Quick Look: The Best Health Insurance in New Mexico
Famous for its unique man-made structures like the Gila Cliff dwellings to its natural wonders, like Carlsbad Caverns, the Land of Enchantment is truly a state of marvels. But when it comes to finding the best health insurance New Mexico, scouring the web to compare rates is the farthest thing from enchanting. Fortunately, Benzinga has you covered with comprehensive reviews on affordable health insurance in New Mexico.
Best Health Insurance Providers in New Mexico
Finding the best health insurance in New Mexico doesn’t have to be a challenge. We’ve narrowed down the many options available to give you the widest variety of choices at some of the lowest costs in the state.
Offering a variety of PPO plans in New Mexico, it received particularly high marks for acute hospitalization coverage. Since no one ever plans to be in the hospital for any length of time, it’s good to know that you have coverage available in emergencies. This can help ease the financial stress so that you can concentrate on recovering quickly and fully.
While this varies person to person, Aetna typically offers affordable plans for comprehensive coverage. But be careful when searching -- not every plan is ACA compliant, so you may want to compare against plans offered on the state marketplace to be sure you're getting adequate coverage.
Aetna also offers a mobile app that can help provide you with personalized health tips and advice to live better.
2. Blue Cross and Blue Shield of New Mexico
With both HMO and PPO plans to choose from, Blue Cross and Blue Shield (BCBS) provides versatile coverage for a variety of health insurance needs. Through its website, you can choose the type of plan you want as well as compare between them.
You can also see the approximate deductible, premium and coinsurance you’d be responsible for, all directly online. A helpful brochure guides you through the process. BCBS offers plans in every county of New Mexico, so you can count on having coverage no matter where you live in the state.
As one of the largest national health insurance companies, UnitedHealthcare offers both POS and PPO plans in New Mexico. UnitedHealthcare provides NM residents with a variety of deductibles and premium levels so you can customize your coverage according to your needs and budget.
It is rated highly by the NCQA for immunizations as well as preventive services like flu shots and BMI assessments. It is also rated highly for acute hospitalization, which involves unplanned and unexpected inpatient hospital stays.
Another large and well-known insurer providing services throughout the country, Cigna offers PPO coverage in New Mexico. Cigna has excellent ratings in preventive and diagnostic care. Depending on your income level, you may qualify for federal subsidies to help lower the number of your monthly premiums.
Members also enjoy low copays and $0 cost for most in-network preventive care including checkups, health screenings, flu shots and some prescription drugs. You can get a free quote directly online.
Where to Get New Mexico Health Insurance
Many New Mexico residents get health insurance through their place of work, but others opt to buy a plan on the state health exchange. Still, others choose a private health insurance plan for themselves or their families. Any of these options is better than having no health insurance at all, as the high costs of medical treatment and emergency surgery can quickly wipe out your savings. Having the right health insurance can help ease this financial burden.
New Mexico State Marketplace Open Enrollment
- The New New Mexico Health Insurance Exchange is transitioning from the federal Healthcare.gov marketplace to a state marketplace, known as beWellnm, for open enrollment
- You can begin comparing plans as early as October 1
- Open enrollment for New Mexico coverage begins November 1
Useful Insurance Terms to Know
As you research the choices available for affordable health insurance in New Mexico, you’ll come across certain terms that are used to explain your financial responsibilities when it comes to paying for your insurance. It’s a good idea to familiarize yourself with these so you’ll understand how much of your treatment or surgery insurance covers and how much you’ll be responsible for.
- Premium: This is a monthly fee that you pay to the insurance company in order to keep your policy active.
- Deductible: The deductible is money that you pay out of pocket before insurance takes over. It’s common among insurance companies to balance out the deductible and the premium. If you don’t get sick often, you may find it better to have a high deductible plan. This means in the event that you are hurt or sick, you’ll pay more for treatment, but you’ll also have a lower monthly premium. If you make frequent trips to the doctor (such as for the management of chronic conditions like asthma), you may be better suited to having a low deductible insurance plan. This means you’ll pay less before the insurance takes over the remaining amount, but in exchange for greater coverage, you’ll likely pay a higher premium each month.
- Copay: This is a small and inexpensive fee that you pay to your doctor when you receive treatment at their office.
