Medicare New Mexico offers healthcare coverage to people age 65 and older. There are several types of plans and insurance providers, so research your options thoroughly before you sign up for Medicare New Mexico.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in New Mexico for the 2021 plan year:
- A total of 431,894 residents of New Mexico are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly decreased in New Mexico compared to last year — from $16.47 in 2020 to $13.26 in 2021.
- There are 47 Medicare Advantage plans available in New Mexico for 2021, compared to 38 plans in 2020.
- All New Mexico residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in New Mexico for 2021.
There are four main types of Medicare plans in New Mexico, and understanding each one will help you make an informed decision about your healthcare needs. Each type offers different coverage options, from basic to comprehensive.
Also known as Part A and Part B, original Medicare New Mexico provides basic healthcare coverage to people age 65 and older across the United States. If you qualify for social security benefits, you’ve likely already been enrolled in Part A and may qualify for premium-free coverage.
Original Medicare coverage includes:
- hospital services
- hospice care
- part-time home health services
- short-term skilled nursing facility stays
- outpatient services
- annual flu vaccine
- blood tests
- doctor’s appointments
Medicare Advantage in New Mexico
Medicare Advantage (Part C) plans in New Mexico give you a range of coverage options at all premium levels.
These all-in-one plans include all the services covered by original Medicare, as well as drug coverage. Some Medicare Advantage plans in New Mexico also include additional coverage for health and wellness programs, preventative health, dental care, or vision needs.
Medicare Advantage plan carriers in New Mexico include:
- Amerigroup Community Care of New Mexico
- Blue Cross Blue Shield of NM
- Lasso Healthcare
- Molina Healthcare of New Mexico
Not all carriers provide insurance in all counties, so check the location requirements of each provider, and use you ZIP code when searching to make sure you’re only looking at plans that are available in your county.
Medicare supplement plans in New Mexico
Medicare supplement insurance (Medigap) plans are available through private insurance carriers in New Mexico. These plans help cover some costs of original Medicare, like copays and coinsurance costs.
Many insurance companies offer Medigap plans in New Mexico. As of 2021, some of the companies offering Medigap plans throughout the state include:
- AARP – UnitedHealthcare
- American Continental (Aetna)
- Blue Cross and Blue Shield of New Mexico
- Garden State
- Great Southern
- Sentinel Security
- State Farm
These plans are only available with original Medicare. You may not purchase both a Medicare Advantage plan and a Medigap plan.
Most people age 65 and older are eligible for Medicare New Mexico. To be eligible you must:
- be age 65 or older
- be a citizen or permanent resident of the United States for the past 5 or more years
You may also qualify for Medicare New Mexico if you:
- have a permanent disability
- have been eligible for Social Security disability benefits for 24 months
- have a chronic illness such as amyotrophic lateral sclerosis (ALS) or end stage kidney disease (ESRD)
When can I enroll in Medicare New Mexico plans?
The initial enrollment period is your first opportunity to enroll in Medicare New Mexico coverage. This 7-month period starts 3 months before the month you turn 65, includes your birth month, and stretches 3 months after your turn 65. You can enroll in Medicare parts A and B during this time.
Other times you can enroll in Medicare include the open enrollment period (January 1 to March 31) and annual enrollment period (October 15 to December 7).
You may also be able to enroll during a special enrollment period if you’ve recently certain qualifying life changes.
Tips for Enrolling in Medicare in New Mexico
With so many Medicare plans in New Mexico, it will take some time to find the right plan for your health needs and budget. Here are some tips to help you evaluate your plan options.
- Find out if your preferred doctor or pharmacy is covered. Each Medicare Part D and Advantage Plan carrier works with a set number of network-approved doctors and pharmacies. Call your doctor’s office to find out what carriers they work with, and make sure you’re only considering plans that will cover your doctor’s appointments.
- Make a complete list of your current medications and prescriptions. Each plan has a list of drugs covered, so compare that list against your own and only opt for a plan that will provide you with appropriate drug coverage.
- Compare ratings. To find out what others have thought about each plan, compare the star ratings of each plan to see which performs better. CMS uses a 1- to 5-star rating system, where a 4 or 5 indicates that people who were enrolled in the plan the previous year had good experiences with it.
If you need advice on how to choose a plan, or to clarify your eligibility or enrollment dates, contact any of the following state organizations for help.
- New Mexico Department of Aging & Long-Term Services, 800-432-2080. The Department of Aging provides unbiased counseling on Medicare, State Health Insurance Assistance Program (SHIP) services, Ombudsman information, and access to services such as meals or groceries.
- Paying for Senior Care, 206-462-5728. Find out about Prescription Drug Assistance in New Mexico, as well as financial assistance for care and assisted living.
- Medicare, 800-633-4227. Contact Medicare directly to ask about Medicare plans in New Mexico, ask about Star Ratings, or enquire about special enrollment periods.
- More than 400,000 New Mexico residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in New Mexico.
- There are also several Medigap plan options if you live in New Mexico and are looking for additional coverage.