Medicare plays a key role in providing health and financial security to beneficiaries residing in New Mexico. With more than 429,300 New Mexico beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in New Mexico. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in New Mexico?

Medicare covers most New Mexico residents who are 65 or older, and it also covers disabled New Mexico residents. In general, Medicare enrollment in New Mexico works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

New Mexico Medicare Enrollments

260,012

Original Medicare Plans
(Part A and B)

169,344

Medicare Advantage & Other Health Plans

153,885

Stand-alone Medicare
Part D (Drug plans)

429,356

Total Medicare Beneficiaries
in New Mexico

New Mexico Medicare Advantage Plans (Part C)

More than 37% of New Mexico Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in New Mexico who are enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 38 Medicare Advantage plans are available in New Mexico. The average monthly Medicare Advantage premium changed from $19.42 in 2019 to $16.96 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in New Mexico.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 169,344 beneficiaries enrolled in Medicare Advantage and other plans in New Mexico. More than 37% of New Mexico Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Depending on your county, New Mexico Medicare beneficiaries can select from between two and 23 Medicare Advantage plans.

New Mexico Medicare Supplement (Medigap) Insurance Plans

Medigap insurers in New Mexico aren’t required to offer coverage to applicants under the age of 65.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

Although the majority of states ensure access to Medigap coverage for disabled enrollees, Medigap insurers in New Mexico aren’t required to offer coverage to applicants under the age of 65.

However, New Mexico is one of several states where pre-ACA high-risks pools remain operational. With this coverage, enrollees are able to supplement Medicare if they’re unable to get Medigap coverage. For more information about New Mexico Medical Insurance Pool’s Medicare carve-out plan, click here. This is a good option for people under age 65 who aren’t able to get a plan from private Medigap insurers in New Mexico.

New Mexico Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 153,885 Medicare beneficiaries in New Mexico enrolled in stand-alone Part D prescription drug plans and 160,771 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 26 stand-alone Part D plans available in New Mexico, with premiums ranging from about $15 to $126 per month. About 37% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in New Mexico

  • New Mexico Aging and Long-Term Services Department provides accessible, integrated services to older adults, adults with disabilities, and caregivers to assist them in maintaining their independence, dignity, autonomy, health, safety, and economic well-being, thereby empowering them to live on their own terms in their own communities as productively as possible.
    Contact: Visit the Department’s home page to contact a representative via live chat, or call 1-800-432-280.

  • Aging and Disability Resource Center (ADRC): ADRC assists elders, persons with disabilities, and caregivers to find services and resources to help them live well and independently.
    Contact: Call 1-800-432-2080 or 505-476-4937 (TTY). There is a live chat option on the center’s website, as well.

  • New Mexico’s State Health Insurance Assistance Program (SHIP) provides local, in-depth, and objective insurance counseling and assistance to Medicare-eligible individuals, their families, and caregivers.
    Contact: Call 1-800-432-2080

  • Area Agencies on Aging (AAAs): New Mexico’s four Area Agencies on Aging, or AAA’s, administer, plan and support community-based services for individuals 60 and older, or age 55 and older in tribal programs. Most of the services coordinated through the AAA’s are provided at the local level. Specific services offered by each AAA vary throughout the state, but each AAA offers a wide array of programs to help older New Mexicans and their families get the help and information they need. Each AAA is responsible for services within one or more Planning and Service Areas (PSA’s) and has developed specific plans for each region.
    Contact: Call 1-800-432-2080. A list of the AAAs, their addresses and contact details is available on the New Mexico Aging & Long-Term Care Services website.

  • Senior Information and Assistance Program connects you to other agencies throughout the city of Albuquerque and Bernalillo County. Senior Information Representatives will personally assist you in navigating through the maze of community services available to seniors who live in the City of Albuquerque and Bernalillo County. We connect you, family members, and caregivers to an array of resources and services that make it easier to maintain a healthy lifestyle and stay involved in the community.
    Contact: Call 505-764-6400 (TTY: 1-800-659-8331) or email [email protected].

  • Deming Luna County Senior Citizens Center is a non-profit corporation governed by a Board of Directors and Executive Director, Julie Bolton. Their mission is to promote independence, preserve dignity, and enhance life quality for a diverse population of older adults and people with disabilities. Their purpose is to provide services and programs to senior citizens, 60 years of age and older living in the City of Deming, Village of Columbus and Luna County. The Commission on Aging has been providing services to senior citizens in Luna County for over 35 years.
    Contact: Call 575-546-8823 or by email at [email protected].

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of New Mexico. Our process makes it easier for you to access your Medicare eligibility in New Mexico so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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