Eligibility for Medicaid in New Mexico

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Answering the question “What are the requirements for Medicaid in New Mexico?” and discovering exactly who is eligible for Medicaid in the state is an effective way for a petitioner to ensure a higher chance of qualifying for benefits. Understanding how to qualify for Medicaid, which is called Centennial Care in New Mexico, involves learning the program’s eligibility guidelines and requirements. These Medicaid eligibility requirements will shift slightly depending on which category of Medicaid an applicant is eligible to receive. However, there are some basic eligibility requirements for Medicaid that all petitioners must meet to receive benefits. Learn more about NM Medicaid benefits eligibility by reviewing the following informative sections.

Who is eligible for Medicaid in New Mexico?

Generally, petitioners who qualify for Medicaid in New Mexico must be part of a low-income household. A candidate who is eligible for Centennial Care is an individual or family who otherwise would not have access to affordable and comprehensive health care. Medicaid benefits eligibility guidelines place applicants into specific categories, each with its own eligibility criteria. The categories of beneficiaries covered by Centennial Care include, but are not limited to:

  • Parents or caretakers of children.
  • Pregnant women.
  • Children younger than 19 years of age.
  • Women diagnosed with breast or cervical cancer.
  • Children living in foster care.
  • Adults between 19 and 64 years of age.

For more information about who is eligible for Medicaid, download our comprehensive guide today.

What are the requirements for Medicaid in New Mexico?

To become eligible for New Mexico Centennial Care, petitioners must meet basic requirements for Medicaid in terms of citizenship or legal status and state residency, in addition to income. Applicants must be either a U.S. national, citizen, legal alien or permanent resident. Additionally, they must be a resident of the state of New Mexico. Unregistered immigrants may be able to qualify for emergency Medicaid in NM if they are able to meet other Medicaid eligibility requirements, such as income criteria. All applicants, regardless of immigration status, must be able to provide proof of identity, citizenship or qualified non-citizen status, state residency and income. To learn more about requirements for Medicaid eligibility and required documentation, you can download our complimentary guide.

What are the income requirements for Medicaid in New Mexico?

The income requirements for Medicaid in New Mexico will depend on the category of Medicaid that a candidate qualifies to receive. For example, to qualify for children’s Medicaid, a candidate who is between six and 19 years of age must be part of a household with an income that does not exceed 190 percent of the federal poverty level (FPL). Adults between 19 and 64 years of age must have a household income that is at or below 138 percent of the FPL. Due to the Affordable Care Act (ACA) Medicaid expansion, more children and pregnant women are able to qualify for Medicaid coverage, as the percentage amount for income based on the FPL was increased. Additionally, the ACA extended Medicaid eligibility in NM to adults without dependents, who can now qualify for benefits based solely on income.

When determining income eligibility for Medicaid benefits in New Mexico, the state takes into consideration a candidate’s income and household size. When a married couple with no children is being considered, the state determines their eligibility for Medicaid benefits by combining the couple’s income before taxes and other deductions. The program also takes into account how many dependents are living together in a household. When determining Medicaid eligibility, the state will still consider children who may be away at school. For pregnant women, the unborn child is counted when determining benefits.

Applicants who are trying to meet NM Medicaid benefits eligibility guidelines will have their income determined by calculating some of the following income sources:

  • Income earned
  • Income received for services performed
  • Unearned monthly income
  • Pensions
  • Annuities
  • Federal Veteran’s benefits
  • Social Security benefits

However, some income will not be considered when determining a candidate’s eligibility for Medicaid benefits, such as SSI income, tax refunds, non-cash payments and veteran’s benefits supporting dependents.

What are the Medicaid application guidelines in New Mexico?

Once an applicant has determined that he or she meets Medicaid eligibility requirements, he or she can apply to receive benefits. Medicaid has no deadline, and applications are rolling, meaning an applicant can choose to apply for benefits whenever he or she needs them. Medicaid application guidelines require a petitioner to choose a method of application and supply all requested information. During the Medicaid application process, applicants must provide accurate, up-to-date information along with any requested documentation. Once a candidate has successfully submitted his or her Medicaid application, he or she will be contacted by the Human Services Department and instructed what next steps to take.