Medicare Supplement Plans in New Mexico

Summary: Medicare Supplement plans in New Mexico help fill the gaps in out-of-pocket expenses Original Medicare doesn’t cover. There are a variety of Medigap plans in New Mexico available to cater to different budgets and healthcare needs. Compare the Medicare Supplement plans available in New Mexico so you can find the coverage that suits you most. Estimated Read Time: 11 mins

Table of Contents:

1. Best Medicare Supplement Plans in New Mexico
2. Eligibility for Medigap Plans in New Mexico
3. Medicare Supplement Plan Costs in New Mexico
4. Companies Offering Medigap Plans in New Mexico
5. Medigap Plans in New Mexico for the Disabled Under 65
6. Medicare Supplement Plan Rating Methods in New Mexico
7. Medigap Guaranteed Issue Protections in New Mexico
8. When to Enroll in Medigap Plans in New Mexico
9. Does New Mexico Allow Medicare Excess Charges?
10. Additional Medicare Coverage Options in New Mexico
11. How to Apply for a Medicare Supplement plan in New Mexico

Medicare Supplement plans in New Mexico include coverage for deductibles, copayments, and coinsurance left behind by Original Medicare (Medicare Part A and Part B) that you would otherwise be responsible for paying. Having Medicare Supplement (Medigap) coverage in place eliminates the burden of outrageous or unexpected medical expenses.

Best Medicare Supplement Plans in New Mexico

Medicare beneficiaries in New Mexico have the option to choose from various private insurance carriers offering up to 12 different Medicare Supplement insurance plans. No matter which company you select, the Medicare benefits in each different lettered plan will be consistent.

This is because all Medicare Supplement plans in New Mexico are standardized, as required by federal law. For example, if you enroll in Medigap Plan N with Aetna or Cigna or any other carrier offering Medigap policies in New Mexico, the Medicare benefits will be the same across all insurers.

You will also be able to use your Medigap plan with any healthcare provider that accepts Original Medicare, as Medicare Supplement plans don’t have restrictive networks.

There is no real best Medicare Supplement plan because what may be the best plan for you might not be best for your spouse or neighbor. Choosing the best Medigap plan for you depends on your budget and healthcare needs. However, some of the more popular options among New Mexico seniors for affordability and comprehensive coverage include:

• Medicare Supplement Plan F
• Medicare Supplement Plan G
• Medicare Supplement Plan N

Medicare Supplement Plan F in New Mexico

Medicare Supplement Plan F in New Mexico is one of the most popular options when it comes to supplemental Medicare coverage. However, this plan is only available to those who were eligible for Original Medicare prior to January 1, 2020. Those who enrolled in Medicare after this time are not eligible to enroll in the plan.

Medicare Supplement Plan F covers 100% of the cost you pay out-of-pocket after Original Medicare covers its portion of your benefits. This means aside from your monthly premiums, you will not pay anything out of pocket for your healthcare coverage.

Medigap Plan F in New Mexico includes:

• Part A deductible, coinsurance and hospital costs, and hospice care coinsurance
• Part B deductible, copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

While this plan saves you money at the doctor’s office, it does often have the highest monthly premium. Therefore, there may be other options that work best for your situation.

Medicare Supplement Plan G in New Mexico

Medicare Supplement Plan G is the most popular plan for those ineligible for Medigap Plan F. Plan G covers everything after Original Medicare aside from your Medicare Part B deductible. Thus, once you meet your Part B deductible, you will receive full coverage for your healthcare services for the year.

Medigap Plan G in New Mexico includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

This plan is a great option for someone who frequents the doctor or hospital and wishes to have the lowest out-of-pocket costs possible. Plus, the monthly premium for Plan G is not as high as other Medigap plans in New Mexico.

Medicare Supplement Plan N in New Mexico

Medicare Supplement Plan N is a great option for New Mexico Medicare enrollees who don’t receive frequent care at a medical facility but wish to have healthcare in the case of a catastrophic event.

