Medicare in New Mexico
Written by: Aaron Garcia
Reviewed by: Shikita Nunnery, Licensed Insurance Agent
Key Takeaways
Medicare in New Mexico is a federal program available to all legal U.S. residents aged 65 and older.
Original Medicare’s Parts A and B cover hospital and medical services. Medicare Advantage in New Mexico is an alternative that often bundles Part D and other services.
The pricing for Medicare plans in New Mexico is based on standard costs and personal details like your work history and income.
Red or green chile — it’s the fundamental question New Mexicans may answer several times a day. And let’s face it, it doesn’t matter what you decide, as long as it’s not “Christmas-style” or “mild.”
But there’s another critical decision to make if you’re close to 65 or older: how to receive your Medicare in New Mexico. Ask yourself some important questions: What are the different kinds of Medicare? How much does Medicare cost? Does Medicare Advantage in New Mexico make sense for me?
My Medicare coverage doesn’t address all of my needs.
Find The Right PlanHow Do I Apply for Medicare in New Mexico?
There are several ways you can enroll in Medicare in New Mexico, including:
- Online through the Social Security Administration
- In person at a local Social Security office.
- Over the phone at 1-800-772-1213 (TTY: 1-800-325-0778)
If you’re already receiving Social Security or Railroad Retirement Board (RRB) benefits, you may be automatically enrolled when you turn 65. If not, you’ll probably need to enroll yourself. Your first chance to sign yourself up is known as your Initial Enrollment Period (IEP). This is a seven-month window that includes your birth month, plus the three months before and after.
With Medicare, timing can be everything, so you’ll want to know more about your IEP and Medicare’s other enrollment periods.
What Is the Income Limit for Medicaid in New Mexico?
It’s important to know that Medicaid is not the same as Medicare in New Mexico. Medicaid is a state and federal program designed to help low-income adults, children and seniors. In New Mexico, this also applies to Native Americans living in tribal and non-tribal areas. There are several programs, and eligibility depends on your income and household size.
Find a local Medicare plan that fits your needs.
Find Plans TodayWhat Are the Standard Medicare Costs for 2024?
Medicare Part A
Premium:
- $0 if you or your spouse worked 10 or more years
- $278 a month if you worked between 7.5 and 10 years
- $505 a month if you worked fewer than 7.5 years
Deductible:
- $1,632 each plan period
Copayments & coinsurance:
- Hospital stays: $0 copay for Days 1-60 following deductible payment; daily charges for Days 61 and after
- Skilled nursing facility: $0 for Days 1-20 (each plan period); daily charges for Days 21 and after
Medicare Part B
Premium:
- $174.70 monthly and up
- Income-based
Deductible:
- $240
Copayments & coinsurance:
- None for most preventative services.
- 20% of the Medicare-approved costs for other services.
- 35% for outpatient health services.
Medicare Part D
Premium:
- Income-based; varies by plan
Deductible:
- Plan-based; not to exceed $545 in 2024
Copayments & coinsurance:
- Depends on plan specifics and drugs needed
What Is the Best Medicare Plan?
The answer to this question is completely based on you and your needs. Choosing between Medicare plans in New Mexico should start with understanding your options.
There are two main ways to receive Medicare in New Mexico: Original Medicare (Parts A and B) and Medicare Advantage (Part C). Here’s how they work:
Original Medicare (Parts A and B)
Original Medicare is made up of Parts A and B. They work separately and provide a base level of care.
- Part A: Helps cover stays at hospitals, nursing homes, skilled nursing facilities, hospice care, and some home health care.
- Part B: This portion helps cover medically necessary and preventive services from doctors and other providers
Medicare Advantage (Part C)
Medicare Advantage (Part C) substitutes for Original Medicare (Part A & B) and offers the same benefits. Part C plans usually bundle additional services like dental, hearing, vision, and prescription drug coverage.
New Mexicans on Original Medicare may also choose to enroll in a Medicare Prescription Drug Plan (Part D) and Medicare Supplement Insurance (Medigap).
Medicare Prescription Drug Plan (Part D)
Part D provides prescription drug coverage as a standalone plan purchased separately from Original Medicare. Medicare Advantage plans typically include Part D coverage.
Medicare Supplement Insurance (Medigap)
Medigap policies are sold separately by private insurance plans and help cover “gaps” in Original Medicare. These gaps refer to the range of high out-of-pocket costs that can come with Parts A and B, such as deductibles, coinsurance and copays. Like Part D, Original Medicare enrollees pay their Medigap premiums separately from Original Medicare.
Find the Medicare Plan that works for you.
Find My Ideal PlanWhat Are the Disadvantages of Medicare Advantage Plans?
The answer really depends on what you need out of your plan. It doesn’t matter whether you have Medicare Advantage or Original Medicare in New Mexico; what may be an advantage for someone in Las Cruces could be a downside for folks in Farmington. To help, here are some resources to figure out how the Medicare plans in New Mexico stack up for you:
- Enrollment Checklist: Assess your budget, coverage needs and enrollment timing
- Medicare Star Rating System: See what other enrollees think of their plans
- Pros and Cons: What to know about Original Medicare vs. Medicare Advantage in New Mexico
- Pro Tips: Little-known pointers you’ll want to know
- Contact GoHealth: Our licensed insurance agents are available to shop plans and explain the differences you need to know.
What Are the Top Medicare Advantage Plans?
There are several Medicare Advantage options to choose from in New Mexico. They may include the following plan types:
- A Health Maintenance Organization (HMO) uses primary care physicians and provider networks to manage your care.
- Preferred Provider Organizations (PPO) use primary care physicians but offer some out-of-network coverage
- Private Fee-For-Service (PFFS) plans pay your providers each time you receive a service.
- Special Needs Plans (SNP) help enrollees living with specific health conditions. D-SNP assists dual eligible individuals, and C-SNP is for people with chronic diseases.
Finding the right Medicare for you comes down to your needs and which plans are available in your area. If you need help exploring Medicare plans in New Mexico and how they’ll work for you, give GoHealth a call. Our licensed insurance agents will talk through your needs and options to find a plan that works for you.
Looking for a plan with prescription drug coverage?
Find My Ideal MA PlanMedicare in New Mexico by the Numbers
Medicare
New Mexico
See more +
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
New Mexico Medicare Resources & Contacts
To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which New Mexico-based resources, like these, may be able to help:
Nationwide Resources
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status