New Mexico's Medicaid Income Eligibility Requirements

Medicaid, a federally funded public health insurance program that provides coverage to those who meet qualifying income guidelines, operates in the state of New Mexico through the New Mexico Medical Assistance Division (MAD) and the New Mexico Human Services Department. Applicants who wish to receive coverage through the Medicaid program must meet certain income requirements as mandated by state and federal guidelines. These requirements vary based on household size, medical need and individual circumstances.

Pregnant Women

• Women in the state of New Mexico who wish to enroll in coverage through Medicaid to receive health care during their pregnancy and delivery are required to meet economic guidelines in order to qualify. To be approved through Medicaid in New Mexico, pregnant applicants must not have income exceeding 185 percent of the federal poverty level. Once approved, all prenatal health care services will be paid for through the program, which also includes delivery and related hospital stays as a result of the birth. Interested applicants must be willing to show proof of income to determine eligibility.

Children Through Nineteen

• In New Mexico, all children are eligible for Medicaid coverage from birth through the age of 19 as long as their income does not exceed 185 percent of the recognized federal poverty level. In addition, babies who are born to mothers who have been deemed eligible for Medicaid coverage are automatically enrolled in the program and will remain covered through Medicaid until the infant turns one year of age. At that point, the mother will need to formally apply for Medicaid on behalf of the child for coverage to continue, and both the mother and infant must continue to reside within the state. To be approved, applicants must be able to document income and proof of identity.

Elderly and Disabled

• Eligibility for elderly or disabled applicants for Medicaid in New Mexico is determined by eligibility standards for Supplemental Security Income (SSI). The maximum monthly income standard for single applicants is $552 and the maximum monthly income standard for couples is $829. In addition, applicants must not have resources such as bank accounts, stocks or bonds exceeding $2,000 for single applicants and $3,000 for a married couple. Assets such as the applicant's primary home, vehicle and furniture are not considered disposable assets in regard to Medicaid coverage in New Mexico and will not cause the applicant to be disqualified. Applicants must provide proof of income and disability, if appropriate, to establish proof of need.