Acknowledging the high costs of healthcare and private insurance, the federal government funds Medicare, which offers health insurance coverage to persons over 65. Americans with certain disabilities may also qualify for New Mexico Medicare insurance.
While Medicare is federally supported, the state government of New Mexico also offers several programs designed to assist Medicare beneficiaries living in the state. These programs provide various degrees of financial assistance, as well as free counseling regarding Medicare issues.
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New Mexico Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2024 Medicare trends in New Mexico:
- A total of 451,437 residents of New Mexico are Medicare enrollees.
- The average Medicare Advantage monthly premium decreased from $12.65 in 2023 to $13.57 in 2024 for New Mexicans.
- As of 2024, there are 62 Medicare Advantage plans available in New Mexico.
- All New Mexico residents with Medicare can purchase a Medicare Advantage plan, including those with $0 premiums.
- As of 2024, there are 22 stand-alone Medicare prescription drug plans offered in New Mexico.
- The lowest monthly premium for a Medicare prescription drug plan is $0.50.
Medicare Offered in New Mexico
Medicare is a government health care program that offers financial assistance to those 65 or older and people of any age with specific disabilities.
Original Medicare
At the heart of Medicare is Original Medicare, which may be obtained from the Medicare agency itself. It comprises Medicare Part A and Part B. Part A doesn’t typically require a premium. It covers various hospital services, including inpatient care and care in skilled nursing facilities.
Medicare Part B deals with medically necessary treatments, including outpatient care, durable medical supplies, and preventive screenings. Medicare Part B requires most beneficiaries to pay a premium, but the amount will depend on the beneficiary’s annual income.
Medicare Advantage
Medicare Advantage plans in New Mexico offer you a range of coverage options at all premium levels. These include Medicare Part A, B, and D benefits and drug coverage with additional optional health and fitness services (like dental or vision) for those who need it. Each plan comes with various benefits and will have differing costs.
Other types of supplemental plans can cover healthcare services not covered by either Medicare Part A or Part B. The supplemental plan can even cover the costs of deductibles and other out-of-pocket expenses.
These plans will also require a premium, which will have to be paid in addition to the premium for Medicare Part B.
New Mexico Medicare Advantage options include plans from the following private insurance companies:
- United Healthcare
- Blue Cross Blue Shield of New Mexico
- Presbyterian Senior Care
- Cigna
- Aetna
- Molina
- Amerigroup Community Care
- Lasso
- WellCare
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Medicare Supplement Plans
If you are a New Mexican and want to save money on Medicare, consider applying for a Medigap plan. These plans can help cover some of the costs associated with original Medicare, like copays and coinsurance costs. However, the cost and out-of-pocket expenses will vary from company to company.
Your eligibility varies depending on where you live within the state. All of the plan categories are standardized under Medigap so that the same plan will have the same benefits regardless of the insurer. Medigap plans are not compatible with Medicare Advantage. You can only have one or the other!
As of 2024, some of the companies offering Medigap plans within New Mexico include:
- AARP – UnitedHealthcare
- American Continental
- Blue Cross and Blue Shield of New Mexico
- Cigna
- Garden State
- Great Southern
- Lumico
- Sentinel Security
- State Farm
- USAA
New Mexico Medicare Enrollment
New Mexico residents are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
Requirements
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
New Mexico Enrollment Tips & Advice
A significant number of New Mexico residents find it difficult to afford Medicare expenses. New Mexico has among the highest enrolment rates for their Medicare Savings Programs (MSP) at 71%. The national average is 51%.
In New Mexico, the following services are available to you at no cost to help with your enrollment and questions regarding expenses or rebates:
- The Department of Aging
- State Health Insurance Assistance Program (SHIP)
- Prescription Drug Assistance in New Mexico
How Do I Enroll in a Medicare Plan?
If you have any questions about New Mexico Medicare and your eligibility for supplement or advantage plans, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.
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