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An Overview on Medical Insurance in New Mexico

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Medical Insurance in New Mexico

Medical Insurance in New Mexico

Introduction: The health insurance situation in New Mexico is very much displeasing, in respect of health insurance situation in other states of United States. The Center for Disease Control conducted a survey on New Mexico health insurance situation. The survey report revealed that over 21% of the total New Mexico residents did not get health insurance coverage for each year, between 2001 and 2003.

Here, in this article, we have talked about the New Mexico medical insurance regulations, elaborately. The article also contains a brief discussion on New Mexico state-aided medical insurance alternative options. Being a New Mexico dweller, you can make use of this article to get informed about the health insurance status of your state.

Some Regulations for New Mexico Medical Insurance

To control the overall New Mexico health insurance market and to monitor the activities of different New Mexico medical insurance companies, the state government has introduced some regulations that are discussed below:

  • As per New Mexico health insurance rules, all New Mexico medical insurance companies should provide coverage to the New Mexico residents, who have medical insurance through a company. Moreover, the individuals can not be limited access to New Mexico medical insurance.
  • However, New Mexico individuals seeking for individual medical insurance coverage can be refused or limited access to coverage, depending on the health condition and age.
  • Every New Mexico medical insurance plan should be consisted of a guaranteed provision for renewal.
  • Guaranteed renewability provision lets a New Mexico individual renew his or her existing medical insurance plan.
  • Renewal provision is guaranteed, only if the policy holder has disbursed all the premiums, in time and provided no fake information, during the term of the existing policy.
  • New Mexico medical insurance companies can implement both of pre-existing health condition waiting periods and elimination riders.
  • According to health insurance laws, a pre-existing health condition may be defined as an illness for which an individual was treated or otherwise diagnosed or received advice within 6 months, before application for a new health insurance plan.
  • As per New Mexico medical insurance regulations, an elimination rider can turn down an individual from getting coverage for a health condition, body system or body part, even permanently; for the entire term of a policy.
  • Pre-existing health condition waiting period can not be imposed on HIPAA eligible New Mexico individuals.
  • New Mexico medical insurance companies can inflict a waiting period for any health condition for no more than 6 months.
  • As per state laws, pregnancy may be considered as a pre-existing health condition and medical insurance companies can impose a waiting period for pregnancy.
  • All newborns and adopted children should be covered under parent's individual New Mexico health insurance plan that offer dependant coverage; for the first 31 days from the day of birth or adoption.
  • New Mexico health insurance costs differ; based on gender, age, and health condition and tobacco use of the applicant. Coverage cost is restricted, if a New Mexico individual is getting coverage under New Mexico Health Insurance Alliance.
  • New Mexico residents, who are between employers or medical insurance policies, are able to access temporary New Mexico health insurance plans offered by several health insurance companies.

New Mexico Medical Insurance Alternative Options

New Mexico state government offers some medical insurance alternative programs to the individuals, small businesses, self-employed and families those are residing in New Mexico and having difficulties to get New Mexico health insurance. The programs are as follows:

  • New Mexico Health Alliance: This state program is perfect for the New Mexico self-employed individuals with no recruits. Through New Mexico Health Alliance, these individuals can buy a small group New Mexico medical insurance policy. However, coverage is obtainable, only if a self-employed individual is covering self as well as his or her family members. Pre-existing health condition waiting period may be applied.
  • New MexiKids: This is New Mexico's Children's Health Insurance Program or NMCHIP, which is especially designed to provide coverage to the children below and up to the age of 19. However, children from the families that are not eligible for New Mexico Medicaid and unable to pay for New Mexico medical insurance are only eligible for the program.
  • New Mexico State Coverage Insurance: This program is especially designed for the self-employed, small businesses and uninsured individuals. To get access to this program, the applicant should meet all the qualifying criteria and should be between the age of 19 and 64. The applicants can't be refused for any health condition.
  • New Mexico Medicaid: New Mexico individuals, who meet all the health-related as well as income criteria, can access this program.
  • New Mexico Medical Insurance Pool or NMMIP: This is the New Mexico medical insurance high-risk pool. New Mexico individuals, who are considered to be “uninsurable” by most of the insurers, can purchase group New Mexico medical insurance policy, through this program.

New Mexico Division of Insurance

The mailing address of New Mexico Division of Insurance is provided below:

New Mexico Division of Insurance

P.O. Box 1269
Santa Fe, NM 87504-1269
Switchboard telephone no: (505) 827-4601
(800) 947-4722 (Toll-free in New Mexico)
Fax No: (505) 827-4734


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