If you have Original Medicare, there is no annual out-of-pocket limit on your healthcare costs. Medicare Supplement plans in New Mexico help protect you against significant medical debt. Commonly known as Medigap, the right amount of Supplemental coverage for you depends on your unique situation.
How Does Medigap Work in New Mexico?
Across the country, Medigap plans help pay your out-of-pocket costs with Original Medicare. This includes Part A, inpatient care, and Part B, medical services.
There are 10 standard Medicare Supplement plans available in New Mexico (A, B, C, D, F, G, K, L, M, and N). Some insurers also offer high-deductible versions of one or more Medigap plans.
Medicare Supplement plans are standardized, meaning that you get the same benefits with Plan A (or D, G, etc.) no matter where you buy it. Costs, however, may vary, but Medigap insurers must follow state and federal guidelines when setting premiums.
Unlike Original Medicare, you can be denied Medigap coverage if you don't have a guaranteed issue right – even if you qualify for Medicare. This is because insurance companies use a process called medical underwriting to decide whether to offer you a plan and at what rate. If you smoke, have preexisting health conditions, or are otherwise considered a high-risk enrollee, Medigap insurers may charge you higher premiums or even refuse to sell you a plan.
Who Qualifies for Medicare Supplement Insurance in New Mexico?
At the federal level, you qualify for Medicare Supplement Insurance in New Mexico once you enroll in Original Medicare and are at least 65 years old. Most states also require Medigap insurers to offer plans to beneficiaries who aren't yet 65 and qualify for Medicare due to a disability, but New Mexico is not one of them.
Under-65 Medicare enrollees can use the New Mexico Medical Insurance Pool (NMMIP) to take part in the Carve-Out Plan. Click this link to learn more.
What Does Medigap Cover?
Medicare Supplement coverage varies according to the plan you choose, although each option includes the Medicare Part A coinsurance and gives you an additional 365 lifetime reserve days as a hospital inpatient.
Use the following table to compare Medigap plan benefits:
Medicare Supplement Insurance does not include prescription drug coverage. You get those benefits with a Medicare Part D prescription drug plan.
Medigap Plan C and Medigap Plan F in New Mexico
Due to a new federal law, Medigap Plan C and Medigap Plan F are not available to those who qualify for Medicare on or after January 1, 2020. The law prohibits Supplement plans that cover the Medicare Part B deductible.
Medigap Plan D or Medigap Plan G offer the same benefits as Plans C and F, minus the Part B deductible. You also usually pay less for Plans D and G.
When Is the Best Time to Join a Medicare Supplement Plan in New Mexico?
The best time to join a New Mexico Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It starts the day you are both age 65 or older and enrolled in Original Medicare.
During your Medigap OEP, your application cannot be denied. Insurers also cannot charge you a higher premium, even if you have preexisting medical conditions.
If you qualify for Medicare due to a disability, you also get a Medigap OEP when you turn 65. You'll receive the same protections as someone who is brand-new to Medicare.
Choosing a Medigap Plan in New Mexico
Since New Mexico Medigap plans are standardized, the first step is deciding how much coverage you want. We recommend choosing a plan with the most comprehensive benefits you can afford.
Look at pricing next. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you get older. These policies cost the most over time.
- Community rated: This pricing method does not consider your age. Over time, these plans cost the least.
- Issue-age rated: Premiums are based on your age at the time you join the plan. While they won't rise due to aging, they may go up because of inflation.
Our Find a Plan tool makes it easy to compare Medigap plans in New Mexico. Simply enter your location information and coverage start date to review Medicare plan options in your area.
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