The State Coverage Insurance Program is a program offered by private insurers in partnership with the state of New Mexico that makes low-cost health insurance available to small employers, self-employed and individuals (See Chapter 4).
When can I get State Coverage Insurance (SCI)?
- If you are between 19 and 64 years old, uninsured (and have not voluntarily dropped insurance within the last 6 months), and earn less than 200% FPL, you may be able to buy health insurance through SCI. In addition, you will be required to provide a letter of support from the individual who is going to pay the premium.
WHAT WILL SCI COVER?
- SCI provides basic coverage to eligible individuals. Coverage includes physician services, hospital, prescription drugs, X-rays, and mental health services. All individuals are subject to a $100,000 annual cap. Services may vary depending on the plan. No dental or vision services.
- Currently, three health plans participate in SCI, Lovelace, Molina, and Presbyterian.
WHAT ABOUT PRE-EXISTING CONDITIONS?
- There are no pre-existing condition exclusion periods when you buy health insurance through SCI.
WHAT CAN I BE CHARGED FOR SCI COVERAGE?
- As an individual, you will have to pay the $75 employer contribution in addition to the monthly premium (up to $35 per month). You may also be responsible for co-payments.
- For more information about SCI, contact the New Mexico Health Insurance Solutions Center at 866-901-4538 or visit them on the web at http://www.insurenewmexico.state.nm.us/.