Health insurance regulations vary by state, and in New Mexico, the Department of Insurance sets guidelines and pricing, meaning available plans can differ. Understanding the options, limitations, and requirements specific to New Mexico is the first step in finding the right health insurance.
New Mexico has elected to use a State-Based Marketplace that uses the federal platform (SBM-FP) for enrollment in qualified health plans (QHP). If you choose a qualified health plan here, you can enroll through HealthCare.Gov, or a private exchange like AHiX Marketplace. However, subsidies are only available when enrolling through the State-Based Marketplace.
Qualified plans comply with the Affordable Care Act, covering ten Essential Health Benefits without discrimination based on age, gender, location, or lifestyle. Low-income individuals and Medicaid recipients can enroll year-round.
Non-qualified plans do not comply with the federal government’s health insurance requirements and do not cover maternity, mental health, substance abuse or pre-existing conditions. AHIX does not offer these plans in New Mexico.
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New Mexico individual health insurance is designed for those purchasing coverage for themselves or their families. You can obtain insurance through a private exchange like the AHiX Marketplace, directly from an insurance provider, through HealthCare.gov, your employer-sponsored plan, or government programs like Medicare and Medicaid. Under the Medicaid Expansion in New Mexico, individuals under 65 years old with an income up to 138% of the federal poverty level (FPL) may qualify for low-cost or free health insurance.
Average Cost of Individual Health Insurance in New Mexico
For ACA-qualified health plans, individuals in New Mexico (Age 40, Zip code 87102) can expect the following average monthly premiums:
Single adult
Married Couple
Finding the right New Mexico health insurance plan ensures you get affordable coverage that meets your healthcare needs. Compare plans today to explore your best options.
New Mexico family health insurance provides coverage for households with at least one spouse and a dependent. You can explore qualified health plans through the AHiX Marketplace or obtain employer-sponsored coverage if available. Since Medicare is designed for seniors aged 65 and older, it does not provide coverage for families. However, families with a household income below 138% of the federal poverty level (FPL) may qualify for Medicaid in New Mexico. For reference, in 2020, a family of five earning less than $42,338 annually met Medicaid eligibility requirements.
A married couple with one child
A married couple with two children
A married couple with three children
Average Cost of Family Health Insurance in New Mexico
Below are the average monthly premiums for a 40-year-old policyholder with dependents under 26 years old enrolled in a Health Maintenance Organization (HMO) plan:
Choosing the right New Mexico health insurance plan ensures that your family gets comprehensive coverage at an affordable cost. Compare available plans today to find the best option for your needs.
Plan Type | Monthly Premium | Deductible | Ideal For | Coverage Description |
---|---|---|---|---|
Bronze | $ (Lowest) | $$$$ (Highest) | Individuals who need minimal coverage or primarily emergency services | Bronze plans offer basic coverage with the lowest monthly premiums but come with higher out-of-pocket costs. Suitable for younger, healthier individuals who expect low healthcare usage. |
Silver | $$ | $$$ | Individuals who need a balance between premium cost and healthcare usage | Silver plans provide a balance between premium costs and out-of-pocket expenses. These plans are ideal for those who use healthcare services occasionally and want moderate coverage. |
Gold | $$$ | $$ | Individuals who expect regular healthcare needs | Gold plans have higher monthly premiums but lower out-of-pocket costs, making them suitable for people with frequent healthcare needs. |
Platinum | $$$$ (Highest) | $ (Lowest) | Individuals with extensive healthcare needs | Platinum plans offer the most comprehensive coverage with the highest premiums but the lowest Cost-sharing, perfect for individuals or families requiring extensive healthcare services. |
Consider the following statistics about healthcare coverage in New Mexico.
Total New Mexico Population
Uninsured New Mexico Residents
New Mexico HMO Enrollment
Annual Employee Premium in New Mexico
Hospital Costs in New Mexico before Insurance
Health insurance helps protect you from big medical bills and ensures you get the care you need. Each plan explains what services are covered and how costs are shared between you and the insurance company, making healthcare more affordable.
Explore Health PlansAffordable dental and vision insurance covers routine cleanings, eye exams, fillings, and prescription lenses. It ensures regular care, lowers out-of-pocket expenses, and makes essential health services affordable and accessible for everyone.
Browse Dental PlansShort-term health insurance offers temporary coverage for people between plans, like seasonal workers or new employees waiting for group benefits. These affordable plans are simple to enroll in and provide basic care until long-term options are ready.
Find Short-Term Health PlansNo, New Mexico does not require residents to have health insurance. However, doctors say it is strongly recommended to have coverage to avoid high medical expenses in case of emergencies.
Finding the right New Mexico health insurance plan doesn’t have to be difficult. Whether you need coverage for yourself or your family, the AHiX Marketplace makes comparing plans simple and affordable.
Browse qualified and non-qualified health insurance plans in New Mexico to find coverage that fits your needs and budget. Let us help you navigate your options and select the right policy at the best price.
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