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2021 New Mexico Health Insurance
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Having health insurance in a time where viruses are running rampant is just one way to protect yourself, but so many New Mexico residents continue to live without any medical coverage or are settling for being under-insured. One thing is certain: Medical insurance is a necessity and helps you get access to the best healthcare available in your region and beyond. Don’t go without it.
There are hundreds of New Mexico health plans available for you to browse. Before you begin searching for deals, there are some things you need to know about New Mexico health insurance.
Let’s have a look.
Types of Health Plans
There are a couple of ways you can determine the level of coverage you have and how your healthcare will be taken care of—just look at your metal tier and network type. The metal tiers were established with the Affordable Care Act and include bronze, expanded bronze, silver, and gold. Some states have platinum level, but NM does not. You can also opt for catastrophic health insurance, which is the minimal coverage allowed.
Aside from metal tiers, you have medical networks or organizations—HMOs, PPOs, EPOs, POS plans, and more—that enable a group of healthcare providers to see to your care more effectively and keep medical costs low.
Here are the differences between these health plans:
Upon joining an HMO, you get access to a network of medical professionals and facilities, including a primary care physician (PCP). The PCP you choose becomes the main coordinator of your healthcare. You must receive referrals from them before visiting specialists. There are copays but not much else, unless you go out of network. Then, you pay in full.
The exact opposite of HMOs, PPOs have a network that reduces the cost of healthcare, but you can also leave the network for care. You do not need to choose a PCP and do not need referrals. However, you do pay more overall for a PPO.
You receive access to a small network with an EPO and can see any doctor or specialist without a referral. However, you do need to pay a copay and coinsurance. If you go out of network, you are not covered by your insurance.
Offering the best of HMOs and PPOs, a POS plan lets you choose a PCP for referrals. However, you can go to either in or out of network specialists and facilities. The costs are higher out of network, but they are more reasonable than going out of network with a PPO.
There are other kinds of plans available that are tied to savings accounts, often called Health Savings Accounts (HSAs). If you are interested in that, contact an insurance carrier representative to learn more.
Compare New Mexico health plans to see which network is perfect for you.
Why You Should Have New Mexico Medical Insurance
If you are still waffling about whether to get yourself Individual health insurance or a family policy, then consider the benefits of having a major medical plan. First, while health insurance may be costly from a month-by-month view, think about the cost of a single inpatient day or what it could take to cover an unexpected injury or illness. One visit to the emergency room without health insurance could cost you thousands of dollars. Unless you are part of the wealthy 1 percent, you probably don’t have that kind of money laying around.
So, health insurance protects you from those sudden injuries and accidents that could leave you bankrupt.
Secondly, preventive care is covered by ACA-compliant health policies. This means that, instead of visiting the ER when something doesn’t feel right or when you are having difficulties, you can take care of your health more proactively—and save money doing it.
That brings us to the third point: essential health benefits (EHBs). The Affordable Care Act introduced core health components for every compliant health plan to include. These benefits are as follows:
Some policies will provide additional benefits, like birth control and breastfeeding services for women. Most will also refuse to cover things considered non-essential, like plastic surgery, LASIK, alternative therapies, and also infertility treatments.
Short Term Health Insurance
New Mexico defaults to federal guidelines for short term medical insurance plans. With the changes made by the Trump administration, New Mexico altered the terms for short term insurance. As of 2019, you can only have an initial term of 3 months and no more. Renewals have been banned, and you cannot get another short term plan if you had one within the previous 12 months.
After these changes came into effect, insurance carriers throughout New Mexico stopped offering short term health insurance. Now, New Mexico is one of 11 states that has no short term plans.
If you need insurance immediately, see if you are eligible for a special enrollment period (SEP).
What You Need To Know About New Mexico Health Insurance
New Mexico has started to reform its state health insurance options, but it has been without struggles. As a resident of New Mexico, you have probably realized that insurance rates have dropped significantly recently. In fact, bronze, silver, and gold have dropped more than 12 percent since 2018. This means you’re in luck—you can snag a great deal.