With Medicare Supplement Plan N, you will be responsible for covering the Medicare Part B deductible, $20 copayments at the doctor’s office for primary care and specialists, $50 copayments at the emergency room if you are not admitted, and excess charges if your state and doctor allows them.

Medigap Plan N in New Mexico includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays/coinsurance
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Among the top three plans, Medicare Supplement Plan N has the lowest monthly premiums.

Eligibility For Medigap Plans in New Mexico

To be eligible for a Medicare Supplement plan in New Mexico, you must meet the eligibility criteria for Original Medicare. Typically, these requirements include being at least 65 years old and being a United States citizen for at least five years.

However, some exceptions may allow individuals to qualify for Medicare insurance at a younger age. These exceptions include being diagnosed with end-stage renal disease (ESRD), although Medicare coverage won’t start until after a waiting period. This waiting period is usually at least four months of undergoing dialysis.

Other exceptions include being diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, or receiving Social Security Disability Insurance (SSDI) for at least 24 months.

If you currently have a Medicare Advantage plan (Medicare Part C) and want to enroll in a Medigap plan, you will need to choose between the two. You cannot have both types of coverage at once.

Before applying for a Medigap policy, you must first disenroll from your Medicare Advantage plan. This can only be done during valid election periods. These periods include the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period.

How Much Do Medigap Plans in New Mexico Cost?

Medicare Supplement plans in New Mexico do not cost the same as Medigap plans in other states. This is because Medigap plan pricing is not regulated by the government. Thus, different carriers can charge different rates for your chosen plan.

Medigap premiums are based on several factors. The pricing method used by your state, your age, your gender, and your ZIP Code all play a role in determining how much you will pay for your Medicare Supplement plan each month.

The table below is a sample of what you might pay in New Mexico based on your age and gender.

* If on Medicare before 1/1/20

It’s important to remember that the prices shown in the above chart are just average examples in New Mexico. Your actual premium costs could be higher or lower than those listed due to the previously mentioned factors or other personal factors.

Companies Offering Medicare Supplement Plans in New Mexico

Several carriers in New Mexico offer Medicare Supplement plans. However, each carrier can have slightly different premium rates. Although your plan’s benefits are standardized, the benefits of being a member of certain insurance companies can be individualized.

Below is a list of carriers who offer Medigap plans in New Mexico. However, this is not a comprehensive list. The carriers below are just a few of the most prominent and popular in New Mexico.

• Aetna
• Blue Cross Blue Shield of New Mexico
• Cigna
• Humana
• UnitedHealthcare

While it’s important to consider the cost of the monthly premium when choosing a Medicare Supplement insurance company, there are other factors to consider as well. Independent credit agencies like A.M. Best and S&P assess the financial stability of insurance providers. They provide insights into the carriers’ ability to cover your healthcare expenses properly.

Additionally, consumer agencies like the Better Business Bureau (BBB) evaluate customer service based on complaints, giving you valuable information about the overall consumer experience. Taking all these factors into account will allow you to make an informed decision when choosing an insurer for your Medigap policy in New Mexico.

Medigap Plans in New Mexico for Those Under 65 on Disability

Medicare Supplement plan carriers are not required to sell Medigap plans to those under 65. In New Mexico, some insurance companies offer at least one Medigap plan to those who are on Medicare due to disability. However, Medicare Supplement plans tend to cost more for those on disability because of the claim’s risks.

Beneficiaries under 65 may find Medicare Advantage plans to be more suitable for their budget.

However, upon turning 65, any disabled beneficiary can enroll in Medicare Supplement coverage without medical underwriting. This means a lower rate and more coverage on the first day of the month you turn 65 years old.

Medicare Supplement Rating Methods in New Mexico

Medicare Supplement insurance companies in New Mexico evaluate premium prices using three different rating methods: Attained-Age Rated, Issue-Age Rated, and Community Rated.

Insurance companies in New Mexico commonly use the Attained Age method to determine your Medigap premium annual increases. This means your premiums for Medicare supplements are determined based on your current age and go up yearly. This increase in premiums is typically due to the higher healthcare costs associated with aging and the increased utilization of medical services.

