How to Get New Mexico Medicaid Benefits?

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We have scoured the internet to provide all you need to know about the New Mexico Medicaid Benefits.

Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.

This post will teach you all you need to learn about Medicaid in New Mexico.

What is the New Mexico Medicaid Program?

New Mexico Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the New Mexico Medicaid Program?

New Mexico Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled, or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in New Mexico?

[Find it here:https://www.benefits.gov/benefit/1636]

Phone

1-800-283-4465

Mailing Address

New Mexico Medicaid HQ, NM Human Services Department

P.O. Box 2348, Santa Fe, NM 87504-2348

Email: NM.Customers@state.nm.us.

What are the Medicaid plans in New Mexico?

The following are the medicaid plans in New Mexico:

Coordinated Long Term Supports and Services (CoLTS)

Older adults, people with disabilities, and dual eligibles who aren’t currently using long-term services can receive acute, primary, and specialty care, as well as long-term services and support through Coordinated Long Term, Supports and Services (CoLTS).

Salud! Behavioral Health

Now being given (or excluded from) N.M. A unique limited benefit-plan contract covers Salud! and COLTS programs and behavioral health treatments as a part of the Salud! Behavioral Health program.

State Coverage Initiative (SCI).

New Mexico launched the State Coverage Initiative (SCI) to benefit people without children. Acute, primary, and some specialty care, as well as behavioral health treatments, are covered. Participation in the program is optional.

How do I apply for New Mexico Medicaid?

Call 1-800-283-4465 to enroll. 

Apply in person at New Mexico Medicaid HQ, NM Human Services Department.

Online:  Download and print the application.

Mail: To P.O. Box 2348, Santa Fe, NM 87504-2348

Email: NM.Customers@state.nm.us.

What is covered by New Mexico Medicaid?

New Mexico Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

Can I have both New Mexico Medicaid and Medicare?

A “dual-eligible” Medicare special needs program may be available to New Mexicans who qualify for Medicare and Medicaid (DSNP). 

New Mexico Waiver

For more information, please visit https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NM.

The following are the waivers of Mexico:

  • Coordinated Long Term Services;
  • Mi Via-ICF/M.R.;
  • Mi Via NF ;
  • Developmental Disabilities Waiver 
  • Medically Fragile
  • Centennial Care Waiver

Copayments?

They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by New Mexico Medicaid?

New Mexico Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for New Mexico Medicaid?

Income from the applicant spouse might be transferred to the non-applicant spouse if their monthly income is less than $2,288.75 to raise it.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for New Mexico Medicaid, thanks to the asset spend down option.  

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
  • When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in New Mexico?

The best plan for you is the one that meets your demands and offers the most benefits in terms of health insurance and monetary help because it varies from person to person.

Where do I find the letter showing the reason(s) for denial or discontinuance from New Mexico Medicaid?

By signing into your account at Portal, you can see the progress of your New Mexico  Medicaid application.


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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