Age and location change your rate. For example, the average monthly premium for a 21-year-old is around 28 percent cheaper than what a 40-year-old would pay. Rates for a 21-year-old is $255/month for catastrophic, $252 for bronze, $238 for expanded bronze, $328 for silver, and $309 for gold. A 40-year-old pays $326 a month for catastrophic, $322 for bronze, $304 for expanded bronze, $420 for silver, and $395 for gold. A 60-year-old pays nearly double what a 40-year-old enrollee pays.
Family health insurance in New Mexico is affordable. Generally, you pay for both parents (or a single parent) and then a flat rate for children under 15 years old. For example, a family for three pays $1,091 a month while a family of four would pay around $1,342. Once a child turns 15 or older, the rate increases.
You can learn more about healthcare and insurance costs in New Mexico by visiting the state’s Department of Health website.
Unemployed, Part-Time, and Self-Employed
Since NM has no short term health plans, you may be wondering about health insurance for unemployed residents. COBRA might be too expensive if you have been out of work for a while, and if you cannot find something short term, what then? If you recently lost work, you have 60 days from that point to qualify for a special enrollment period. If not, then you will need to wait until open enrollment.
Finding health insurance for self-employed workers is similar to seeking out individual health coverage. Part-time employees can do the same. If you are making less than the Federal Poverty Line, then you may be eligible for subsidies or tax breaks, as well.
Differences Between 2020 Open Enrollment and 2021
Wondering when open enrollment begins in your state? For most places in the US, open enrollment begins on November 1, 2020 and ends December 15, 2020. The 2021 New Mexico open enrollment period is the same. Some states are offering extensions in the wake of the global pandemic, but NM has yet to declare if it will do the same. Keep an eye out for more information.
Those who enroll during the open enrollment window will have their new health coverage begin on January 1, 2021.
There are many changes happening in New Mexico that may affect open enrollment for 2021. First, New Mexico Health Connections—one of the few remaining CO-OPs from the ACA—is closing at the end of 2020 and will no longer offer health insurance plans. That said, there are two new insurance carriers joining the marketplace for the 2021 season: Western Sky Community Care by Ambetter/Centene and Friday Health Plans.
That means the amount of insurers on the federal exchange for NM has increased to five. Here is a rundown of the insurers and their rate changes from 2020 to 2021:
- Molina: Offering a slight rate decrease of 0.2 percent. Molina decreased their rates for the 2020 season, as well.
- Blue Cross Blue Shield of New Mexico: Proposed a 3.56 percent rate increase for 2021.
- Friday Health Plans: New to the Marketplace. No rate change.
- True Health: Proposed a 4 percent rate increase to all plans.
- Western Sky Community Care: Although currently a Medicaid insert, Western Sky is offering individual health plans for 2021. They are new to the market, and therefore have no rate change.
Another insurer, Presbyterian Health Plans, offers policies outside of the Marketplace. The carrier has opted to leave its rates the same for 2021.
As mentioned earlier, those who may have missed 2020 open enrollment or who recently lost their insurance or need to change their New Mexico medical insurance coverage because of a major life event may be eligible for a special enrollment period (SEP). For example, if you are unemployed because of COVID-19 and lost your employer-based health insurance, you may be able to use the SEP to get health insurance immediately.
Don’t wait until open enrollment begins to start searching for the best health insurance rates. Begin today! Compare New Mexico health plans side by side to see which policies offer the most coverage for the most affordable price.
Keep Yourself and Your Family Protected
Don’t go unprotected. Get health insurance and get your preventive care covered. There are plenty of benefits to help you stay healthy and keep any conditions in check. Additionally, medical insurance will give you peace of mind for the future, no matter what happens in 2020 and beyond.
Now is the best time to start your search for 2021 health insurance quotes. AffordableHealthPlansUSA.com can help. With just your zip code, you can get quotes, compare coverage plans, and seize amazing deals. What are you waiting for?