New Mexico Medicare Supplement Plans (Medigap)

You are here:

New Mexico Medicare Supplement plans were designed for purchase, when seeking extra Medicare coverage. These supplement plans were created to add additional coverage to your traditional Medicare coverage plan. This will typically include other out-of-pocket expenses, like deductibles, coinsurance and copays.  

Medicare supplement plans are the same as Medigap insurance. Each Medicare supplement plan can be purchased through separate private insurance companies. For New Mexico Medicare coverage, there are several plans and options available to you.  

New Mexico Medicare Options ExplainedNew Mexico Medicare Options Explained

As a Medicare beneficiary in New Mexico, there are currently four options available for Medicare coverage.  

  • Part A (Hospital Insurance) 
  • Part B (Doctors Insurance) 
  • Part C (Medicare Advantage) 
  • Part D (Prescription Drug Plan) 

Medicare Part A covers any and all inpatient procedures or hospitalization.  

Medicare Part B in New Mexico covers any medical expenses that occur outside of a hospital setting. This will include any additional testing, doctor visits, outpatient procedures, etc.  

Medicare Part C, also known as Medicare Advantage, is sold through private, Medicare-approved, health insurance companies. Medicare Advantage replaces your Part A and Part B Medicare coverage, but may hold some limitations.   

Medicare Part D will cover the costs of prescription drugs medically necessary for health care.

Eligibility for New Mexico Medicare Supplement Plans

If you are seeking Medicare coverage, there are a few qualifications that must be met first. In order to be eligible for a New Mexico Medicare Supplement Plan, you must be: 

  • 65 years of age or older, and enrolled in Medicare Part B, or 
  • Disabled, under 65. 

A senior, 65 years of age or older, must enroll in Medicare when they are first eligible. If you do not enroll when you are first eligible, you may incur additional charges. This is caused by the Part B Late Enrollment Penalty. If you do not enroll within your first 12-month period, your Medicare Part B premium will increase by 10% each year

If you currently receive disability benefits from Social Security, or Railroad Retirement benefits, you automatically qualify for Part A and Part B (the Original Medicare) Medicare coverage. 

At this time, New Mexico residents cannot purchase Medicare coverage from our carriers. However, this does not mean there are no carriers who offer plans to those on disability.  

Enrolling in New Mexico Medicare Supplement Plans

If you are currently a New Mexico resident, your Open Enrollment Period (OEP) will start on the 1st day of the month you are at least 65 years old, and when your Medicare Part B has become effective.  

This means, if your 65th birthday was on February 31st of 2018, and your Medicare Part B coverage became effective on April 20th, your open enrollment period would begin on May 1st. Once you’ve determined when your OEP begins, it will be in effect for 6 months. Within this 6 months, you are granted Guaranteed Issue (GI).

Guaranteed Issue is the period of time after enrollment, when insurance companies are required to allow you to enroll in a Medicare supplement plan, or Medigap policy. With guaranteed issuance, no senior can be denied a Medicare supplement plan or Medigap policy.  

New Mexico Medicare Supplement Plans Premiums

Cost varies when it comes to New Mexico Medicare Supplement Plans pricing. Cost is determined by the insurance carrier, not the state. When determining the cost, the carrier will take into consideration your location, age, and sex. Therefore, Medigap premiums in Albuquerque, New Mexico, will be different from premiums in Rio Rancho, New Mexico.  

Medigap carriers classify costs into three different pricing methods.  

  1. Issue Age Rated: This pricing method is based on the age you were at the time you purchased your policy. Costs will not increase because of your age. However, the older you are when you purchase your policy, the more you pay. 
  2. Community Rated: Everyone will pay the same amount, regardless of age. Your premium will not go up as you get older.  
  3. Attained Age Rated: Medigap that is age attained rated is calculated by your current age. This is likely the lowest-priced option at first, but will increase as you age. This increase could be anywhere from 1.5%, up to 5% each year. 

Please keep in mind, there are some policies that may seem like a good deal up front. In reality, you could end up paying more than anticipating. Be sure to do plenty of research when considering a Medicare policy provider. 

