In addition to nursing home care and assisted living services, benefits are available to help this population to remain living at home. This is true regardless of the long-term care Medicaid program for which one is an applicant and regardless of if one or both spouses are applicants. Health insurance for people 65 and older Under 65 with certain disabilities . 2. 03. New Mexico Medicaid Long-Term Care Definition. Nearly 300,000 people . The cost of Medicaid and expenses associated with the program may change based on a range of factors. Presbyterian Healthcare Services has served New Mexicans for more than 110 years. PART 600 BENEFIT DESCRIPTION. If the Look-Back Rule is violated, a Penalty Period of Medicaid ineligibility will be established. 1915(c) Waiver Allocation and Transition Guide - nmhealth.org Learn more about calculating the spousal allowance. The links below give basic information about these eligibility categories. Hsd 100 form: Fill out & sign online | DocHub 2) Program of All-Inclusive Care for the Elderly (PACE) Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. All rights reserved. You can qualify for Medicare A and B by: To speak with a licensed agent about enrolling in Medicare,click hereor give us a call at 833-438-3676. States may alter certain Medicaid benefits depending on regional needs and resources. Connect with a Medicaid planner. Familiarizing oneself with general information about the application process for long-term care Medicaid can be helpful. The Departments Income Support Division offices make eligibility determinations for Medicaid, except for those categories administered by the Children, Youth and Families Department, the Social Security Administration, and the Premium Assistance programs. The table below presents the most recent, point-in-time count of total Medicaid and endstream endobj 212 0 obj <. There are also many non-countable (exempt) assets. Some providers may not be able to take new Medicaid patients. Further complicating eligibility are the facts that the financial requirements change annually, vary with marital status, and that New Mexico offers multiple pathways towards Medicaid eligibility. gross income (MAGI). In New Mexico, a non-applicant spouse can further increase their spousal income allowance if their housing and utility costs exceed a shelter standard of $686.63 / month (effective 7/1/22 6/30/23). Need help sorting through your options? 01. Before applying for NM Medicaid coverage, petitioners benefit from knowing what expenses may be associated with Medicaid. Welcome to Benefits.gov | Benefits.gov w`rWUYoZr* ~"oP0 @% 7h}|qbDzDueXaG7imzw5R[%gU Medicaids Look-Back Rule The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. Alternative Benefit Plans (ABP) must cover the 10 Essential Health Benefits (EHB) as described in section 1302 (b) of the Affordable Care Act whether the state uses an ABP for Medicaid expansion or coverage of any other groups of . Persons who are disabled and over the age of 64 can receive program benefits under the aged (65+) category. The technical storage or access that is used exclusively for anonymous statistical purposes. The term 1937 Medicaid Benchmark or Benchmark Equivalent Plan has been retitled to Alternative Benefit Plans. MIZ3d|UAtRkE@X;3= %)n Source: Medicaid/CHIP Medicaid - New Mexico State Dental Some providers may not be able to take new Medicaid patients. An applicant must have a medical need for Medicaid long-term care. Copyright 2023 New Mexico Dental Association. coverage to low-income adults. If you are enrolled in a Centennial Care - Managed Care Organizations you must use one of the following links to locate the dental providers for your plan: The information for these providers is based on the information the Medicaid program currently has available on file. Blue Cross and Blue Shield of New Mexico's (BCBSNM's) Medicaid plan is Blue Cross Community Centennial SM. hL;;>~ ?w=nxu;.k '7|n;#2)iE g>RU4]bI )q \mhJ?