In New Mexico, as in many other states, your health insurance options are somewhat dependent on your health status.  Even if you are sick, however the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination (see page 6).
• All group health plans in New Mexico must limit exclusion of pre-existing conditions. There are rules about when a pre-existing condition exclusion period can be applied and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage (see page 8).
• Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable (see pages 14 and 25).
• If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage (see page 14).
• If you lose coverage under a fully insured group health plan in New Mexico, you can buy a conversion policy. This is an individual policy from the company that insured your former group. You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for a conversion policy (see page 19).
• If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you can buy individual health insurance from the New Mexico Medical Insurance Pool (NMMIP) or from the New Mexico Health Insurance Alliance (the Alliance). You will not have a pre-existing condition exclusion period. There are limits on what you can be charged for coverage under NMMIP and the Alliance (see pages 20 and 22).
• If you are not HIPAA eligible but have difficulty obtaining an affordable individual health insurance policy because of your health condition, you may also be eligible NMMIP coverage. There are limits on what you can be charged for an NMMIP policy (see page 23).
• If you are a small employer buying a group health plan policy, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis (see page 26).
• In addition, if you are self-employed with no other workers, you are eligible to obtain coverage through the Alliance if you enroll with a dependent (see page 27).
• If you are a small employer buying a group health plan policy through the Alliance, you cannot be charged more due to the health status of those in your group, however the Alliance can charge you more, within limits, based on age, gender, family size, where you live, and the plan that you choose. This is called modified community rating (see page 29).
• If you are a small employer buying a group health plan policy outside of the Alliance, you can be charged more, within limits, based on the health status and other factors of those in your group (see page 29). Even with these limits, however, premiums can be significantly higher if someone in your group has a serious health condition (see page 27).
• If you work for an eligible small employer or are self employed, you may be able to obtain insurance through the Small Employer Insurance Program (see page 30).
• If you work for a small employer, are self-employed, or meet other eligibility requirements you may be able to buy subsidized health insurance through the State Coverage Insurance program (see pages 31 and 38).
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The New Mexico Medicaid program offers free or subsidized health coverage for families with children, pregnant women, elderly, and disabled individuals with very low incomes (see Chapter 5).
• If your children are under the age of 19, do not have health insurance and meet other qualifications, you may be able to buy insurance for them through the New Mexi Kids Program (see page 32).
• If you believe that you have or at risk for breast or cervical cancer, you may be eligible for free screening and treatment.
• The New Mexico Breast and Cervical Cancer Early Detection Program provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer may be eligible for treatment through the New Mexico Medicaid Program (see page 32).
• If you have a low or modest household income, you may be eligible for subsidized health insurance through the State Coverage Insurance Program (see pages 31 and 38).
• If you have lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 65% of the cost of qualified health coverage, including COBRA (see page 33).
• If you are a retiree aged 55-65 and receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), then you may also be eligible for the HCTC (see page 33).