Medicare in New Mexico

Mike Olmos by Mike Olmos | Licensed since 2010
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This article was updated on: 09/16/2018

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Beneficiaries in New Mexico generally have two main options for receiving their Medicare benefits: Original Medicare, Part A and Part B, or Medicare Advantage, also called Medicare Part C, offered by private Medicare-approved insurance companies.

Original Medicare is the federally funded health insurance program largely designed for those aged 65 and older (though younger residents with certain disabilities may also be eligible). If you have Lou Gehrig’s disease (also known as ALS) or end stage renal disease (ESRD), you can qualify for enrollment before age 65. Medicare Advantage is offered by private health insurance companies with Medicare’s approval. These plans must cover at least what Original Medicare does (with the exception of hospice care), while many plans may include vision, dental, and even prescription drug coverage as well.

Types of Medicare coverage in New Mexico

Original Medicare, Part A and Part B, includes hospital insurance (Part A) and medical insurance (Part B).

Medicare Advantage provides an optional, alternative way to receive your Medicare Part A and Part B benefits. It’s available in New Mexico, although not every plan may be available in each county. Additionally, plan details and costs may differ by location and provider. These plans are offered by private Medicare-approved insurance companies. While you’re enrolled in a Medicare Advantage (Medicare Part C) plan, you must continue paying your Medicare Part B premium, along with any premium the Part C plan may charge.

Medicare Part D Prescription Drug Plans (PDPs) provide stand-alone prescription medication coverage. A Medicare beneficiary may purchase this coverage to work alongside his or her Original Medicare, Part A and Part B. These plans are offered by private Medicare-approved insurance companies. You can also get this coverage through a Medicare Advantage Prescription Drug plan.

Medicare Supplement insurance plans, also known as Medigap, cover certain costs that Original Medicare does not, including deductibles, copayments, coinsurance, and other out-of-pocket costs. Most states, including New Mexico, can offer up to ten standardized Medigap policy options, each plan marked with a letter. Plans of the same letter offer the same benefits, although not every company offers all ten plans.

Local resources for Medicare in New Mexico

Medicare Savings Programs in New Mexico: Beneficiaries with low income may be able to save money on Medicare each year through savings programs. These programs can help Medicare beneficiaries in New Mexico pay for some of Medicare’s premiums, deductibles, and coinsurance.

New Mexico State Health Insurance Counseling and Assistance Program (SHIP): This is a national program that offers free personal counseling to people with Medicare and their families.

How to apply for Medicare in New Mexico

The Medicare enrollment process works the same in New Mexico as in any other state. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. Residents who are eligible for Medicare are enrolled automatically at age 65, or sooner if they are already receiving disability benefits through the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). Disabled residents can enroll before age 65 if any of the following applies:

  • You receive disability benefits for more than 24 continuous months
  • You have Lou Gehrig’s Disease (also known as ALS)
  • You have End-Stage Renal Disease (ESRD).

In the first two of these cases, a Medicare card and will arrive, along with an introductory packet, in the mail a few months prior to the Medicare start date. If you have ESRD, you need to enroll manually as described below.

For those who must enroll manually, visit your local SSA office. You may also register online or over the phone.

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • If you worked for a railroad, call the RRB at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

Please note that if you choose not to register for Medicare when you are first eligible, you may face a financial penalty for late enrollment should you choose to enroll down the line.

I can help you compare the Medicare Advantage, Medicare Part D, and Medicare Supplement insurance plans available in your part of New Mexico. And who am I? Find out more about me by checking out my profile; just follow the View profile link below. I can speak with you by phone or send you information about plans by email; use the links below to tell me which way works better for you. If you’d like to learn more on your own, just click the “Compare Plans” button on this page.

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