Paul Sanchez
There are several options for medical insurance in New Mexico. BeWell, New Mexico's Health Insurance Marketplace, is a popular choice for those who don't qualify for Medicaid or have a health plan through their job. They offer subsidies to lower the cost of monthly premiums. Additionally, the New Mexico Premium Assistance Program provides support for members of federally recognized tribes who qualify for federal Premium Tax Credits. Presbyterian Health Plan, Inc. offers Medicaid-eligible members value-added coverage through their Turquoise Care program. Blue Cross and Blue Shield of New Mexico provide access to a large network of trusted doctors, hospitals, dentists, and pharmacies. For those who have been denied health insurance, the New Mexico Medical Insurance Pool offers an alternative solution.
| Characteristics | Values |
|---|---|
| Health Insurance Marketplace | BeWell |
| Medicaid Program | Turquoise Care |
| Individual and Family Health Insurance | BCBSNM |
| Medical Insurance for Uninsurable Residents | New Mexico Medical Insurance Pool |
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![Insurance Laws of the Territory of New Mexico. Comp. 1909. Jacobo Chavez, Superintendent of Insurance, Santa Fe, New Mexico 1909 [Leather Bound]](https://m.media-amazon.com/images/I/617DLHXyzlL._AC_UY218_.jpg)
What You'll Learn
BeWell, New Mexico's Health Insurance Marketplace
BeWell offers a range of health coverage benefits, premiums, and services for individuals and families. Over 30% of BeWell customers pay $10 or less in monthly premiums, with some even qualifying for $0 monthly premium plans. The platform provides transparency in coverage options, ensuring that users don't have to base their healthcare decisions on financial constraints.
BeWell holds two types of events throughout the year to assist New Mexicans in enrolling in health insurance plans. Enrollment events allow individuals to meet with certified enrollment counselors and get immediate assistance in signing up for a plan. Educational events, on the other hand, provide information about the enrolment process and the various plans available. After attending an educational event, individuals can enrol in a plan at a later date.
The Health Insurance Marketplace Affordability Program, established under New Mexico's Health Care Affordability Fund, works in partnership with BeWell to lower premiums and out-of-pocket costs for most enrollees. The New Mexico Premium Assistance Program also helps lower monthly premium payments for those who qualify for federal Premium Tax Credits. Additionally, Turquoise Plans, exclusively offered on BeWell, provide significant savings on out-of-pocket expenses, making healthcare more financially accessible.
BeWell is committed to answering users' questions and providing clear information about health insurance options in New Mexico. With its range of plans and financial assistance programs, BeWell ensures that all New Mexicans can access the healthcare coverage they need.
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Medicaid Coverage through the NM Human Services Department
New Mexico residents can apply for Medicaid Coverage through the NM Human Services Department. Medicaid is a federal and state-funded insurance program that provides healthcare coverage for eligible low-income individuals and families. The program is managed by the state and overseen by the Centers for Medicare and Medicaid Services (CMS).
To be eligible for Medicaid in New Mexico, applicants must meet certain income and asset requirements. These requirements vary based on factors such as family size, age, and whether the applicant has a disability. For example, as of 2023, an individual must not have an income higher than $18,720 per year, while a family of four must not exceed an annual income of $38,280.
The NM Human Services Department offers several Medicaid programs with different eligibility criteria, including:
- Traditional Medicaid: This program covers children, pregnant women, parents and caregivers, as well as adults with specific disabilities.
- Medicaid Expansion: Under the Affordable Care Act, New Mexico expanded its Medicaid program to cover more adults, including those without minor children. This expansion covers adults under 65 with incomes up to 133% of the federal poverty level.
- Medicare Savings Programs: These programs help Medicare beneficiaries with limited incomes and assets by paying for some or all of their Medicare premiums, deductibles, and coinsurance.
New Mexicans can apply for Medicaid online, by phone, or in person at their local NM Human Services Department office. They will need to provide various forms of documentation, including proof of identity, income, and residency. Once approved, individuals can access healthcare services through their chosen Medicaid provider, such as Presbyterian Health Plan's Turquoise Care program.
