Medicaid Costs and Coverage in New Mexico

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New Mexico Medicaid coverage provides eligible individuals or families with health care at a low or no cost. The various types of Medicaid insurance and coverage available to petitioners extends across a range of services, but also excludes coverage for other types of services. In addition to questions about coverage, “How much is Medicaid?” is a common question asked by potential applicants to the program. The funding for Medicaid coverage comes from both the federal and state government. In New Mexico, state officials manage the program, including reviewing applications and providing information to residents and applicants. While officials attempt to keep Medicaid cost estimates low, in some cases there are costs to the recipient. Medicaid costs include such expenses as deductibles and copayments, which are out-of-pocket expenses that programs may sometimes not cover. Knowing what Medicaid covers and potential costs are vital for applicants seeking assistance. Get answers to the question “How much does Medicaid cost in NM?” and learn more about covered services by reading the following sections.

What services are covered by Medicaid in New Mexico?

The federal government outlines the basic Medicaid coverage guidelines, including the services that the program will provide. States may alter certain Medicaid benefits depending on regional needs and resources. The cooperation between officials and vital funding help create a system that is flexible, allowing each state to adjust accordingly and provide assistance to potential beneficiaries accordingly. The coverage benefits of Medicaid include a range of services that are mandatory across the nation and in New Mexico. For instance, services covered by Medicaid in New Mexico include inpatient and outpatient care. However, having Medicaid coverage does not always mean that there is no cost associated with the program. 

Medicaid covered services are either mandatory and required by all states to implement, or they may be optional, which means may or may not be adopted by the state. For instance, the Affordable Care Act (ACA) introduced an expansion of Medicaid to cover more individuals. New Mexico chose to extend Medicaid as outlined in the ACA, allowing for that additional coverage to more residents. Often, what Medicaid covers in a state depends on local resources and needs, leading to the exclusion of certain types of coverage. Regardless of whether or not a service is mandatory or optional, there may be related costs. Some examples of the types of Medicaid services in NM that are mandatory include:

  • Emergency room services.
  • X-Rays.
  • Testing and treatment for specific diseases.
  • Pediatricians.
  • Doctor visits.
  • Services from a primary care physician.

New Mexico Medicaid coverage extends to a broad range of potential beneficiaries. Both families and individuals benefit from the assistance. However, additional groups receive certain other advantages as well. For instance, children receive extra services under Medicaid, such as counseling and vision, hearing and dental screens. You can download our complimentary guide to learn more about services covered by Medicaid.

What does Medicaid not cover in New Mexico?

There are some services that are not covered by Medicaid in New Mexico, as there are some limits to the program. In some cases, Medicaid coverage will not help a potential beneficiary. Medicaid services in NM are intended to provide low-income applicants with aid for necessary health care, so the program excludes certain services that are considered elective procedures. These services not covered by Medicaid include:

  • Cosmetic procedures.
  • Occupational, speech or respiratory therapy.
  • Hair transplants
  • Treatment of infertility.

To learn more about services that are not covered by Medicaid and more, download our comprehensive guide today.

How much does Medicaid cost in New Mexico?

New Mexico Medicaid cost estimates are kept as low as possible to help applicants with limited income. However, some additional Medicaid costs may be required of beneficiaries. Before applying for NM Medicaid coverage, petitioners benefit from knowing what expenses may be associated with Medicaid. For instance, those requesting preventative services may face some out-of-pocket expenses. However, in cases where copayments are due, Medicaid coverage caps the amount that a provider may charge for services. Furthermore, some Medicaid beneficiaries may be exempt from such extra costs. The cost of Medicaid and expenses associated with the program may change based on a range of factors. In specific situations, the answer to “How much is Medicaid?” is sometimes zero. Some recipients receive exemptions from every paying copayments or other expenses associated with coverage. Beneficiaries who are minors, living in nursing homes or pregnant will typically not have to pay any out-of-pocket costs.


What Is Medicaid?

Medicaid is a medical assistance program that provides coverage for various types of medical care. Eligible individuals and families can receive coverage for doctor visits, X-rays, labs, inpatient care, outpatient care and more. However, not all procedures are covered under the federal medical assistance program. To learn about which procedures are covered and to find out all about the Medicaid program, download our comprehensive guide.


Who Is Eligible to Receive Medicaid Benefits?

Medical assistance benefits are available to a wide variety of low-income individuals and families within the United States. However, all Medicaid applicants must meet the established eligibility requirements, which range from income limits to citizenship qualifications. To find out if you or your family is eligible to receive Medicaid benefits, download our comprehensive and complimentary guide.