|>'7/NR`+5xr0533Otf}AL]T68d!wA!YN0MSH]Fgiv"waMEur,M\_Y+L lC/!WsH':>/Sfd~d "nhQ8noieWggwqu= 8]Qa{]Okmn1. If any information is not current, please use your local phone directory to locate the dental providers. The coverage benefits of Medicaid include a range of services that are mandatory across the nation and in New Mexico. voluntarily reported 15 of 24 frequently reported health care quality measures in measures in the CMS Medicaid and CHIP Child Core Set. In 2023, the community spouse (the non-applicant spouse) can retain 50% of the couples joint assets, up to a maximum of $148,620. New Mexico Medicaid coverage applies to the following services when they are medically necessary: breast pumps and replacement supplies, ground and air ambulance, maternity and pregnancy-related services. New Mexico Medicaid members can receive up to the following rewards from Centennial Care in 2019: $20 value for completing a diabetes nephropathy exam for kidney health. %%EOF In addition to nursing home care and assisted living services, benefits are available to help this population to . We have cared for New Mexico's Medicaid members since 1997. *Disclaimer: SCAN Health Plan is only available in select counties in the state of California. A lock ( You can apply for New Mexico Medicaid online, by mail, or in person atyour localHuman Services Department field office. 4. In New Mexico, Medicaid is called Centennial Care. States have the option to cover pregnant women under CHIP. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces . Before you apply through Yes NM, review the benefits, costs, eligibility requirements, and application process. We can help you if you are healthy or if you have special needs or need complex healthcare services. CMS Medicaid and CHIP Child and Adult Core Sets and additional data sources in . Medicaid services in NM are intended to provide low-income applicants with aid for necessary health care, so the program excludes certain services that are considered elective procedures. This includes cash, stocks, bonds, investments, bank accounts (credit union, savings, and checking), IRAs / 401Ks, real estate in which one does not reside, and any remaining funds from Covid-19 stimulus checks. There are several ways for seniors to apply for Centennial Care in New Mexico. For instance, services covered by Medicaid in New Mexico include inpatient and outpatient care. 576 0 obj <> endobj A trustee manages the trust and has legal control of the money. Once youve 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. Share your form with others. 8.200.400 NMAC - New Mexico There is no bias, no cost to you, and never any obligation to enroll. You can receive an additional $25 if you complete the 9-week challenge. However, having Medicaid coverage does not always mean that there is no cost associated with the program. New Mexico State Health Insurance Assistance Program (SHIP) 18004322080. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. To apply online, visit Yes New Mexico.. New Mexico's Medicaid has 40 Categories of Eligibility - Families.com If you continue to have problem accessing the chat icon call, Customers can call 1-800-283-4465 and Providers can call 1-800-299-7304. determine Medicaid eligibility for other populations. If the non-applicants share falls below $31,290, 100% of the assets, up to $31,290 can be retained by the non-applicant spouse. Let's find a plan to fit you, in a few short steps. MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging, *All of ones monthly income with the exception of a, What is the Medicaid Estate Recovery Program, Minimum Monthly Maintenance Needs Allowance, Learn more about calculating the spousal allowance, New Mexico Centennial Care Community Benefit, Program of All-Inclusive Care for the Elderly, local Human Services Department (HSD) Income Support Division (ISD) office, 2023 New Mexico Medicaid Long-Term Care Eligibility for Seniors, $2,000 for applicant & $148,620 for non-applicant, Medicaid Waivers / Home and Community Based Services, Regular Medicaid / Aged Blind and Disabled. 4 0 obj eligibility verifications plans, MAGI Conversion Plans change in enrollment since the initial open of the Health Insurance Marketplaces, The technical storage or access that is used exclusively for statistical purposes. Presbyterian Healthcare Services has served New Mexicans for more than 110 years. ): up to 90% of the federal poverty level for their household size. If the individual does not have an existing Medicaid category that requires transition of care, then proceed to Step 4. Information about efforts to enroll eligible individuals in Medicaid and CHIP in . More. The Qualified Medicare Beneficiary (QMB) program provides Medicare coverage of Part A and Part B premiums and cost sharing to low-income Medicare beneficiaries. However, in cases where copayments are due, Medicaid coverage caps the amount that a provider may charge for services. Please visit our. More detailed information and source references are available on each of these topics. A locked padlock Your household income must be below 138% of theFederal Poverty Levelto qualify. Income is counted differently when only one spouse applies for Regular Medicaid / Aged Blind and