Health Insurance Companies New Mexico Options and Enrollment

New Mexico residents have several health insurance options to choose from, including Blue Cross and Blue Shield of New Mexico, Presbyterian Health Plan, and UnitedHealthcare. These companies offer a range of plans to fit different budgets and needs.

Blue Cross and Blue Shield of New Mexico, for example, offers a variety of plans, including HMO and PPO options, and covers services such as doctor visits, hospital stays, and prescription medications.

Presbyterian Health Plan is another option, offering plans that cover services like primary care, specialist care, and hospital stays, with different levels of coverage available to suit different needs.

New Mexico residents can enroll in health insurance through the state's health insurance marketplace, or by purchasing a plan directly from an insurance company.

New Mexico has a diverse range of health insurance companies offering coverage through the Marketplace. Five insurers offer exchange plans in New Mexico, including UnitedHealthcare, which joined in 2024.

For 2025, four insurers will participate, as Ambetter/Western Sky will no longer offer coverage. This change affects enrollees with 2024 Ambetter/Western Sky plans, who must select new coverage during the open enrollment period.

One insurer stands out for offering the most affordable health insurance plans in the gold tiers: Blue Cross Blue Shield. Their plans cost an average of $451 before premium tax credits for 40-year-old individuals.

Here's a brief overview of the most affordable health insurance companies in New Mexico:

New Mexico has a relatively stable marketplace with a few changes in recent years. Five insurers offered exchange plans in New Mexico for 2024, but that number will decrease to four for 2025.

One of the most notable changes is the addition of UnitedHealthcare as a new insurer for 2024. However, Ambetter/Western Sky will no longer offer coverage after 2024.

Fortunately, all exchange carriers in New Mexico offer plans statewide, so consumers in all areas of the state have access to the same plans. This is a rare advantage in the US, where plan availability often varies by region.

Here's a look at some of the most affordable health insurance plans in New Mexico:

To be eligible for marketplace health insurance in New Mexico, you must be lawfully present in the US, live in the state, and not be incarcerated. You also can't be enrolled in Medicare.

Short-term health insurance plans in New Mexico are subject to strict regulations. The state's Office of the Superintendent of Insurance (OSI) has the authority to regulate some aspects of these plans.

As of February 1, 2019, short-term plans in New Mexico are limited to non-renewable terms of no more than three months. This means that consumers can't keep renewing their short-term plans.

The Trump administration had initially allowed short-term plans with extended durations, but New Mexico's regulations took effect and limited the terms to three months. This change was made to protect consumers from short-term plans that don't provide adequate coverage.

HB285, a law passed in March 2019, gives OSI the authority to regulate a wide range of provisions related to short-term plans, including minimum loss ratios and minimum standards for benefits. This law strengthens the state's regulatory approach to short-term health insurance.

Consumers who purchase short-term plans in New Mexico must be aware that they can't have had short-term coverage within the previous 12 months. This is a regulation that aims to prevent consumers from relying on short-term plans as a long-term solution.

Short-term plans in New Mexico can't be sold to consumers who have had short-term coverage within the past year. This ensures that consumers are not taking advantage of short-term plans as a way to avoid more comprehensive coverage.

As of April 2019, insurers were required to stop selling non-compliant short-term plans. Any plans that had already been sold had to terminate by December 31, 2019. This was a significant change that aimed to protect consumers from plans that don't meet the state's regulations.

New Mexico's regulations on short-term health insurance plans aim to protect consumers from plans that don't provide adequate coverage. By limiting the terms of short-term plans and regulating the benefits they provide, the state is ensuring that consumers have access to more comprehensive coverage.

The frequency of doctor visits among New Mexico residents varies depending on their insurance type.

Group insurance enrollees in New Mexico have a relatively standard number of doctor visits.

Individual insurance enrollees also have a frequency of doctor visits close to the national average.

Medicare Advantage enrollees in New Mexico, however, visited doctors approximately 25% less than the national average.

New Mexico residents with group and individual insurance spent roughly the same number of days in the hospital as the national average.

Medicaid managed care patients in New Mexico spent a significant amount of time in the hospital, with some patients staying for twice as many days as the national average.

