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New Mexico Health Insurance

 

All health insurance policies in New Mexico are considered guaranteed renewable as long as your premiums are paid up to date.  So this means your health insurance can not be canceled because you become sick.

 

New Mexico mandates that health insurance companies cover newborns and adopted children for the first 31 days, on their parent’s policy.  But inversely pregnancy is, and can be considered a pre-existing condition, except on group health policies.  Pregnancy is a pre-existing condition but not on group health insurance.

 

Some other mandates by New Mexico are minimum hospital stays after mastectomies, and childhood immunizations.

 

The New Mexico Medical Insurance Pool (NMMIP) is New Mexico's high risk pool.  This is a group of residents that do not qualify for private insurance because of their health status. 

 

If you are an individual you will have a 6 month pre-existing clause on your policy while HIPAA eligible individuals will not.

 

The New Mexico Division of Health Insurance is another great resource to find out additional information about health insurance in NM.

 

                               Request a New Mexico Health Insurance Quote

 

 

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New Mexico Small Business Health Insurance

 

In New Mexico, a group health plan, can not base your health insurance premiums on your health.  This is called non discrimination.  Small Business Health Insurance in New Mexico is also guaranteed issue, meaning that you can not be turn down for coverage, while large companies with more than 50 employees can be refused coverage.

 

Pre-existing exclusions are limited on the amount of time they can exclude coverage.  Also if you have current coverage, without lapses, that will be credited against

your pre-existing period.  Pregnancy is not considered a pre-existing condition on a group health plan.

 

New Mexico limits what small business health insurance companies can consider pre-existing.  Currently insurers can only consider treatments, or diagnosis, that occurred within the last 6 months leading up to the new coverage.

 

The maximum pre-existing waiting period is 6 months for an employee. If you are a late enrollee your maximum waiting period is 18 months.  Any pre-existing periods must be applied only after written notice.

 

New Mexico does limit the amount of variation between premiums of different group health plans.  Each Small Business Plan will have certain enrollment periods in which employees can sign on to get coverage.

 

If you are a small business in New Mexico, you will have certain standard options mandated by New Mexico.  As a small employer you must be offer these plans.

 

For additional information on Small Business Health Insurance in New Mexico click here.

 

                               Request a New Mexico Small Business Health Insurance Quote

 

 

New Mexico Individual Health Insurance

 

All New Mexico Health Insurance Policies have to cover disabled children on their parent’s policy into their adulthood.

 

In New Mexico, insurance companies are able to decide if they want to insure you or not.  They can either rate you up or just refuse coverage.  Also New Mexico does not mandate what you buy, so insurance companies are able to design specific policies for specific consumers, rather than make insurance companies offer similar policies.

 

New Mexico allows health insurance companies to include pre-existing conditions.  Some insurance companies will use elimination riders that completely eliminate coverage for a pre-existing condition.  Others will use pre-existing periods of no more than 6 months.

 

Relative to Pre-Existing Conditions, Insurance companies in New Mexico must give credit to prior credible coverage as long as there was not more than a 31 day lapse in coverage.

 

The rates that an individual pays for a New Mexico Health Insurance Plan are based on age, location, health history, family size, sex etc.  Sadly there is no limit on how much an insurance company can charge and individual for coverage.

 

The New Mexico Health Insurance Alliance is a state run program that offers private health insurance to HIPAA individuals as well as small groups and self employed businesses.

 

Members of the Alliance group will have access to HMOs, PPOs and Indemnity policies.  Pre-existing conditions can only be excluded for 6 months on an Alliance plan.  The coverage will be good until you stop paying your premiums or you do not qualify.  For additional information about the New Mexico Health Insurance Alliance click here.

 

New Mexikids is an insurance program started in New Mexico.  The idea of it is to provide affordable health insurance to New Mexico children.  Not everyone will qualify so visit the site to get more information

 

For additional information about Individual Health Insurance in New Mexico click here.

 

                              Request a New Mexico Individual Health Insurance Quote

 

 

New Mexico Self Employed Health Insurance

 

In New Mexico, self employed people are not able to buy health insurance like other small businesses.  As a self employed business owner you have the option of getting on an Alliance policy and being covered under their laws, or to buy an individual policy and be protected under those laws.  It would be wise to look into both options.

 

Another option for affordable New Mexico Self Employed Health Insurance is often associations or self employed groups.  Just keep in mind that not all of these groups or associations are regulated by the state.

 

One benefit for Self Employed people is that they are able to deduct 100% of their health insurance premiums from their taxes!