The issue-age method is similar to the attained-age method, but your premium will not increase due to your age. Rather, it will increase based on external factors like inflation. States that use issue-age ratings typically have lower rate increases than states that do not.

The community rating ensures that all individuals enrolled in the same Medigap plan within a specific geographic location in New Mexico pay the same premium, regardless of their age. While the premium may increase due to external factors like inflation, it is not directly tied to your age alone

Medigap Guaranteed Issue Protections in New Mexico

Residents of New Mexico are granted specific guaranteed issue rights or Medigap protections under federal law. These rights ensure that they can enroll in a Medigap plan without facing denials of coverage or higher premiums based on pre-existing conditions, ensuring access to Medigap coverage when needed.

One significant guaranteed issue right is the Medicare Advantage trial period. If someone joins a Medicare Advantage plan when first eligible for Medicare and decides to disenroll within the first year, they have a one-time guaranteed issue right to enroll in a Medigap plan without undergoing medical underwriting.

Another essential protection is available for those who experience a loss of coverage. If someone loses employer-based retirement coverage or if their current Medigap plan is terminated or discontinued, they have a guaranteed issue right to enroll in another Medigap plan.

These guaranteed issue rights also apply if someone moves out of state and their Medigap carrier is no longer available. To qualify for this protection, they must apply for a new Medigap plan within 63 days of the termination of their existing plan.

Furthermore, there are guaranteed issue rights associated with Medicare Advantage plans. If someone’s Medicare Advantage plan is terminated, they move out of its service area, or they lose coverage due to circumstances beyond their control, they have a guaranteed issue right to enroll in a Medigap plan. To be eligible for this protection, they must apply for a Medigap plan within 63 days of the termination of their Medicare Advantage plan.

When to Enroll in a Medigap Plan in New Mexico

As a resident of New Mexico, you become eligible for a Medicare Supplement plan as soon as you enroll in Original Medicare. There is no specific deadline for enrolling in supplemental insurance, but if you apply outside of your Open Enrollment Period, you may need to answer underwriting questions about your health.

After you enroll in Medicare Part B, you automatically get a six-month Medigap Open Enrollment Period. During this time, you can enroll in a Medigap plan without undergoing medical underwriting. This is the best opportunity to get a Medicare Supplement plan because insurance companies cannot deny you coverage or charge higher premiums based on preexisting health conditions.

If you delay enrolling in a Medigap plan due to having creditable coverage in addition to Medicare Part B, you can qualify for a Special Enrollment Period. This period grants you guaranteed issue rights, allowing you to get a Medigap plan without underwriting.

Does New Mexico Allow Medicare Excess Charges?

New Mexico is one of several states that allow physicians to charge Medicare Part B excess charges if the doctor does not accept Medicare assignment. This means you may be charged up to 15% more than what Medicare agrees to pay.

However, most healthcare providers do accept Medicare assignment, making excess charges relatively uncommon.

Additional Medicare Coverage Options in New Mexico

Aside from Medicare Supplement plans, there are other options available for coverage in New Mexico.

If a Medicare Supplement plan isn’t for you, a Medicare Advantage plan (Medicare Part C) is a solid option. However, these plans may not be as comprehensive as Medigap plans. They may also come with more out-of-pocket costs, and you will have to deal with physician networks.

Medicare Part D plans are also available in New Mexico to provide you with prescription drug coverage. They can help cover the costs of expensive prescription drugs, and there are various Part D plans to choose from for all budgets. Just be sure that the Part D plan you’d like to enroll in offers your prescriptions in the plan’s formulary.

In addition to Medicare plans, there are ancillary coverage plans for dental, vision, and hearing available in New Mexico. These plans provide coverage not found in Original Medicare or in a Medigap plan.

How to Apply for a Medicare Supplement plan in New Mexico

If you wish to enroll in a Medicare Supplement plan in New Mexico, our team of licensed insurance agents are here to help. We are available to compare top plans in your area, help you understand your coverage, and help you work through any issues in your coverage.

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