The difference in hospital stay duration is particularly notable when comparing Medicaid managed care patients to those with private insurance.

Medicaid managed care patients in New Mexico spent roughly 20% more days in the hospital than the national average.

To enroll in a health plan through beWellnm, you can visit their website, compare plans, and enroll in coverage during open enrollment or a special enrollment period. You can also get help from an insurance agent, broker, Navigator, or certified application counselor.

If you're looking for a health plan specifically for students, the University of New Mexico offers a health plan administered by BlueCross BlueShield of New Mexico. You can access machine-readable files for UNM Medical Plans to see in-network rates and out-of-network allowed amounts.

To be eligible to enroll in private health coverage through beWellnm, you must be lawfully present in the United States, live in New Mexico, and not be incarcerated. You can use beWellnm's Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies.

In New Mexico, you can enroll in a health insurance plan through the state-based Marketplace, beWellnm. To do so, you can visit their website, compare plans, and enroll in coverage during open enrollment or a special enrollment period.

The open enrollment period in New Mexico runs from November 1 to January 15. To guarantee coverage starts on January 1st, you must choose your plan by December 15th. Otherwise, coverage won't start until February 1st.

There are several ways to enroll in a health insurance plan in New Mexico, including visiting beWellnm's website, enlisting the help of an insurance agent or broker, or contacting them by phone at 1-833-862-3935.

To be eligible to enroll in a private health coverage plan through beWellnm, you must be lawfully present in the United States, live in New Mexico, and not be incarcerated. You must also not be enrolled in Medicare.

The individual health plan, also known as Obamacare or the Affordable Care Act (ACA), is available to those who do not qualify for other types of insurance. This type of insurance is often purchased by self-employed and unemployed individuals who are not eligible for employer-provided insurance.

Here are the basic plan types available through beWellnm:

To qualify for income-based federal subsidies through beWellnm, you must meet certain criteria, including not having access to an affordable plan offered by an employer and not being eligible for New Mexico Centennial Care (Medicaid).

Medicare Enrollment is a crucial step in securing your healthcare coverage. You can learn about Medicare, Medicare Advantage, and Medigap coverage available in New Mexico through a guide.

In New Mexico, Medicare coverage and enrollment can be complex, but understanding the options is key. The state has its own regulations regarding Medicare supplement plans.

To enroll in Medicare, you'll want to consider the different types of plans available, including Medicare Advantage. These plans are offered by private companies that contract with Medicare.

Medicare Advantage plans include various types, such as HMOs, PPOs, and Special Needs Plans. These plans can offer different levels of coverage and costs.

You can find charts showing the cost and number of enrollees for Medicare and Medicare Advantage. However, these charts don't include costs like co-pays or deductibles.

Medicare Advantage plans can be a good option for those who want more flexibility in their healthcare coverage. These plans allow you to see doctors and hospitals outside of your network for an additional fee.

The cost of health insurance in New Mexico can vary significantly. The average cost of health insurance in the state is $6,886 per person, which translates to $27,542 for a family of four.

Marketplace benchmark plans in New Mexico cost an average of $515 per month, making them more expensive than the nationwide average of $497 per month.

For a 30-year-old making $40,000 per year, the median monthly rates across all metal tiers for health care coverage plans in Albuquerque, Las Cruces, Rio Rancho, Santa Fe, and Roswell are $388.70, $472.10, $388.70, $451.36, and $535.81, respectively.

Most subsidy-eligible enrollees in New Mexico will see no changes in their insurance premiums, despite the 10% average rate increase for full-price plans in 2025.

The average cost of health insurance in New Mexico varies by city, with the lowest-cost bronze plan available in the state costing $454 per month on average, the lowest-cost silver plan costing $500 per month, and the lowest-cost gold plan costing $407 per month.

Here's a breakdown of the average monthly rates for health insurance in New Mexico by city:

Selecting a gold-tier plan from New Mexico's state-based Marketplace can be a cost-effective option, with some plans costing as low as $451 per month for a 40-year-old individual.

Blue Cross Blue Shield (BCBS) offers New Mexico's most affordable health insurance plans in the gold tiers, with an average premium of $451 per month.