New Mexico Health Insurance

According to the Center for Disease Control, an average of 21.3% of New Mexico residents went uninsured for New Mexico health insurance each year between 2001 and 2003.

New Mexico Health Insurance Regulations

Under New Mexico health insurance law, any individual obtaining health insurance through an employer cannot be denied or limited access to that health insurance. Individuals looking for individual New Mexico health insurance can be denied and limited in coverage. Any individual looking to renew his or her health insurance through a New Mexico health insurance company is guaranteed the right to renew coverage provided no false information has been provided and all premiums have been pain on time. This is called a guaranteed renewability provision.

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Pre-Existing Conditions

New Mexico health insurance can impose both elimination riders and pre-existing condition exclusion periods. Elimination riders permanently exclude a medical condition or body part from any coverage under the plan. Pre-existing condition provisions exclude coverage for any condition for which an individual was diagnosed, treated, or obtained medical advice during the 6 months prior to the beginning of new coverage. The pre-existing exclusion period can last a maximum of 6 months, but it does not apply to HIPAA eligible individuals.

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Pregnancy

Pregnancy can be considered a pre-existing condition under New Mexico health insurance law. If a parent has individual health insurance with dependent coverage, than that coverage automatically covers newborns and adopted children for the first 31 days after birth or adoption.

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Temporary Insurance

New Mexico health insurance rates vary depending on age, gender, smoking, and health. If an individual is covered under the Alliance (see below), however, that coverage cost is limited. Temporary New Mexico medical insurance is available through some companies for individuals looking for health insurance coverage between jobs or between policies.

Alternative New Mexico Health Insurance Options

For individuals, families, small businesses and self-employed individuals who have difficulty obtaining health insurance in New Mexico, the following state programs may help:

• New Mexico Health Insurance Alliance is for self-employed individuals without employees. This group of individuals can purchase a small group New Mexico health insurance plan through the Alliance. Coverage is available only if the individual is covering self and one additional family member. Pre-existing exclusion periods may apply.
• New Mexico Medicaid is available to any qualifying individual who meets the eligibility requirements.
• New Mexico Medical Insurance Pool (NMMIP) is the high-risk pool for New Mexico. It allows individuals who might otherwise be considered “uninsurable” the ability to purchase health insurance through a group plan through the state. Pre-existing exclusion periods may apply.
• New MexiKids is the state’s Children’s Health Insurance Program and is designed to provide health insurance for children under 19 whose families may not qualify for Medicaid and who may not be able to afford New Mexico health insurance.
• New Mexico State Coverage Insurance is a program for uninsured, self-employed individuals and small businesses. Individuals must meet eligibility requirements and must be between 19 and 64 years of age. Individuals cannot be turned down for health reasons.

New Mexico Division of Insurance

Mailing Address:
P.O. Box 1269
Santa Fe, NM 87504-1269

Switchboard (505) 827-4601
Toll Free in New Mexico (800) 947-4722
Fax Number (505) 827-4734

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For other New Mexico Insurance Resources, See:

• New Mexico Auto Insurance
• New Mexico Home Insurance
• New Mexico Health Insurance

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