New Mexico Health Insurance Guide

From red rock canyons to historic pueblos and scenic deserts, New Mexico remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances.

As of 2025, the uninsured rate in New Mexico reflects steady improvement, supported by early Medicaid expansion and growing ACA enrollment. If you’re currently without coverage, here’s what you need to know about getting insured in New Mexico.

Health Insurance Options in New Mexico

New Mexico offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many New Mexico residents receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum. Each tier offers a different balance of monthly costs and out-of-pocket expenses:

• Bronze: Low premiums, high out-of-pocket costs; good for low healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher premiums, lower out-of-pocket expenses; ideal for frequent healthcare users.
• Platinum: Highest premiums, lowest out-of-pocket expenses.

Metal Tier Breakdown:

Medicaid

New Mexico’s Medicaid program, known as Centennial Care, provides free or low-cost coverage for eligible low-income residents. Medicaid plan benefits include preventive services, hospital care, mental health services, long-term care, and prescription medications.

Centennial Care is managed by several health plans, including Blue Cross Community Centennial, Presbyterian Health Plan, and Western Sky Community Care. Eligibility is based on income and household size.

Short-Term Plans

Short-term medical (STM) plans offer temporary health coverage and can be a practical solution for individuals who are between jobs, recently lost employer coverage, waiting for ACA or Medicare eligibility, or need affordable protection during a coverage gap.

In New Mexico, STM plans are restricted to a maximum duration of 90 days and are not renewable. These plans follow federal rules but are not regulated under the ACA, meaning they may not cover pre-existing conditions and typically exclude benefits like maternity, mental health, or preventive care.

While short-term plans are not substitutes for comprehensive health insurance, they may offer temporary protection during coverage gaps.

STM Plan Enrollment

Unlike ACA-compliant plans, you can enroll in short-term health plans year-round.

Quick Coverage Start: Many short-term plans can begin as soon as the next day after your application is approved.

Children’s Health Insurance Program (CHIP)

Known as New Mexico CHIP, this program helps children and pregnant women in families that earn too much for Medicaid but need affordable insurance. CHIP in New Mexico is administered under the broader NJ FamilyCare umbrella.

Student Health Insurance

College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans—making New Mexico student health insurance accessible and flexible for a wide range of needs.

Medicare

Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage Plans (Part C): Offered by private insurers, these plans combine Parts A and B and often include additional benefits like dental, vision, and prescription coverage.
• Medicare Part D: Prescription drug plans available to anyone with Medicare, offering coverage for medications and many vaccines.
• Medicare Supplement plans (Medigap): Help cover out-of-pocket costs not paid by Original Medicare, including coinsurance, copayments, and deductibles.

Assistance is available through New Mexico’s State Health Insurance Assistance Program (SHIP), operated by the Aging and Long-Term Services Department.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to temporarily continue your employer-sponsored coverage. While often more expensive, COBRA can serve as a bridge until you secure new coverage.

Enrollment Periods in New Mexico

• Open Enrollment for 2026 Coverage: November 1, 2025 – January 15, 2026
  During this period, all eligible residents can apply, renew, or change their marketplace health plans through BeWellnm.
• Special Enrollment Period: Available year-round for individuals experiencing qualifying life events, including:
  • Loss of coverage
  • Marriage or divorce
  • Birth or adoption of a child
  • Relocation
  • Major change in income

You typically have 60 days from the qualifying event to enroll.

Health Insurance Providers in New Mexico

As of 2025, these insurers typically offer individual and family plans through BeWellnm:

• Blue Cross and Blue Shield of New Mexico
• Friday Health Plans
• Molina Healthcare of New Mexico
• Presbyterian Health Plans
• True Health New Mexico
• Western Sky Community Care

Plan options vary by region, and availability may differ by county or zip code.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common cost terms:

• Premium: Monthly payment to maintain your plan.
• Deductible: What you pay before insurance covers services.
• Copayment (Copay): Fixed amount per visit or service.
• Coinsurance: Shared costs with your insurer after the deductible.
• Out-of-Pocket Maximum: Your yearly cost cap for covered services.
• In-Network vs. Out-of-Network: Using in-network providers usually results in lower costs.

Understanding health insurance doesn’t have to be overwhelming. This helpful glossary offers clear definitions of key terms to support confident decision-making.

Bottom Line

Health insurance in New Mexico includes a broad range of choices—whether through your employer, the ACA marketplace, Medicaid, or Medicare. By staying informed and comparing options during the appropriate enrollment periods, you can secure affordable, reliable coverage that supports your well-being.

Need help choosing a plan? Use our ACA Subsidy Calculator to find out if you qualify for ACA plan financial aid or speak with a licensed insurance agent for personalized assistance.