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New Mexico Health Insurance Consumer Guide
This guide to health insurance in New Mexico is designed to help you understand the coverage options and potential financial assistance available to you and your family.
Starting in the fall of 2021, New Mexico began using its own state-run health insurance exchange – beWellnm. Before that, the state used the federally run HealthCare.gov Marketplace platform.
New Mexico residents can use beWellnm to shop for individual and family health plans offered by various private health insurance carriers. These plans are used by people who aren’t eligible for Medicare, Medicaid, or an affordable employer-sponsored health plan.
Explore our other comprehensive guides to coverage in New Mexico
Dental coverage in New Mexico
In 2023, New Mexico's health insurance Marketplace has certified individual and family dental plans from two insurers.1 Our guide will help you understand your dental coverage options in New Mexico.
New Mexico’s Medicaid program
Centennial Care – New Mexico’s Medicaid program – covers more than 900,000 low-income residents. New Mexico expanded Medicaid under the ACA, and Centennial Care enrollment has grown by 94% since 2013.2 After being paused for three years due to the pandemic, Medicaid disenrollments resumed in New Mexico in May 2023. By July, about 75,000 people had been disenrolled from the program.3
Medicare coverage and enrollment in New Mexico
More than 450,000 New Mexico residents had Medicare coverage as of 2023.4 Our New Mexico Medicare guide explains the various parts of Medicare, New Mexico coverage options for Medicare Advantage and Part D, and the state’s rules regarding Medigap (Medicare Supplement) availability.
Short-term health insurance coverage in New Mexico
As a result of the state’s strict rules regarding short-term health insurance, insurers currently don’t offer short-term health policies in the state.5
Frequently asked questions about health insurance in New Mexico
Who can buy Marketplace health insurance in New Mexico?
To be eligible to enroll in private health coverage through beWellnm, you must:6
- Be lawfully present in the United States, and live in New Mexico
- Not be incarcerated
- Not be enrolled in Medicare
So most New Mexico residents are able to enroll in a health plan through the exchange.7 But a more pressing question for most people is eligibility for financial assistance in the form of state and federal subsidies through beWellnm.
To qualify for income-based federal Advance Premium Tax Credits (APTC), New Mexico Premium Assistance, federal cost-sharing reductions (CSR), or New Mexico’s State Out-of-Pocket Assistance (SOPA), you must:
- Not have access to an affordable plan offered by an employer. If you are eligible to sign up for an employer’s plan and aren’t sure whether it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies via beWellnm.
- Not be eligible for New Mexico Centennial Care (Medicaid).
In addition to those basic parameters, beWellnm premium subsidy eligibility will depend on your household’s income and how that compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location.
When can I enroll in an ACA-compliant plan in New Mexico?
For 2024 coverage, enrollments must be completed by December 23, 2023 in order to have coverage effective January 1, and enrollments completed between December 24 and January 15 will have coverage effective February 1. But the deadline for a January 1 effective date could change in future years.
After the open enrollment period ends, you may still be able to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage.
New Mexico also has an Easy Enrollment Program that allows people to start the health insurance enrollment process via state tax returns.
And some people can enroll year-round even without a specific qualifying life event. This includes the low-income special enrollment period, which is available to applicants with household income up to 200% of the poverty level in New Mexico.9 (The household income cutoff for this SEP is 150% in most states.)
Enrollment in New Mexico Centennial Care (Medicaid) is available year-round.
How do I enroll in a Marketplace plan in New Mexico?
To enroll in an ACA Marketplace/exchange plan in New Mexico, you can:
- Visit beWellnm – New Mexico’s health insurance exchange – to compare the health plans available in your area, determine whether you’re eligible for financial assistance (including federal and state subsidies), and enroll in coverage during open enrollment or during a special enrollment period.
- Enroll in a beWellnm plan with the help of an insurance agent or broker, Navigators, certified application counselors or an approved enhanced direct enrollment entity.10
You can reach the beWellnm call center at 1-833-862-3935.
How can I find affordable health insurance in New Mexico?
When you enroll in coverage through beWellnm, you may find that you’re eligible for financial assistance. And the assistance may be more robust than it is in many other states, as both federal and state subsidy programs are available in New Mexico.
As a result of the Affordable Care Act (ACA), federal premium subsidies (advance premium tax credits, or APTC) are available depending on your income. If you’re eligible for APTC, it will reduce the amount you pay for your health coverage each month, as long as you enroll in a metal-level plan through beWellnm.
