New Mexico Health Insurance

New Mexico (NM)

Individual Health Insurance Regulations

Medical insurance is necessary to protect your family's health against sickness or injury. Before opting for health coverage, you need to assess through your family's medical needs and your budget. Being a New Mexico resident, you can choose from various product alternatives. The Insurance Division of New Mexico Public Regulation Commission supervises the regulations under which the New Mexico health insurers can sell private health plans to individuals and families.
Individual medical insurance plans in New Mexico are not guarantee issue. New Mexico law permits all individual insurance plans to be medically underwritten, allowing an opportunity to review your past and current health history. Based upon information provided to the insurance carrier, the insurance company may opt to deny coverage, approve coverage or approve a modified version of coverage with specific limitations or exclusions. Each carrier can impose a 6-month exclusionary period limit on pre-existing medical conditions after reviewing your 6-month-old health history. If you have prior creditable coverage, it must be recognized and applied to the 6-month exclusionary period. New Mexico law also permits the use of elimination riders which may temporarily or permanently eliminate coverage of specific health conditions. Insurance premiums are not regulated in New Mexico.
Search for plans and the costs associated with them using the search box above. We provide individual, family, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

New Mexico (NM)

Small Group Health Insurance Regulations

Defined as any company with 2-50 employees, small group health coverage in New Mexico is guaranteed issue. Guarantee issued coverage assures that the group may not be declined coverage based on past or current health history of the group or its individual members. Insurance carriers may impose a 6-month maximum exclusionary period on pre-existing medical conditions on all applicants lacking prior creditable coverage. The look back period is limited to 6 months. Each qualified employee may be required to satisfy an employer imposed waiting period prior to joining the group health plan. New Mexico provides for the medical underwriting of group rates. Small groups with an unfavorable health history may be charged a maximum premium no more than 20% of the insurance company's index rate.

New Mexico COBRA and Continuation Coverage

Groups with more than 19 employees must also offer COBRA under federal law entitling employees to receive 18 months of COBRA coverage under federal law. Under special circumstances, dependents and permanently disabled persons may remain on COBRA for up to 36 months. Your COBRA option must be accepted within 63 days of the termination date of your group health plan.
Title 13, Chapter 10, Part 11.31, the mini-cobra law of New Mexico is similar to the federal COBRA law. The state regulated COBRA program offers continuation of group health benefits to qualifying employees for a period of six months. To qualify for mini-COBRA, an employee must have been covered under the group health plan for at least 6 months and must be eligible through a qualifying event. A COBRA qualified individual must elect their COBRA coverage within 30 days of the loss of their eligibility for group health coverage. Monthly premiums under the mini-COBRA program are the sole responsibility of the employee. Conversion plans are available to any person that elects to convert their COBRA coverage into an individual health plan. For those that are exhausting their COBRA coverage, the state high-risk pool offers guaranteed individual health plans if accepted within 63 days of the COBRA termination date.