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, 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.
Get Health Insurance in New Mexico
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The Best Health Insurance in New Mexico:
- Best Overall in New Mexico: Presbyterian Health Plan
- Most Affordable: Aetna
- Best for Custom Coverage: BCBS of New Mexico
- Best for Low Deductibles: UnitedHealthcare
- Best for Member Rewards: Cigna
- The Best Health Insurance in New Mexico:
- What is Health Insurance?
- Average Cost of Health Insurance in New Mexico
- Types of Health Coverage
- What Does Health Insurance Cover?
- What Does Health Insurance Not Cover?
- Best Health Insurance Providers in New Mexico
- Finding the Best Health Insurance in the Land of Enchantment
- Frequently Asked Questions
What is Health Insurance?
Health insurance covers you in case of illness, injury or an accident. If you have a chronic health condition like asthma, high blood pressure or diabetes, your health insurance provider may also offer tips and resources to help you better manage this condition so that you can live a healthier life. If you’re interested in getting health insurance coverage and are wondering how to get health insurance, you have several options available.
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.
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 $440 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.
Types of Health Coverage
There are many types of health coverage available in New Mexico. Pay careful attention to the type of plan you’re considering, since 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.
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.
1. Presbyterian Health Plan
Presbyterian Health Plan offers all 3 types of health plans (HMO, PPO and POS) so that you can choose the one that’s best for your needs and budget. Presbyterian Health Plan scored particularly high nationally in women’s reproductive health, including prenatal checkups and postpartum mother and newborn care.
It also scored highly with regard to childhood and adolescent immunizations as well as coverage for adult flu shots. If you’re concerned about mental health coverage, the plan was rated highly for providing proper followup to patients suffering from mental illness or addiction to drugs, alcohol or other substance abuse.
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 to help ease the financial stress so that you can concentrate on recovering quickly and fully.
Aetna also offers a mobile app that can help provide you with personalized health tips and advice to live better.
3. 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 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.
Finding the Best Health Insurance in the Land of Enchantment
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 so that you can best 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.