Disabled; The income of both the applicant and non-applicant spouse is calculated towards the applicants income eligibility. Medicare 4. (2) SSI medicaid extension - Categories 001, 003 and 004: MAD provides coverage for certain groups of applicants or eligible recipients who have received supplemental security income (SSI) benefits and who have lost the SSI benefits for specified reasons listed below and pursuant to 8.201.400 NMAC: Often, what Medicaid covers in a state depends on local resources and needs, leading to the exclusion of certain types of coverage. While officials attempt to keep Medicaid cost estimates low, in some cases there are costs to the recipient. CMS provided states with a template for completing their "MAGI Conversion Plans" that are designed to reflect the MAGI-based eligibility standards that are used to determine Medicaid and CHIP eligibility. purposes of verifying eligibility for Medicaid and CHIP. Information about how determines whether a person In federal fiscal year (FFY) 2019, reported of 22 frequently reported health care quality When a state did not report a measure or used non-Core Set specifications, the measure is not included below or in the count of measures reported by the state. In specific situations, the answer to How much is Medicaid? is sometimes zero. Furthermore, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse to prevent spousal impoverishment. Transportation services are usually only available to those who do not have their own reliable means of transportation. When a state did not report a measure or used non-Core Set specifications, the measure is not For long-term care services via the Regular Medicaid program, a functional need with the Activities of Daily Living is required, but a NFLOC is not necessarily required. For example, for a Waiver to cover home modifications, it may be required that a beneficiary be unable to safely live independently without modifying the home. PDF January 2021 NEW MEXICO MEDICAL ASSISTANCE PROGRAMS Eligibility Categories Following the death of the Medicaid participant or in the event of Medicaid disenrollment, the remainder of the funds must be paid to the state of New Mexico. )[{)& yKI\;{{_ 9 RA7fk2\`R/l'" 0jiDQc7Q_Sw-~wa*h;P8\8BhcjqMp endstream endobj 577 0 obj <. Testing and treatment for specific diseases. Please note that this list is provided only as a resource and the providers may not be members of the NMDA. New Mexico Medicaid Centennial Care Community Benefit Program Thus, 8% of the NM Medicaid population was experiencing SMI/SED at the start of the demonstration. The MMMNA is said to be the minimum amount of monthly income to which a non-applicant is entitled. We help individuals nationwide with Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Extra Help, and Final Expense. Medicaid & CHIP Enrollment Data. 5. Furthermore, some program benefits may have additional eligibility criteria specific to the particular benefit. Other eligibility criteria also apply, for example, with respect to citizenship, immigration status and residency. . CHIP covers birth through age 18 unless otherwise noted in parentheses. hb```b````a`ag@ ~f(,FS%) Hch`!A(f`eXQ$.AN|D9;O Hs00vn d`'el \` q Use of this content by websites or commercial organizations without written permission is prohibited. Expansion Adults (all adults, including Parents and . The U.S. Federal Gift Tax Rule does not extend to Medicaid eligibility. Explore key characteristics of Medicaid and CHIP in , I also agree that by submitting this Contact Request form, I am bound by Medicare Health Benefits, LLC Privacy Policy and Terms of Use. More on how Medicaid calculates income. Call our team today and get your questions answered with, How to get Both Medicare and Medicaid in New Mexico, dual-eligible Medicare special needs plan, Entering your 25th month of SSDI benefits, Medicare Part A: Coverage and Costs for 2020, Understanding Medicare Part B: Coverage and Costs for 2020, Free infant car seats and cribs for eligible members, Boys & Girls Club memberships for eligible members, Native American traditional healing benefit, Practice dental and gynecology visits for those fearful of attending gynecology or dental appointments, 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, $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 childs asthma controller medication, $60 value for filling your bipolar disorder medication as prescribed, $60 value for filling your schizophrenia medication as prescribed. New Mexico Medicaid covers medical services, prescription drugs, dental, vision, mental health, long-term care, some home health benefits, and transportation services. 