If you’re having trouble finding adequate New Mexico health insurance coverage, we at HealthQuoteInfo can help. We can share our knowledge and experience so you can make sense out of the complex rules and options in this industry.
If your concern is that private insurance may be too expensive for your budget, the state offers Medicaid and other programs. These policies are designed to provide adequate health coverage for New Mexico residents.
Centennial Care Medicaid& Low Income Health Insurance New Mexico
In 2014, the Medicaid program in New Mexico was renamed as Centennial Care. The new name emphasized the new expanded guidelines that were applied to the program to enable many more to qualify.
Centennial Care uses a managed care model, which means the state doesn’t directly provide Medicaid benefits to its beneficiaries. Instead, New Mexico has contracted with private insurers to offer the Medicaid benefits to the qualified applicants.
By the end of 2018, four insurers have been selected to have contracts with Centennial Care. These are Blue Cross Blue Shield of New Mexico, Presbyterian, Molina, and UnitedHealthcare. However, for 2019 Molina and UnitedHealthcare were not picked to continue to provide Medicaid coverage in the state. Instead, Western Sky Community Care has joined the roster along with Blue Cross Blue Shield and Presbyterian.
Medicaid for Adults
The Other Adult Category 100 covers individuals from ages 19 to 65 who may or may not have dependents. They should not have Medicare entitlement, and they should meet residency and citizenship requirements. Pregnant women cannot qualify, as there is another Medicaid category specifically for that group. To qualify, the family household income must not exceed 133% federal poverty level (FPL). That is a monthly income of $2,727 for a household of four.
The Parent/Caretaker Category 200 is for caretakers with one or more dependent children. The individual can be a natural, step, or adoptive parent of the child if they are living with the child. If they’re not living with the child, the child must be living with specified relatives for the applicant to qualify. The income requirements come with a fixed monthly income amount for different household sizes. A family of two has a monthly income limit of $608, a family of three has $765, and a family of four has a $923 monthly income limit.
Medicaid for Pregnant Women
Category 300 offers full benefits for pregnant women. The unborn child will automatically be included in the coverage. The income limit uses the same fixed amounts as mentioned for Category 200.
Category 301 offers only pregnancy-related Medicaid services such as ultrasound. The unborn child will also be included in the category. The income limit is 250% FPL which for a family of four is a monthly income $5,125.
For regular children’s Medicaid, the clients can have private insurance. However, the CHIP programs require that the child does not have any other insurance.
For children under six years of age, there’s the Category 400 plan that’s available for families with less than 200% FPL. There’s also another Category 402 program that’s offered for those with a family income within 200% to $240% FPL.
For children ranging in age from six to 18, the Category 410 has an income ceiling of less than 138%. The other program for this age group has an income limit ranging from 139% to 190% FPL.
Centennial Care runs the Children’s Health Insurance Program (CHIP) as well. For the children under six years of age (Category 420), the income limit is from 240% to 300% FPL. The Category 421 is for children from ages 6 to 18, and the income ceiling is 190% to 240%.
ESI & Small Business Health Insurance New Mexico
If you’re self-employed in New Mexico, you can obtain employer-sponsored insurance for your employees. A small group plan needs only two to 50 employees, and you can count yourself among the employees. A health plan can help you find the most qualified applicants in your area for your business.
For employees, health plans obtained through the workplace are often much more affordable than private health plans. That’s because employers cover a significant portion of the premiums for their employees. Employees can also be enrolled in these health plans even if they have pre-existing medical conditions.
Employees should try to maintain their coverage, as having no prior health insurance can permit carriers to refuse treatments for pre-existing conditions. For those employees who have had a lapse of coverage for more than 63 days, their medical history for the last six months will be reviewed, and the carrier can refuse coverage for the pre-existing condition for the first 12 months of the policy.
It’s for this reason that if you lose your job or eligibility for your ESI, you can continue paying for the premium through the COBRA program. This grants you continuous access to your health insurance coverage for up to 18 months. During that time, you can obtain new employment or insurance without having to go through a lapse of coverage.
Private Health Insurance in New Mexico
The advantage of obtaining private insurance is that you can purchase the plan that’s best for you and your family. You’re not limited by the choices of your employer as to which plans are available.
Obtaining such plans can done right now. Simply enter your zip code into our search bar. You will then see a list of available health insurance plans for your area, and you can compare them to one another to determine which plan suits your needs and budget.
New Mexico Open Enrollment 2019 & New Mexico Obamacare Insurance
The New Mexico Open Enrollment period for health insurance in 2019 will run from November 1st, 2018 to December 15th, 2019.
For all your other questions regarding health insurance in New Mexico, please do not hesitate to give us a call at 1-855-614-5057. We stand ready to guide you so that you can get the health & medical insurance coverage you need and deserve.