MEDICAID

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 Medicaid is a program that provides health coverage to some low-income New Mexico residents. Medicaid covers families with children and pregnant women, the elderly, and people with disabilities, if state and federal guidelines are met.  Legal residents who are not U.S. citizens may be eligible for Medicaid.  Non-citizens who do not have immigration documents cannot enroll in Medicaid, but may be covered if treated for an emergency condition.

  • For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

In New Mexico you may be eligible for Medicaid if you are an infant, a child, pregnant, the parent of a dependent child, elderly, or disabled and your family income meets the Medicaid income standards. 

Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact the New Mexico Human Services Department, Income Support Division for more information.

Low income persons eligible for Medicaid in New Mexico*

Category                        Income eligibility (as percent of federal poverty level)

Child 0-19                       235% (monthly income of about $3,251 for family of 3)

Pregnant woman           185%

Working parents              67%

Non-working parents      29%

* Eligibility information was compiled State Health Facts Online, the Henry J. Kaiser Family Foundation and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level*, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2006:

Size of Family Unit           U.S. Poverty Guideline (annual income)

               1                                           $  9,800

               2                                           $13,200

               3                                           $16,600

For larger families add $3,400 for each additional person.

So, for example, using this guideline, 235% of the federal poverty level for a family of 3 would be an annual income of $39,010, or a monthly income of $3,251.

Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

  • Parents who receive benefits under TANF (also known as NM Works) should know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12-month transitional period.

In addition, your children may continue to qualify for Medicaid if your family’s income meets certain income standards.

  • Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits are eligible for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage at least for a limited time.

  • People who are 65 and over and who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program. 

If your household income is below 120% of the poverty level, Medicaid will pay for your monthly Medicare Part B premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

Contact the Human Services Department, Income Support Division for more information about other eligibility requirements.

  • There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Human Services Department, Medical Assistance Division.


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