The Insure New Mexico Solutions Center offers a variety of products that are designed to serve working adults, pregnant women and children who cannot afford health insurance on the commercial market.

* Indicates new products or promotions offered by Insure New Mexico


What Insure New Mexico offers for adults

State Coverage Insurance

• Participation level: 10,237 people enrolled

• Who: Ages 19 to 64; total countable family income up to 200 percent of the federal poverty level; must be working at least part time for a small business with 50 or fewer eligible employees or be self-employed. Spouses can participate as individuals or through an employer.

• Benefits: Annual limit of $100,000 per enrollee.

• Carriers: Lovelace, Molina and Presbyterian

• Cost for employee: $0 to $35 per month based on income; no deductible; co-payments for doctor visits and prescriptions based on family income.

• Cost for employer: 0-$75 per employee per month

• *New option: State helps with premium payment for people making less than 100 percent of the federal poverty level.



Health Insurance Alliance

• Participation level: 5,904 people enrolled

• Who: Workers at small businesses with at least two and no more than 50 eligible employees. Self-employed people must have at least one dependent.

• Benefits: HMO and PPO commercial insurance packages

• Carriers: 11 commercial carriers

• Cost for employee: Depends on plan

• Cost for employer: No defined contribution



Medicaid

• Participation level: Provides services to 141,105 adults and 277,181 children in New Mexico. That's 21 percent of the state population.

• Who: Most are pregnant women and children; family income is 185 percent of the poverty level or less.



New Mexico Medical Insurance Pool

• Participation level: 4,440 people enrolled

• Who: People who have a rejection notice for comprehensive coverage because of a health condition or have a quote for rates that are higher than the pool's qualifying rates.

• Carrier: Blue Cross and Blue Shield of New Mexico

• Cost: The pool sets rates through a review of the average rates charged by major New Mexico health insurers for individual health coverage. See www.nmmip.com for current rates.



*Small Employer Insurance Program

• Participation level: Not up and running because not enough employers are interested.

• Who: Employees and their dependents who work at a business or nonprofit group with 50 or fewer eligible employees. Self-employed workers are also eligible.

• Carrier: Blue Cross and Blue Shield of New Mexico

• Cost for employee: Varies by worker's age, gender and geographic location.

• Cost for employer: Must contribute at least 50 percent of the monthly premium for its workers.



*Premium Assistance for Maternity

• Participation level: 926 participants

• Who: Pregnant women ineligible for Medicaid based on income

• Carrier: Medicaid fee-for-service provider network

• Cost: Enrollment fee based on month of pregnancy — either $150 or $300.



Family Planning and Pregnancy

• Who: Women of child-bearing age with a family income of 185 percent of the federal poverty level or less. Babies born to these women, until age 1.

• Benefit: Family planning services, pregnancy-related costs



What Insure New Mexico offers for children

New Mexikids

• Participation level: 266,561

• Who: Children from birth to 18 in families with incomes up to 235 percent of the federal poverty level.

• Carriers: Lovelace Community Health Plan, Molina Health Care and Presbyterian Health Plan

• Cost: A one-time enrollment fee, semiannual premiums and co-payments for prescriptions ($2) and doctor visits ($5) are required of families whose income is above 135 percent of the poverty level. Families with lower incomes pay nothing.



*Premium Assistance for Kids

• Participation level: 2,780 children enrolled

• Who: Children from birth to age 11 who aren't eligible for Medicaid based on income and live in families with incomes up to 300 percent of the poverty level.

• Carriers: Presbyterian and Lovelace health plans

• Cost: 50 percent of the premium of a commercial insurance plan for children; state assists with cost of premium.



Could you qualify for one of these programs?

Look up your family's monthly income to see if you fit the Federal Register's measures of poverty. If you are under 300 percent of the federal poverty level, then Insure New Mexico might have a program that can help you with health care coverage.


300 percent of the federal poverty level:

Family size: 1; Monthly income: $2,553

Family size: 2; Monthly income: $3,423

Family size: 3; Monthly income: $4,293

Family size: 4; Monthly income: $5,163

Family size: 5; Monthly income: $6,033

Family size: 6; Monthly income: $6,903


200 percent of the federal poverty level:

Family size: 1; Monthly income: $1,702

Family size: 2; Monthly income: $2,282

Family size: 3; Monthly income: $2,862

Family size: 4; Monthly income: $3,442

Family size: 5; Monthly income: $4,022

Family size: 6; Monthly income: $4,602


Some programs disregard certain kinds of income, which means your income might seem too high, but after adjustments, you could be accepted into a plan. An Insure New Mexico specialist can review your financial situation.

Call the Insure New Mexico Solutions Center at 888-997-2583 or visit www.insurenewmexico.state.nm.us.

In Santa Fe County, make an appointment with the Income Support Division by calling 827-1932.