⁶ 2026¹⁵

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.