 

For additional information about Self Employed Health Insurance in New Mexico click here.

 

                               Request a New Mexico Self Employed Health Insurance Quote

 

 

Temporary New Mexico Health Insurance

 

Many situations may arise where you find yourself without health insurance, or about to be without health insurance.  These reasons could range from graduating college to being in-between jobs.  Instead of going without health insurance you should look into getting a New Mexico Temporary Health Insurance Policy.  These policies will be cheap, with high deductibles and low coverage, but getting a New Mexico Temporary Health Insurance Policy is much better than going with out health insurance.  It is important to note, that New Mexico Temporary Health Insurance is not guaranteed renewable.

 

For additional information about Temporary Health Insurance in New Mexico click here.

 

                               Request a New Mexico Temporary Health Insurance Quote

 

 

What types of New Mexico Health Insurance are there?

 

HMO- Health Maintenance Organization.  This type of insurance is called managed care.  This means you have certain network of doctors and hospitals in New Mexico that you have to go to for care.  Most New Mexico HMO’s have office visit co-payments that range from $10 to $35, and hospital deductibles that range from $250 to $1,500.  Often the most affordable health insurance plans are HMO’s due to the fact they are managed care.

 

PPO-Preferred Provider Organization.  This type of insurance is also called managed care but it gives the consumer much more freedom; they allow you to visit any doctor or hospital in or out of network.  Most New Mexico PPO’s have an in network and an out of network charge.  If the in network co-insurance is 100% then the out of network co-insurance would be 80%.  If the in network co-insurance is 90% then the out of network co-insurance would be 70%   Typically New Mexico PPO’s offer co-payments for doctor visits as well as hospitalization. 

 

Indemnity Plan - In New Mexico, as health insurance rates continue to rise, many people are finding it more affordable to drop their health insurance and buy a New Mexico Major Medical Health Insurance Plan.  An Indemnity plan can also be called a major medical plan or catastrophic health insurance.  Whatever you call it, typically a New Mexico Indemnity Plan would cover more “major” claims.  An Indemnity plan has an annual deductible and will usually allow you to pick different co-insurance options.  Indemnity plans allow you access to any doctor or hospital, and for this reason they are typically very expensive.

 

Discount Medical Plans – In recent years many Discount Medical Plans have started to surface.  These plans have relatively inexpensive, but consumers must realize that this is not insurance.  All these companies do is to get their customers discounted rates (20-50% off) on certain procedures at certain physicians and hospitals. 

 

Federal Mandated Health Insurance Laws

 

HIPAA

Along with New Mexico Health Insurance Laws, there are Federal Laws that regulate Health Insurance companies.   HIPAA (Health Insurance Portability and Accountability Act of 1996). This act mandated federal standards for individual and group health insurance plans.  Some of the standards that it established were relative to guaranteed renew ability, crediting for prior health coverage and pre-existing condition waiting periods.

 

ERISA

Large corporations do not have health insurance policies.  Typically they are self funded, meaning the corporation pays for all of their employee’s medical bills instead of buying health insurance.  Most of these “self funded” companies are regulated by the federal government under ERISA (Employee Retirement Income Security Act)

 

COBRA

In New Mexico it is mandated, by the state, that all companies that offer a New Mexico Group Health Insurance Policy must also enable their employees to extend their health coverage temporarily; called Cobra.  A New Mexico Cobra Insurance is typically available for a time period under 18 months.   In New Mexico you are given 60 days to decide if you are going to take New Mexico Cobra Insurance or not.  Once you have passed on the opportunity to take Cobra, you are not eligible to receive it.

 

Cobra Insurance was introduced in 1985.  Cobra stands for Consolidated Omnibus Budget Reconciliation Act.  If you would like more information about your Cobra Insurance options please contact your companies HR department.

 

Often employees are surprised at the cost of a New Mexico Cobra Insurance.  The reason for this is that they are now responsible for 103% (100% of the premium plus a 3% administration fee) of a monthly health insurance premium when they probably only paid 20% while employed. 

 

Whether nor not to take Cobra is an important question, and you should realize there are alternatives to a New Mexico Cobra Insurance Policy.  One should realize what they plan to do in the future.  If you are looking for another job, and it will be a few months before you get a job, it might make sense to look for a New Mexico Temporary Health Insurance Plan.  If you are contemplating working at a consultant, it would be in your best interest to look into a New Mexico Self Employed Health Insurance Policy.   

 

 

 

                           Request a Health Insurance Quote from one of QuicklyQuoteMe’s Agents

 

 

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