Top New Mexico Medicare Supplement Plans

When seeking Medicare coverage in New Mexico, it is important to know that the benefits of each letter plan will stay consistent, regardless of the provider. The only thing that may vary, would be the cost.

The most commonly chosen Medicare plans are  

  • Plan N
  • Plan High Deductible F
  • Plan F
  • and Plan G

Plan N: Medicare Plan N covers expenses not paid through Medicare health insurance coverage. While Plan N may not be full coverage, it is considered one of the more affordable plans available. 

Plan HDF: This plan was designed to work with Medicare Part A and Part B (the Original Medicare). With this plan, you’ll receive full coverage on all out-of-pocket costs. High Deductible Plan F will hold you responsible for any medical expenses up to your deductible amount. Due to the deductible, the premium for the HDF plan is much less than Plan F. 

Plan F: Medicare Plan F leaves beneficiaries with minimal out-of-pocket expenses. Regardless of the provider, you will receive the exact same coverage. This plan covers most of the remaining hospital and doctor costs, after Medicare handles their portion of the costs

Plan G: This plan is sold by private insurance companies and all providers offer the same benefits. Remember, prices vary with every provider. Plan G and Plan F are the only plans that cover any of your excess charges.  

Medicare Advantage Plans in New Mexico

Medicare Advantage, or Medicare Part C, is one of the better, more full coverage plans. However, if you choose a Medicare Advantage Plan, you will be required to give up your Part A and Part B coverage. Once you choose a provider for your primary coverage, you will no longer have Medicare Part A and B. 

Medicare Advantage is a great option for many people. While it is popular, Medigap may give you a bit more freedom. If you should decided to choose Medigap, you are not limited to where you seek health care in New Mexico. With Medicare Advantage, there are restrictions on where you receive health care. 

One of the biggest concerns for those seeking health care is cost. We usually find that Medigap is less expensive, and has less out-of-pocket risk. Medigap, along with Original Medicare, gives you the best coverage when medical emergencies arise.  

New Mexico Prescription Drug Coverage

With Part D Prescription Drug coverage, you can avoid paying a majority of the cost of your prescribed medications. 

Select plans do include some drug benefits already. However, you do not want to wait and find that you do not have coverage to pay your prescription drug costs.   

If you do not purchase prescription drug coverage soon after qualifying for Original Medicare, you may be subject to a Part D penalty.  

This penalty is calculated by multiplying the national base beneficiary premium of 1% times the number of months that you did not possess Part D prescription drug coverage.  

Learn More About Medicare Options in New Mexico

If you are seeking Medicare Plans, Medigap, Prescription Drug Plans, or Medicare Advantage, please contact us today. We would love to set you up with an agent to answer all of your questions, and clear up any concerns.  

Additionally, you may also skip the phone call, and leave us your information in the form at the bottom of the page.  

Still conducting some independent research? No worries! To help you decide on a Medicare plan that best suits your medical position, you can compare rates here!  

Resources for New Mexico Medicare Beneficiaries

The cost of health care can add up, and seem intimidating, creating unwanted stress, but it is important to be aware that there are options if you need extra help.  

MSP, or Medicare Savings Program, currently offers four types of programs to those who may require extra financial assistance. 

You may also look into the Senior Health Insurance Counseling Program (SHIP). Each state has its own individual program. Each provides assistance to those who currently have, or are eligible for, Medicare, Medicare Supplements, and Medicare Advantage.

New Mexico Medicare FAQ

  1. What‘s changing in Medicare for 2018 in New Mexico? As of January 1st, 2018, there are just a few changes in Medicare Advantage plans in New Mexico. ER copays have been increased, to encourage patients to seek more appropriate health care, such as a primary care setting, or urgent care.
  2. Why is Medicare expensive in New Mexico? Up until the beginning of 2018, New Mexico was considered to be one of the states with the lowest costs for Medicare coverage. However, due to recent changes in New Mexico Medicare, premiums are expected to continue to increase.
  3. Do Albuquerque physicians accept Medicare? There are several physicians in the Albuquerque, New Mexico area. For more information on which physicians you can choose to seek health care from, we encourage you to contact us today!