What This Page Covers
After reading this page, you will know more about New Mexico Medicaid plans, options, and qualification requirements. This page covers health insurance programs for low-income individuals and families including: Centennial Care, FIT, PACE, CHIP, Medicare-Medicaid Plans, and HIPP.
Health Insurance For Low-Income
New Mexico’s Medicaid and CHIP coverage are handled through managed care organizations contracted by the United States Health and Human Services department. Each individual organization creates a network of clinicians that work together to provide care to their qualified members. With the introduction of Obamacare (the Affordable Care Act), New Mexico opted to expand their Medicaid programs and now services 800,000 residents. If you were denied Medicaid coverage in New Mexico previous to this expansion, you may now qualify.
New Mexico Medicaid Plan Options
Centennial Care is the New Mexico Medicaid option for children offered through managed care programs. Once you obtain eligibility for Centennial Care you can select a carrier for your coverage and they will provide preventive services, behavioral services, long-term care, and help to improve a health condition. This is the program that provides the majority of the coverage for New Mexico residents that qualify for Medicaid.
New Mexico health insurance plans that have been contracted by Medicaid include:
- Blue Cross Blue Shield
- Presbyterian Health Plan
Centennial Care also provides the following services:
- Well Child Checkups
- Vision and hearing
- Dental Care
- Physical, occupational and speech therapy
- Pharmacy services
- Laboratory tests
- Case Management
- Psychiatric hospital services
- And more…
Family Infant and Toddlers (FIT)
The FIT program was developed to provide interventional help to infants and toddlers at risk for developmental delays. The goal is to help the family and child through education and techniques that can help the child’s lifelong health and development.
Program of All-Inclusive Care for the Elderly (PACE)
The Program of All-inclusive Care for the Elderly (PACE) is a managed care model of acute and long-term care individuals age 55 and older that meet state specific criteria for nursing home care placement. The goal of PACE is to empower the individual with the ability to reside in their current community and receive quality care. Ultimately, this should reduce the cost relative to the Medicare, Medicaid, and private-pay traditional payment systems.
HIPP (Health Insurance Premium Payment) Program
Health Insurance Premium Payment (HIPP) Program provides financial assistance to families that qualify for healthcare support despite having insurance through their employer. This program allows the family to begin to increase their long-term health support system `while being able to take advantage of Medicaid’s coverage options. To qualify for this program, one person in the family must be qualified for or currently using Medicaid.
New Mexico Medicaid FAQs
- What is Medicaid?
Medicaid is a state funded insurance that that provides coverage to low income families, pregnant women, newborns, and children that may not be able to afford to purchase their own care.
- Who is eligible for Medicaid?
The following individuals are qualified for New Mexico Medicaid:
- Children 0-18 years with a household income less than 213% of the Federal Poverty Line (FPL);
- Pregnant women with a household income less than 194% of the Federal Poverty Line;
- Parents with dependents and a household income 57% of the Federal Poverty Line.
- How do I find out if I am eligible for Medicaid?
To find out if you are eligible for Medicaid, you must fill out an application for Medicaid or CHIP. You may fill out an application at any time of the year. See more on Medicaid.
- Will Medicaid cover my children?
Your household income level will determine if your child or children can be covered by Medicaid.
- What is CHIP?
CHIP is a program that supports children in families that cannot afford private health insurance, but whose household income is too high to qualify for Medicaid.
- Does Medicaid satisfy the health insurance requirement?
Yes, Medicaid will satisfy the Affordable Care Act (Obamacare) health insurance requirement for the covered individuals.
- What information and documents should I have when I'm signing up for Medicaid?
Depending on the Medicaid program being applied for, you will need the following: Identity, Social Security, proof you live in New Mexico, proof of income, proof of medical costs, and bank account information.
- How does Obamacare work with Medicaid?
Because of New Mexico's Medicaid eligibility requirements, Obamacare does not impact people who qualify for Medicaid and vice versa. As such, tax credits are only available for people who are not eligible for other plans.
- What is Centennial Care?
Centennial Care is the Medicaid option for pregnant women, newborns, children, and parents offered through managed care programs. This is the program that provides the majority of the coverage for New Mexico residents that qualify for Medicaid. Learn more about Centennial Care, here.