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Turquoise Care, a Medicaid program
In New Mexico, Presbyterian Health Plan, Inc. offers Turquoise Care, a Medicaid program that provides value-added coverage for eligible members. This program allows enrollees to continue seeing their doctors at Indian Health Services while still being covered by their plan. Turquoise Care does not require any co-pays, and Native Americans can opt out at any time by contacting the Customer Service Center.
Each of the four Turquoise Care MCOs (Managed Care Organizations) covers the same physical health, behavioral health, and long-term services and supports. Additionally, each MCO offers different Value-Added Services (VAS) on top of the Medicaid-covered benefits. For example, Molina Health Care of New Mexico (MHC) and United Health Care (UHC) are available as new MCOs starting July 1, 2024. If you do not select an MCO during the open enrollment period, you will be automatically assigned to one.
Native Americans have the choice to enroll in Turquoise Care (managed care) or Fee-For-Service Medicaid. Native American children in state custody can select any Turquoise Care health plan or remain in Fee-for-Service Medicaid. If a family is already enrolled in Medicaid and has a new child, they must submit an application to add the child to the household.
New Mexico law mandates that if a prior authorization for medications for cancer or rheumatologic diseases was granted once, that drug will be approved for the lifetime of the drug. Turquoise Care members can access general information, value-added services, and Turquoise Care Rewards on the UnitedHealthcare New Mexico Turquoise Care website. They can also file a grievance or appeal by calling or writing to the provided address.
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BCBSNM Individual and Family health insurance plans
One of the key advantages of choosing Blue Cross and Blue Shield of New Mexico is their extensive network of healthcare providers. This includes one of the nation's largest networks of trusted doctors, hospitals, dentists, and pharmacies, ensuring that you can receive quality care wherever you are in the state. With BCBSNM, you can be confident that you and your family will have access to the medical care you need.
The BCBSNM Individual and Family plans also offer flexibility to suit your specific needs and budget. They offer a range of coverage options, including Gold, Silver, and Bronze level plans. You can choose the level of coverage that best fits your healthcare requirements and financial situation. Additionally, if you are transitioning to Medicare or changing plans, BCBSNM can guide you through the process and help you find the right Medicare plan.
Another benefit of BCBSNM is their commitment to enhancing employee wellness. If you are an employer, BCBSNM offers solutions that prioritize the health of your team. They provide tools and resources to support the wellness of your employees, which can ultimately drive your business forward. By choosing BCBSNM, you are investing in the well-being of your employees and creating a healthier workforce.
Furthermore, BCBSNM health insurance plans go beyond just medical care. They recognize the importance of dental and vision care in your overall health. With their dental plans, you gain access to one of the largest dental networks in the country, ensuring convenient and comprehensive dental services. Their vision benefits also help you save money by providing a range of choices for doctors, opticians, and retailers. Additionally, BCBSNM plans may include telehealth options for medical, behavioural health, or dental care, which can save you time and money.
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New Mexico Medical Insurance Pool
New Mexico has a variety of medical insurance options available to its residents. BeWell, New Mexico's Health Insurance Marketplace, is a service that helps connect New Mexicans to health insurance. They help those who do not qualify for Medicaid or have a health plan through their job. BeWell also helps people qualify for subsidies to lower the cost of monthly premiums.
Blue Cross and Blue Shield of New Mexico (BCBSNM) is another option for health insurance. BCBSNM offers health insurance plans for individuals and families, as well as Medicare plans. They also provide solutions for employers who want to support their team's health. BCBSNM offers access to a large network of trusted doctors, hospitals, dentists, and pharmacies.
The New Mexico Medical Insurance Pool provides access to health insurance coverage for residents who have been denied health insurance and are considered uninsurable. This has been available since 1987.
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Frequently asked questions
BeWell is New Mexico's Health Insurance Marketplace. It connects New Mexicans to health insurance if they do not qualify for Medicaid or have a health plan through their job. It is also the only place where you can qualify for subsidies to lower the cost of your monthly premiums.
The New Mexico Medical Insurance Pool provides access to health insurance coverage to residents of New Mexico who are denied health insurance and considered uninsurable. It was established in 1987.
Turquoise Care is the Medicaid program offered in New Mexico. It provides value-added coverage for Medicaid-eligible members.