1) New Mexico Centennial Care Community Benefit Intended to encourage independent living at home or in the community, a variety of supportive services are provided. %%EOF sources (for example, the Social Security Administration, the Departments of New Mexico Medicaid (Centennial Care) and Yes NM Guide Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance. The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long-term care from a New Mexico Medicaid program. endobj For these persons, Medicaid planning exists. We help make it easy to manage your care. measures in the CMS Medicaid/CHIP Child Core Set. 0 By working with a Medicaid Planning Professional, families can employ a variety of strategies to help them become Medicaid eligible, as well as to protect their home from Medicaids Estate Recovery Program. hb```>Ad`0pgl.B @1#?f|tY99i=`L`7rg`2, d!2 In states that use dollar amounts based on household size, rather than percentages of the FPL, to determine eligibility for parents, we converted those amounts to a percentage of the FPL and selected the highest percentage to reflect the eligibility level for the group. Veterans Aid & Attendance payments are also excluded from income. Are you looking for a Medicaid plan that will help to keep you healthy and happy? 2) Asset Spend Down Persons with assets over Medicaids limit can spend down extra assets to become asset-eligible. Treatment of Income for a Couple The COVID pandemic pushed Medicaid enrollment in New Mexico quite a bit higher: By October 2022, enrollment was 93% higher than it had been in late 2013, and stood at nearly 900,000 people. endobj Completed applications can be faxed to 1-855-804-8960, mailed to Central ASPEN Scanning Area (CASA), PO Box 830, Bernalillo, NM 87004, or dropped off at ones local Human Services Department (HSD) Income Support Division (ISD) office. Information about performance on frequently-reported health care quality measures in the g New Mexico Medicaid Portal Most applicants qualify for full benefits only if their income falls below 185 percent of the Federal Poverty Level Guidelines. However, additional groups receive certain other advantages as well. Traditional Medicine Value Added Services form, More Forms & Documents (Ms formularios y documentos), NM Human Services Department - Centennial Care Overview, HSD Emergency Rental Assistance Program FAQ, HSD Emergency Rental Assistance Program Press Release, Financial assistance and covering your care at a Presbyterian. has expanded Medicare beneficiaries with limited income and resources may be able to enroll in a Medicare Savings Program . For instance, those requesting preventative services may face some out-of-pocket expenses. The Presbyterian Centennial Care plan can do that. This reward is available once per calendar year for anyone over the age of 10. <> These counts do not include the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey 5.0H, Adult Version (Medicaid) (CPA-AD) measure, Medicaid is a public, or government run, form of health . When it comes to a monthly payment (your premium), which do you prefer? Section 8.200.400.14 - RETROACTIVE MEDICAID, N.M. Code R. - Casetext and get either full Medicaid coverage or SSI benefits. 229 0 obj <>/Filter/FlateDecode/ID[<94C9F77D113AD7489832BD6A8AA5D27A><26228B3B93B994419C1B23CF48A07C23>]/Index[211 26]/Info 210 0 R/Length 93/Prev 170436/Root 212 0 R/Size 237/Type/XRef/W[1 3 1]>>stream In New Mexico, state officials manage the program, including reviewing applications and providing information to residents and applicants. Alternative Benefit Plan Coverage | Medicaid Equity interest is the amount of the homes equity that is owned by the applicant. However, in 2023, a spousal income allowance cannot put a non-applicants monthly income over $3,715.50.This is the Maximum Monthly Maintenance Needs Allowance. While this program is jointly funded by the state and federal government, the state administers the program under federally set parameters. Section 8.200.400.14 - RETROACTIVE MEDICAID. The Specified Low-income Medicare Beneficiary (SLMB) program is a type of Medicare Savings Program designed to help qualified beneficiaries - many of whom also have Medicaid - pay their Medicare Part B premiums. Medical Assistance Division: NMAC Eligibility Rule Manual. Medicaid and CHIP agencies now rely primarily on information available through data We use cookies to collect site usage statistics and provide helpful (but not necessary) site functionality. The income requirements for Medicaid in New Mexico will depend on the category of Medicaid that a candidate qualifies to receive. Powered by Medicare Health Benefits. 