New Mexico Medicaid Statistics

Enrollment

  • In 2011, 42% of New Mexico Medicaid enrollees were male and 58% were female.

Costs Covered

  • Total Medicaid spending for New Mexico in 2012 was $3 billion.
  • 31% of Medicaid spending for New Mexico in 2011 went toward individuals with disabilities.
  • 19% of Medicaid spending for New Mexico in 2011 went toward adult individuals (non-disabled, non-elderly).

Conditions

  • In 2008, 51% of New Mexico pregnancies were unintended.
  • In 2010, 13% of New Mexico residents smoked cigarettes.

CHIP

  • In September 2012, 68% of children in New Mexico were enrolled in Medicaid.

Medicaid Expansion

  • An estimated 147,000 New Mexico residents have access to Medicaid with the expansion.
  1. What is Medicaid?

Medicaid is the country’s largest healthcare insurance programs, providing coverage to millions of low-income individuals and families. It is funded by both federal and state governments, and several potential enrollees can qualify, depending on a set of financial requirements, general requirements and medical necessity.

If you have a child or children in your home residing with you, you will be glad to know that they may be eligible to apply for Medicaid’s Children’s Health Insurance Program (CHIP). As part of the eligibility criteria, any child under the age of 19 may qualify for CHIP. Coverage includes a number of healthcare benefits, ranging from routine checkups and doctor appointments to dental care and vision examinations. In order to begin the application process, you can apply on your child’s behalf by visiting the Medicaid New Mexico website.

Since 2014, due to a provision in the Affordable Care Act, 28 states across the country have expanded their Medicaid coverage. Now, millions more have access to the program and a slew of health-related benefits and services that they may not have been able to take advantage of before. New Mexico is one of the states that has allowed Medicaid expansion to reach thousands more of their residents.

  • How do I apply for Medicaid in New Mexico?

You can apply for NM Medicaid, also now known as Centennial Care, through the New Mexico Human Services Department, by either submitting your form online, in person or mailing it in. If you wish to send your application online through the NMHSD website, you will first need to create an account with login and password. Make sure to have certain documents with you in order to facilitate the process when filling out information about yourself. For example, you will be asked for proof of income, proof of current expenses, proof of pregnancy (if applicable), proof of disability (if applicable), proof of identity, proof of Social Security Number, proof of New Mexico residency, proof of immigration status and proof of United States citizenship.

To apply for Medicaid in NM at a field office, simply visit a location near your city or county. You can search for Medicaid offices online and obtain contact information, hours of operation, physical address and fax number under each listing.

If your preferred option is to send your Medicaid application by mail, simply write to the address below:

New Mexico Department of Human Services
PO Box 2348
Santa Fe, NM 87504-2348

You can follow up about the status of your application by calling the toll-free NM Medicaid phone number at 1-888-997-2583. If you need assistance in Spanish, call 1-800-432-6217.

  • What does New Mexico Medicaid cover?

As a general rule, each state must offer a wide range of mandatory Medicaid benefits. Said benefits must encompass everything from basic medical services to certain types of exams and hospital care. For example, you will find the following services available to you as part of your Medicaid plan: home health services, physician services, family planning services, rural health clinic services, transportation to medical facilities, laboratory testing, X-ray services, freestanding birth center services, inpatient hospital care, outpatient hospital care and Early and Periodic Screening, Diagnostic and Treatment services (EPSDT).

The state of New Mexico may choose to offer additional benefits, depending on the type of plan you are enrolled in. These services may also be part of medical assistance coverage: hospice, personal care and assistance, dental services, prosthetics, respiratory care services, clinic services, physical therapy, occupational therapy, speech services, hearing services, language disorder services, senior services for those in a mental disease institution, prescription medicine and state plan home and community based services.

To find out the specifics about your plan, contact a local Medicaid customer service agent who will be able to review the details with you. If you have a child you wish to enroll in the Children’s Health Insurance Program (CHIP), you can also ask question about their coverage and the benefits offered.

  • Who is eligible for Medicaid in New Mexico?

A number of factors come into play when determining who qualifies for New Mexico Medicaid. In terms of financial requirements, an eligible individual or family must have low income. Additionally, one or more of the following factors must apply:

  • You are a blind individual.
  • You are an individual with a disability.
  • You are a senior over the age of 65.
  • You are a pregnant woman.
  • You are the parent of a dependent child or children.
  • You are the caretaker of a dependent child or children.

You must also be a United States citizen or a legal immigrant in order to apply. When submitting your NM Medicaid application, you will be required to show proof that you are a New Mexico resident, along with your current immigration status. If NM Medicaid is unable to verify proof of any necessary requirements, your application process may be delayed.

For a child to enroll in the Children’s Health Insurance Program (CHIP), they must be under the age of 19. To find out more, you can call the National CHIP line at 1-877-543-7669. The enrollment period is open all year round, so you can begin the application process at any time.

Review the 2015 New Mexico Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.
  • What is the Medicaid expansion? Did my state accept the Medicaid expansion?

With the Affordable Care Act, there are 28 states that have chosen to expand their Medicaid coverage, and thus provide greater medical assistance and health care benefits to low income individuals and families. Thankfully, New Mexico has expanded Medicaid, and thus an additional 147,000 individuals in the state can now gain access to this nationwide program and obtain health insurance.

Other states that have climbed onboard with Medicaid expansion include the following: North Dakota, West Virginia, Hawaii, Illinois, California, Colorado, New Hampshire, New Jersey, Hawaii, Connecticut, Arkansas, Arizona, Delaware, Washington, Minnesota, Michigan, Vermont, Maryland, Oregon, Ohio and more. Presently considering expansion are Utah, Wyoming, Indiana and Tennessee, though a decision has yet to be made.

When it comes to the federal government’s involvement with Medicaid expansion, they currently cover 100 percent of related costs. By 2020, however, this is expected to change and each state will need to chip in 10 percent of the funding. You can find out more about the specifics of New Mexico’s Medicaid expansion by contacting your local human services office. A NM Medicaid representative will be able to assist you with any queries you have.

  • How do I contact New Mexico Medicaid?

If you need assistance with the application process or if you want to learn how to apply for Medicaid, the New Mexico Department of Human Services will be able to guide you in the right direction.

In order to speak to a Medicaid agent in person, you can search for Medicaid office locations on their website and find the one nearest you. You can narrow your search options with helpful filters such as Address, P.O. Box, Contact Phone Number, Contact Fax Humber, Resource Links (if applicable) and Hours of Operation. For your convenience, each office location listing will contain all of these important details. Most NM Medicaid branches are open Monday through Friday, from 8 a.m. to 4 p.m. No office is open to the public on weekends.

If you would like to speak to a professional over the phone, you can call the New Mexico Medicaid toll-free phone number at 1-888-997-2583. Local residents can call 505-827-3100. Individuals who need assistance in Spanish should dial 1-800-432-6217.

To submit your query or request by mail, write to the New Mexico Department of Human Services at the address below:

PO Box 2348
Santa Fe, NM 87504-2348

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