Medicare in New Mexico

In this article...
  • Are you eligible for Medicare? Learn more about the Medicare plans available in New Mexico and how to apply.

What New Mexico Medicare Plans Are Available?

Original Medicare

Medicare Part A and Medicare Part B are part of the Original Medicare program. Medicare Part A covers inpatient services, such as nursing care and medical procedures, provided by a hospital, hospice or skilled nursing facility. For many enrollees, Medicare Part A is free, but some people have to pay a premium if they didn't work and pay Medicare taxes in enough quarters.

Medicare Part B covers preventive care, durable medical equipment, ambulance transportation and medical services provided on an outpatient basis, such as a physical examination to diagnose the cause of a persistent cough. Beneficiaries are required to pay a premium for Part B coverage, as well as a deductible and coinsurance for most services.

Medicare Advantage

Medicare Part C, also known as Medicare Advantage, consists of plans offered by private insurance companies. These plans must cover the same services as Original Medicare, but they may also cover additional services, such as dental care or vision exams. The premium for a Medicare Part C plan is set by the individual insurer and varies based on factors such as the level of coverage provided and the amount of the annual deductible.

Medicare Part D and Medicare Supplement Plans

Medicare Part D prescription drug plans are available to Original Medicare beneficiaries. Because Original Medicare only covers prescription medications under certain circumstances, such as when they are administered in a hospital, many people purchase Part D plans to ensure they have adequate drug coverage.

Medicare Supplement plans (also called Medigap) help cover deductibles and other out-of-pocket costs associated with Medicare coverage. Depending on the plan selected, Medigap may also cover emergency medical expenses while traveling in a foreign country, Medicare deductibles, coinsurance for hospice care provided under Medicare Part A or copayment and coinsurance costs under Medicare Part B.

Plan Availability

Original Medicare is available in all 50 states, and Medicare Advantage plans are available in every state except Alaska. Medicare Supplement Insurance (Medigap) is standardized across the United States, but Massachusetts, Minnesota and Wisconsin use different standardization rules than the other states. As of 2020, there were 429,618 Medicare enrollees in New Mexico, with 263,913 people enrolled in Original Medicare and 165,705 enrolled in Medicare Advantage plans.

Who Is Eligible for New Mexico Medicare?

Medicare is available to people 65 and older, people with end-stage renal disease and some younger people with certain disabilities. Most beneficiaries are automatically enrolled in Original Medicare if they start receiving Social Security benefits at least four months before turning 65. For those who aren't automatically enrolled, it's important to know about Medicare's initial enrollment period, general enrollment period and special enrollment periods.

The Medicare initial enrollment period lasts for seven months. It begins three months before a Medicare-eligible individual turns 65 and ends three months after their 65th birthday. During the IEP, a newly eligible individual can sign up for Original Medicare.

Medicare's general enrollment period runs from January 1 to March 31 of each year. During the GEP, anyone who didn't sign up for Original Medicare during their IEP can do so. Some beneficiaries are allowed to enroll in Medicare outside the initial and general enrollment periods if they have special circumstances. These circumstances include a change in residence, loss of health coverage or termination of an insurer's contract to offer Medicare Advantage plans. Opportunities to change plans are known as special enrollment periods.

Medicare also has an annual enrollment period every fall. From October 15 to December 7, enrollees can sign up for a Medicare Part D plan, switch from Medicare Advantage to Original Medicare, switch from Original Medicare to Medicare Advantage or switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn't offer coverage.

How Do I Enroll in Medicare in New Mexico?

Anyone who isn't automatically enrolled in Medicare can sign up for Part A and Part B using the following methods:

  • Filling out the online application.
  • Calling 800-772-1213.
  • Visiting a local Social Security office. Due to the COVID-19 pandemic, the Social Security Administration suspended face-to-face service in March 2020, so check the SSA website or call the local office before showing up in person.

Contact Information for New Mexico Medicare, Medicaid and Insurance Help

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