1. . Most Medicaid eligibility and all CHIP eligibility is based on modified adjusted 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). hb```),|B Send hsd100 via email, link, or fax. 236 0 obj <>stream There is no Look-Back Rule for Regular Medicaid. Medicaid and EMSNC) A Notification of Birth (NOB) MAD 313 form may act as an application, if submitted to HSD by the Medical service provider where the birth occurred proving citizenship The infant continues to reside in New Mexico Category 100 - Other Adults Alternative Benefit Package Income must be under 133% FPL 0 For instance, the Affordable Care Act (ACA) introduced an expansion of Medicaid to cover more individuals. Such services are funded in part with the State of New Mexico.. and (b)national counts and change statistics for the same period. 6201 Centennial Blvd. Some examples of the types of Medicaid services in NM that are mandatory include: New Mexico Medicaid coverage extends to a broad range of potential beneficiaries. For New Mexico elderly residents, aged 65 and over, who do not meet the financial eligibility requirements above, there are other ways to qualify for Medicaid. groups: children, pregnant women, parents/caretaker relatives, and, other adults. New Mexico has a 60-month (5 year) Medicaid Look-Back Period for Nursing Home Medicaid and Medicaid Waivers that immediately precedes ones application date. Share sensitive information only on official, secure websites. In New Mexico, an average of 10% of the Medicaid population had an SMI diagnosis and 6% had an SED designation in August 2019. At the bottom of the Medicaid app, youll find the applications for other programs like cash assistance, SNAP, and LIHEAP (Low-Income Home Energy Assistance Program). The coverage through each of the other plans is relatively similar, though they may have different provider networks and offer extra benefits, like: New Mexico Medicaid members can receiveup tothe following rewards from Centennial Care in 2019: *There may be other limitations to these rewards. I also agree that the above entities may contact me utilizing automated technology, including an autodialer. An exception exists for Holocaust restitution payments; they do not count as income. more of the targeted enrollment strategies outlined in guidance CMS issued on May 17, 2013, Except where noted, the HSD income support division (ISD) determines eligibility in the categories listed below: (1) other adult (Category 100); (2) parent caretaker (Category 200); (3) pregnant women (Category 300); (4) pregnancy-related services (Category 301); (5) loss of parent caretaker due to earnings from . A number of states, which have bought in for all of . When contacting the dental providers, be certain to let them know you are a Medicaid recipient. In 2023, the Gift Tax Rule allows one to gift up to $17,000 per recipient without filing a gift tax return. Applying for Centennial Care can be a complicated, confusing, and lengthy process. Compare plans in your area.Just enter your zip code. of 22 frequently reported health care quality 3. Medical Assistance Division | New Mexico Human Services Department We have free interpreter services to answer any questions you may have about our health or drug plan. 595 0 obj <>/Filter/FlateDecode/ID[<35ADB07DE3CDC849A1801818DC5B6C63>]/Index[576 64]/Info 575 0 R/Length 91/Prev 69601/Root 577 0 R/Size 640/Type/XRef/W[1 2 1]>>stream PDF New Mexico Medicaid Checklist: Alternative Benefit Plan Exemption A .gov website belongs to an official government organization in the United States. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. During the look back, Medicaid checks to ensure no assets were sold or gifted by the applicant and / or their spouse for less than fair market value. <> Medicaid | Blue Cross and Blue Shield of New Mexico - BCBSNM The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Medicaid eligibility and enrollment in New Mexico Giving gifts under this rule is a violation of Medicaids Look-Back Period. New Mexico | Medicaid PDF Information Sheet for Application for Medical Assistance - Conduent We do not offer every plan available in your area. For more information, call the New Mexico HSD Medical Assistance Division (MAD) toll free at (888) 997-2583. Each and every state has a Medicaid program. An official website of the United States government Chat with HSD. Regulations forCentennial Careare promulgated by the Human Services Department andMedical Assistance Division. 397 0 obj <> endobj