- Coinsurance: This is a percentage that’s shared between you and the insurance company. If you have a plan that offers 80/20 coinsurance, for example, that means that the insurance company will cover 80% of covered expenses while you’re responsible for the remaining 20%.
Average Cost of Health Insurance in New Mexico
On average, individuals in New Mexico pay approximately $391 per month for their health insurance coverage. While health insurance doesn’t have the wealth of discounts like car insurance or homeowner’s insurance, there are still several steps you can take to save money and pay less for your health insurance coverage.
- Lower your body mass index (BMI): A high BMI can lead to chronic conditions including high blood pressure, high cholesterol and diabetes. Take steps to lower your BMI by losing weight and eating right to avoid complications caused by being overweight or obese.
- Tobacco use: Smokers pay more for health insurance than nonsmokers and put themselves at risk for a whole host of complications and diseases including cancers of the mouth, throat and lungs. Approximately 17.5% of people in New Mexico are smokers.
- Age: Older people generally have more health problems and as a result, pay more for health insurance than someone in their 20s or 30s.
- Specific location: Your specific location often changes how your coverage is offered because certain cities and counties are riskier than others. This is why you should shop around and learn which carrier can truly serve your location best.
- Dependents: If you add more dependents to your policy, you will pay more money. Make sure the plan you choose doesn’t skyrocket in price when adding dependents.
- Deductible: Policies with high deductibles tend to have lower premiums and vice versa. However, you should not choose a high deductible health plan unless you feel you will never meet the deductible and your out-of-pocket costs tend to remain low.
Types of Health Insurance Coverage
There are many types of health coverage available in New Mexico. Pay careful attention to the type of plan you’re considering. Plans with a lower cost often have high deductibles or have restrictions on the doctors or hospitals you can go to.
- Health maintenance organization (HMO): HMOs offer a lower cost for health insurance than many other types of plans. They do this by working with specific networks of physicians, specialists and hospitals that have agreed to receive a discounted rate for their services. Your healthcare is generally overseen by a primary care physician, and you’ll need a referral from that physician to see a specialist. Both the doctor and specialist should be in the HMO network in order to have the majority of the costs covered by the HMO. If you go outside of the HMO network, you may have to pay the entire amount yourself.
- Preferred provider organization (PPO): PPOs are similar to HMOs in that you have a predetermined network of providers to choose from, however PPOs are not as restrictive as HMOs. There’s more paperwork to deal with in a PPO, and if you go outside of the network, you’ll still be covered to some extent but not as much as if you went to a doctor or specialist within the PPO network. You don’t need a referral to see a specialist.
- Point of service (POS) plan: A POS plan requires you to pay for the service or treatment up-front, and then be reimbursed by the plan after submitting a claim. There’s more paperwork involved since you’re in charge of your care, but you can see any doctor, specialist or hospital that accepts your POS plan.
What Does Health Insurance Cover?
Every health insurance provider is different, but typically they cover some or all of the costs associated with:
- Ambulance services
- Prescription drugs
- Rehabilitative services
- Laboratory services
- Mental health care
- Wellness checks
- Pediatric care
- Emergency services
- Newborn and maternity care
What Does Health Insurance Not Cover?
Although it seems like the list above covers every conceivable health-related illness or injury, there are some things that most health insurance companies don’t cover, including:
- Elective or cosmetic procedures
- Long-term nursing home care
- Infertility treatments
- Alternative therapies
- Dental, vision and hearing
Depending on the insurance plan you select, you may be able to get dental and vision coverage for an additional fee. These are known as “riders” and are like add-ons for your insurance policy.
Finding the Best Health Insurance
Now that you have a clearer idea of the best health insurance companies in New Mexico, we recommend getting a free quote from each one. This will help you determine which choice is right for you and your family. Each company has a variety of plans to choose from, so be sure that the health insurance you choose isn’t based solely on price, but what you get for the money you spend.
Frequently Asked Questions
What is the New Mexico health insurance exchange?
The New Mexico Health Insurance Exchange is known as beWellnm. New Mexico is transitioning their exchange from Healthcare.gov to their own state-ran exchange and website for 2022 open enrollment.
How much is health insurance in New Mexico?
We found an average of $440 per month, although this varies widely by policyholder, plan, provider and more.