Seventy-nine percent of beWellnm enrollees were receiving APTC as of early 2023. These subsidies averaged $534 /month, reducing the average enrollee’s premium to $91/month.11
Applicants with household income up to 250% of the federal poverty level are also eligible for federal cost-sharing reductions (CSR), which will reduce the deductible and other out-of-pocket expenses for Silver-level plans. Seventeen percent of beWellnm enrollees were receiving CSR benefits as of 2023.11
And New Mexico is among the states where additional state-funded subsidies are available. As of 2023, New Mexico began offering state-funded premium subsidies (for applicants with income up to 400% of the poverty level) and cost-sharing assistance (for applicants with income up to 300% of the poverty level), in addition to the federal premium subsidies and cost-sharing reductions.12
New Mexico’s cost-sharing reductions (state out-of-pocket assistance, or SOPA) are being expanded for 2024, ensuring that people with household income up to 300% of the poverty level can get plans with 90% actuarial value (ie, platinum-level coverage).13
Plans with reduced cost-sharing, including federal CSR and SOPA benefits, are known as “Turquoise plans” in New Mexico, to make it easier for consumers to identify them.
Starting with the 2024 plan year, New Mexico will have standardized plans available at the Silver, Gold, and Turquoise level.14
Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Centennial Care (New Mexico Medicaid). Learn more about whether you might be eligible for Medicaid in New Mexico.
How many insurers offer Marketplace coverage in New Mexico?
For 2023, there are four insurers offering plans on New Mexico’s exchange:15
For 2024 coverage, five insurers will offer exchange plans in New Mexico,16 with coverage areas that vary by insurer:
- Blue Cross Blue Shield of New Mexico (Health Care Service Corporation)
- Presbyterian Health Plan
- Western Sky Community Care (Ambetter/Centene)
- UnitedHealthcare of New Mexico (new for 2024)
Are Marketplace health insurance premiums increasing in New Mexico?
For 2024, New Mexico’s Marketplace insurers have proposed the following average rate changes:15
New Mexico’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company
|Blue Cross Blue Shield of New Mexico||5.5%|
|Presbyterian Health Plan||9.7%|
|Western Sky Community Care||11.7%|
|UnitedHealthcare of New Mexico||New for 2024, so no rate change|
A reminder that average rate changes apply to full-price premiums, and most enrollees do not pay full price. Seventy-nine percent of beWellnm enrollees were receiving federal premium subsidies in 2023.11 And many beWellnm enrollees also receive additional state-funded premium subsidies.
How many people are insured through New Mexico's Marketplace?
What health insurance resources are available to New Mexico residents?
The state’s exchange for small businesses, individuals, and families.
Health Action New Mexico
A consumer advocacy organization working to improve healthcare access and affordability in New Mexico.
New Mexico Human Services Department
Administers Centennial Care (Medicaid) and various other social services programs in the state.
New Mexico Office of the Superintendent of Insurance
Licenses and regulates health insurance companies in New Mexico, as well as brokers and agents; can provide assistance and information to consumers who have questions or complaints about regulated entities.
New Mexico State Health Insurance Assistance Program
A resource for New Mexico Medicare beneficiaries and their caregivers.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
- “New Mexico dental insurance guide 2023” healthinsurance.org, Accessed September 2023
- "Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment" KFF. April 2023
- ”Departmental Performance Scorecard Public Health Emergency (PHE) Unwinding Measures” New Mexico Human Services Department. August 2023
- "Medicare Monthly Enrollment" CMS.gov, April 2023
- “Bulletin 2019-05, Sale of Short-Term Limited Duration Plans” New Mexico Office of the Superintendent of Insurance. April 25, 2019
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov
- “Frequently Asked Questions; New Mexico State-Based Exchange” beWellnm, Accessed September 2023
- “Enrollment” beWellnm, Accessed September 2023
- “Special enrollment period for consumer at or below 200% FPL” beWellnm, March 2022
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023
- “Health Insurance Marketplace Affordability Program” NM Office of the Superintendent of Insurance, October 2022
- “2024 Plan Year Health Insurance Marketplace Affordability Program Policy and Procedures Manual” New Mexico Office of the Superintendent of Insurance, April 13, 2023
- “Standardized Health Plan Requirements for the 2024 Plan Year” beWellnm. January 2023
- “New Mexico Rate Review Submissions” HealthCare.gov, September 2023
- “New Mexico SERFF Filings”
- “ASPE Issue Brief (2014)” ASPE, 2015
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022