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New Mexico Medicaid (Centennial Care) and Yes NM Guide

The New Mexico Medicaid program, also called Centennial Care, can save you thousands on healthcare costs if you qualify. Before you apply through Yes NM, review the benefits, costs, eligibility requirements, and application process.

Click below to learn more about NM Medicaid:

What Does NM Medicaid Cover and Cost?

New Mexico Medicaid covers medical services, prescription drugs, dental, vision, mental health, long-term care, some home health benefits, and transportation services. Transportation services are usually only available to those who do not have their own reliable means of transportation.

Most people with NM Medicaid will not owe any money out of pocket. However, people who qualify under the Working and Disabled waiver may owe copayments of up to $7 for some services, $30 for hospital stays, and $3 for prescriptions.

NM Managed Care in 2019

The Centennial Care program is managed through four “plans” in 2019: BlueCross BlueShield of New Mexico, Western Sky Community Care, Presbyterian Health Plan, and UnitedHealthcare Community Plan of New Mexico. The UnitedHealthcare Community Plan is a dual complete plan for members with both Medicare and Medicaid. The coverage through each of the other plans is relatively similar, though they may have different provider networks and offer extra benefits, like:

BlueCross BlueShield of New Mexico:

  • Free infant car seats and cribs for eligible members
  • Extended adult vision benefits
  • Extended lodging for homeless members

    Western Sky Community Care:

    • Boys & Girls Club memberships for eligible members
    • Care grants for special medical needs
    • Caregiver “thanks to you” packages
    • Dental varnish
    • GED prep and testing
    • Native American traditional healing benefit
    • Post-discharge meals
    • Practice dental and gynecology visits for those fearful of attending gynecology or dental appointments
    • Wellness and emotional support

    Presbyterian Health Plan:

    • Up to six dental varnish applications for kids ages six months to three years
    • Medisafe medication reminders to your phone
    • Tabtime Vibe vibrating pill time reminder
    • Up to $300 of traditional Native American medicine
    • Copayment reimbursement for up to three counseling visits for eligible members
    • School-based health clinic reimbursements
    • School sports physicals for kids ages 12-18
    Have Questions? Ask a Licensed Agent in Your Area

    2019 Centennial Care Rewards

    New Mexico Medicaid members can receive up to the following rewards from Centennial Care in 2019:

    • $20 value for completing an HbA1c test for diabetes
    • $20 value for completing a diabetes nephropathy exam for kidney health
    • $20 value for completing a diabetes retinal eye exam
    • $25 value for attending a prenatal visit in your first trimester or first 42 days of enrollment
    • $25 value for completing an annual dental checkup
    • $25 value for attending a primary care physician checkup
    • $25 value for attending a postpartum visit (21-65 days post delivery)
    • $25 value for completing the “Step-Up walking challenge” (ages 10+)
    • $30 value for attending well-baby checkups (0-15 months)
    • $35 value for completing a bone mineral density test
    • $35 value for taking your child to an annual dental checkup
    • $60 value for filling your child’s asthma controller medication
    • $60 value for filling your bipolar disorder medication as prescribed
    • $60 value for filling your schizophrenia medication as prescribed

    *There may be other limitations to these rewards.

    Step-Up Challenge

    After completing the three-week Step-Up challenge, you’ll receive your $25 reward value and will be invited to the 9-week challenge. You can receive an additional $25 if you complete the 9-week challenge. This reward is available once per calendar year for anyone over the age of 10.

    When you register for the 3-week challenge, you will also receive a free pedometer. In 2015, New Mexico Medicaid reported that Centennial Care members logged over eight billion steps total through this challenge.

    New Mexico Medicaid Eligibility

    Parents, pregnant women, kids, women with breast or cervical cancer, and adults under the age of 64 can qualify for New Mexico Medicaid based on income. If you are married and do not have kids, your eligibility will be based on income before taxes and deductions. Income will include wages, services, pensions, annuities, veteran benefits, and Social Security benefits. SSI, tax refunds, and veteran benefits that support dependents will not be considered. Your household income must be below 138% of the Federal Poverty Level to qualify.

    New Mexico Medicaid Eligibility | Medicare Plan Finder

    New Mexico Medicaid Application

    You can apply for New Mexico Medicaid online, by mail, or in person at your local Human Services Department field office. To apply online, visit “Yes New Mexico.”

    To apply by mail, click here to download the English application, or click here to download the Spanish application. At the bottom of the Medicaid app, you’ll find the applications for other programs like cash assistance, SNAP, and LIHEAP (Low-Income Home Energy Assistance Program). You can apply for everything at once, or you can apply solely for Medicaid. Once you’ve downloaded and completed your application, you can either fax it to 1-855-804-8960 or mail it to the Central ASPEN Scanning Area (CASA) at PO Box 830 Bernalillo, NM 87004.

    Yes NM Portal

    Yes NM, or Yes New Mexico, is the portal for people who either have or are applying for the Medicaid program in New Mexico. By creating a Yes NM account, you can apply for benefits, check your application status, or renew your benefits for Medicaid, SNAP, TANF (cash assistance), and LIHEAP (energy assistance). You can also use Yes NM to register to vote and to sign up for “my Social Security.” You can use my Social Security to check your Social Security statements, review your earnings history, and order replacement cards.

    How to get Both Medicare and Medicaid in New Mexico

    New Mexicans who qualify for both Medicare and Medicaid may be eligible for a “dual-eligible” Medicare special needs plan (DSNP). DSNPs can cover your eligible Medicare and Medicaid benefits at little or no cost to you. To enroll, you must first apply for Medicaid in New Mexico and must enroll in Medicare parts A and B. You can qualify for Medicare A and B by:

    To speak with a licensed agent about enrolling in Medicare, click here or give us a call at 833-438-3676. There is no bias, no cost to you, and never any obligation to enroll.

    Dual Eligible Special Needs Plans | Medicare Plan Finder

    Have questions? Ask a Licensed Agent!