Health Insurance Carriers in New Mexico (NM)
New Mexico’s insurance laws have their own special differences, which we have detailed for you below. First, review the list of carriers we recommend in New Mexico and click the links to learn more about them. Second, review basic information about New Mexico Health Insurance laws at the bottom of this page.
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Health Insurance Providers in New Mexico
American Medical Security
Assurant Health (Formerly Fortis)
Blue Cross and Blue Shield of New Mexico
Celtic
Clarendon National
Security Life
Group Health Insurance in New Mexico
- Qualified applicants applying for group health coverage may not be denied or charged more for a policy due to a health problem.
- Life changes relating to family problems and job loss may provide opportunities for group health insurance.
- Employers may require a waiting period for new employees.
- Providers may review six months of a policy holder’s medical history prior to coverage.
- Providers may require an exclusion period of up to six months for fully insured groups based on pre-existing conditions.
- If continuous coverage is maintained without a break longer than 63 days, policy holders are entitled to creditable coverage.
Small Business Health Insurance in New Mexico
- Small businesses with fewer than 50 employees may not be denied group health coverage or be cancelled due to illness in the employee group and must be offered several insurance plans.
- With limits, the cost of premiums may be based on the health of the employee group.
- Annual increases have limitations.
- New Mexico Health Insurance Alliance also has coverage available.
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Self-Employed Health Insurance in New Mexico
- The self-employed may not buy group health coverage unless at least one other family member is also applying. In this case, insurance is available through the New Mexico Health Insurance Alliance.
- Contact the New Mexico Insurance Division for rules concerning professional associations which offer group health insurance.
New Mexico Insurance Division
Public Regulation Commission
P.O. Box 1269
Santa Fe, NM 87120
(505) 827-4601
www.nmprc.state.nm.us/insurance/inshm.htm
Individual Health Insurance in New Mexico
- Providers may refuse insurance due to a medical condition.
- In the case of a pre-existing condition, providers may attach elimination riders on policies.
- Providers may impose exclusion periods for up to six months.
- According to the New Mexico Public Regulation Commission, pregnancy and genetic information may not be classified as pre-existing conditions.
- The cost of premiums cannot be changed based on health, but no limits are imposed on increases otherwise.
- Coverage may not be cancelled due to illness.
New Mexico Health Care Programs
- The New Mexico Health Insurance Alliance offers private health insurance to HIPAA eligible individuals, small businesses, and the self-employed.
- New Mexico Medical Insurance Pool provides individual coverage for those who cannot find coverage elsewhere.
- Medicaid and New Mexi Kids assist low income individuals and families.
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