New Mexico MexiKids Application Information

New Mexikids is a no cost health care insurance coverage for children aged 0 to12 years old. New MexiTeens is also a low cost or no cost at all health care insurance program meant for teens aged between 13 and 19 years old. Both programs are administered by the New Mexico Medicaid program otherwise known as Salud.

If your household income is less than 185% of the Federal Poverty Guidelines, health care services are provided to your child free of charge. If your household income is 185% - 235% of the Federal Poverty Guidelines, some of the health care services your child receives may require you to make a co-payment at the time each service is delivered. Preventive services, such as Tot to Teen Health Checks and vaccinations do not require a co-payment. New MexiKids generally pays for:

  • Regular check-ups
  • Dental care
  • Hospital care
  • Prescription drugs
  • Visual and Audio exams

Waiting Periods

In some cases, there may be waiting periods or a reduction in benefits especially for children that are covered by other health insurance. Contact New MexiKids for detailed information on benefits reduction on the following website:
www.insurenewmexico.state.nm.us/

Health Plan Options

Families residing in New Mexico who wish to enroll their children in New MexiKids may be required to choose from four Managed Care Organizations (MCOs) to provide their medical services. These organizations are Blue Cross and Blue Shield of New Mexico, Lovelace Community Health Plan, Molina Healthcare and Presbyterian Health Plan. Contact New MexiKids directly for information on the available health plan options:
www.insurenewmexico.state.nm.us/NewMexiKidsandTeens.htm

Premium Payments, Co-Payments and Coinsurance

In some cases premiums and co-payments apply; however, this depends on family's income guidelines. For children with family incomes below 185% of the federal poverty level premiums or co-payments do not apply. Children in families with income between 185% - 235% of the federal poverty level may have minimal co-payments for some selected services covered. Some preventive services such as vaccinations do not require a co-payment regardless of household income levels.

Program Length, Enrollment and Renewal

New Mexikids offers a 12 months continuous coverage. Prior to the expiry date of your health plan, a renewal application must be submitted and it will be used to review your current eligibility status.

Eligibility Requirements

In order for children or teenagers to qualify for these programs, they must be:

  • Residents of New Mexico
  • Below 19 years of age and not covered by health insurance (including Medicaid)
  • U.S. national, citizen, legal alien or permanent resident

Contact New MexiKids directly for information on the available Eligibility Criteria:
www.insurekidsnow.gov/state/newmexico/

Note: a parent needs not to be a US national in order to apply for New Mexikids or New MexiTeens insurance coverage for their children.

Eligibility based on Citizenship & Residency

Similar to most health insurance programs in New Mexico, the applicant must be a U.S. citizen and a resident of New Mexico. The only exception for Non-US Nationals is Emergency Medical Services for Aliens (EMSA). However, Income Support Division must determine if a referred alien is eligible for this assistance.

Eligibility based on Age

Children aged 0 to 12 years are eligible to receive Medicaid services through the New MexiKids program. New MexiTeens is a program very similar to New MexiKids, but is reserved for children ages 13-19. Pregnant women of any age may receive coverage during pregnancy

Eligibility based on Citizenship & Residency

In order for children or teenagers to qualify for these programs, they must be:

Eligibility based on Income

The New MexiKids and New MexiTeens programs are open to children from families who make 235% or less of the Federal Poverty Level (FPL). Families with incomes below 185% of the FPL can receive services for their children at no cost, while families with income brackets between 185% - 235% of the FPL receive services at a reduced cost. Pregnant women can receive Medicaid services if they have a family income of 185% or less of the FPL. Pregnant women who are not eligible for Medicaid can sign up for Premium Assistance for Maternity (PAM), this option has no upper-income restrictions. Women diagnosed with breast or cervical cancers need to have a family income of less than 250% of the FPL.

MexiKids Application Instructions

There are several ways to apply for Medicaid:

Apply in Person

You can apply for New Mexikids at most health care facilities and schools. Alternatively, you can visit a local Income Support Division office. Visit New Mexikids webpage for a list of these offices:
www.hsd.state.nm.us/isd/fieldoffices.htm/

Apply by Phone

You can call your Local Income Support Division during normal working hours on Telephone number (888) 997-2583.

Apply Online

Detailed application details are available at
http://www.insurekidsnow.gov/state/newmexico/

New MexiKids Contact Information

New Mexikids
P.O. Box 2348
Santa Fe, New Mexico 87504-2348
888-997-2583