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New Mexico Health Insurance

If you are looking for health insurance, you are likely to get it in two broad categories: individual and group. Individual insurance seekers are mostly self-employed, or are employed by a company that does not have provision for health insurance, or who have a family and who require individual insurance for their family members. In case you opt for an individual policy, you will have to pay an annual premium as well as a deductible for each insured dependent, up to a base amount. Or if you opt for a group policy instead, you have to pay an annual premium, co-payments payable at each medical service, and a deductible payable before the insurer company starts to pay your legitimate medical bills.

New Mexico allows health insurance companies to turn down your application for individual insurance because of a medical condition. In case you have a pre-existing condition, insurers can impose elimination riders on policies. The insurers can also require exclusion periods not exceeding six months at the beginning of new individual coverage. In New Mexico, neither pregnancy nor genetic information can be considered a pre-existing condition. Individual premium costs cannot be changed because of changes in health status, but there are no limits to increases otherwise. Your insurance cannot be cancelled due to illness.

In New Mexico, no qualified person can be refused group health insurance or charged more for a policy on account of a health problem. Life changes concerning family problems, children, marriage, and job loss can affect your opportunities for group health coverage. Your new employer may need a waiting period before offering group health coverage. Pre-existing conditions are set by the new insurer which can look back at your health records for the six months prior to insurance coverage. It can then apply an exclusion period not exceeding six months for fully insured groups on the pre-existing condition, before providing coverage. If you have had unbroken coverage of more than 63 days, you qualify for continuous coverage.

Small businesses with two to 50 employees in New Mexico cannot be refused small group health coverage; their insurance cannot be cancelled either because of illness in the employee group. New Mexico regulations require that you be offered several insurance plans. Annual rise in premium costs has certain limits. You may also purchase your group coverage through the New Mexico Health Insurance Alliance.

Normally self-employed individuals cannot buy group health insurance in New Mexico. However, if you and at least one other family member apply jointly for small group coverage, you can purchase it from the New Mexico Health Insurance Alliance. For joining professional associations which offer group health insurance to its members, one should contact the New Mexico Insurance Division for regulations.

The New Mexico Health Insurance Alliance offers statewide private health insurance to HIPAA eligible persons, small businesses, and the self-employed who qualify. New Mexico Medical Insurance Pool offers individual coverage to residents who have been refused individual insurance. Medicaid and New Mexi Kids also help low income residents of the state.

Since selecting the right quotes is not easy, you should do some research before arriving at a final decision. However, it is certainly better if you appoint professional health insurance agents and brokers who can be of great help in this regard.

Prominent health insurance providers in New Mexico are American Medical Security, Assurant Health (formerly Fortis), Blue Cross and Blue Shield of New Mexico, Celtic and Security Life.

 

 

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Useful links and information:

New Mexico Division of Insurance
(800) 947-4722 (New Mexico calls only)
(505) 827-4601
http://www.nmprc.state.nm.us/insurance/inshm.htm

U.S. Department of Labor, Dallas Regional Office
(214) 767-6831, or

U.S. Department of Labor, Division of Technical Assistance and Inquiries, Washington, D.C.
(202) 219-8776

For Department of Labor publications:
(800) 998-7542
http://www.dol.gov/dol/pwba

New Mexico Human Services Department, Medical Assistance Division
(505) 827-3100
(888) 997-2583
http://www.state.nm.us/hsd/mad/Index.html

Internal Revenue Service (IRS)
(866) 628-HCTC
http://www.irs.gov/individuals/index.html

 

 

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