Requirements for Medicaid in New Mexico

Medicaid, a state- and federally funded program, provides free or low-cost medical care to low-income families in the United States. In New Mexico, Medicaid pays benefits directly to your health care provider. In some cases, you may be responsible for a portion of the medical payment determined by your income. Coverage, if eligible, may be applied retroactively for up to three months.

Eligibility

• Being a low-income family does not automatically qualify you for Medicaid coverage. You must be a U.S. citizen or a legal immigrant who permanently resides in the United States. In most cases, only minor children, families with minor children, pregnant women, blind or disabled people, and people over age 65 will qualify for Medicaid services.

  Income eligibility is based on percentages of annually updated federal poverty guidelines, determined by family size, as well as familial assets and resources.

Required Documentation

• When applying for Medicaid in New Mexico, you need for yourself and all other applicants in your family: social security numbers, proof of any health insurance coverage, proof of all combined income over the past four weeks, and proof of identity in the form of a U.S. passport, a valid New Mexico driver's license, New Mexico state-issued identification card or a certificate of Indian blood.

  You also need proof of citizenship in the form of a U.S. birth certificate, a certificate of naturalization, a certificate of U.S. citizenship, a certificate of birth issued by the U.S. Department of State or a final adoption decree.

Presumptive Eligibility

• Presumptive Eligibility for Medicaid in New Mexico is a short-term program, lasting 60 days or fewer, that provides Medicaid coverage for pregnant women and children up to the age of 19. Effective from the date eligibility is determined, Medicaid coverage lasts until the final day of the following month.

  It is called presumptive eligibility because it is presumed that pregnant women and minor children will be covered by Medicaid.

School Services

• The Medicaid program in New Mexico includes a school-based program that provides services for disabled and special needs children in the school system. Services provided include mental health services, physical therapy, social services, occupational therapy, transportation, audiological therapy, case management, speech therapy and nursing services.

Renewal

• Medicaid eligibility lasts for 12 consecutive months. At the end of the 12-month period, you must renew your application by reporting to the office listed on the renewal notice mailed to you, and disclosing any change in income, address or family size to the agency.