New Mexico State Specific Strategies

New Mexico has created a portal to facilitate insurance coverage called the Insure New Mexico! SolutionsCenter. This initiative features health insurance products custom-designed for each small employer, based on employee demographics and the needs of a specific employer group.  The custom product will incorporate coverage for each employee through publicly administered products including New Mexico State Coverage Insurance (NMSCI), New Mexico Medical Insurance Pool (the Pool), the New Mexico Health Insurance Alliance and the Small Employers Insurance Pool (SEIP).

Premium Assistance for Maternity (PAM) covers pregnancy-related services for women who are ineligible for Medicaid maternity services due to income. The enrollee pays a one-time enrollment fee per pregnancy depending on the trimester in which she enrolls. Enrollment cost during the first 20 weeks of pregnancy is $150. Enrollment cost during the second 20 weeks of pregnancy is $300. 

Under the Insure New Mexico initiative, the state expanded access to care through innovative premium assistance programs for children and pregnant women who are not eligible for Medicaid due to income.  This public/private program not only helps more uninsured children receive the healthcare coverage they need, it also helps assure that children receive healthier starts by encouraging pregnant women to begin receiving healthcare services early in pregnancy.

Premium Assistance for Kids (PAK) covers children ages 0 to 12, or up to 18 years old if part of a sibling group with a child under age 12, who are ineligible for the New Mexikids program due to income. The state assists with 50 percent of the costs of the premium. Premiums range from $70 to $180 per month. The PAK benefit package (an individual commercial benefit package)includes preventive, primary and specialty care, inpatient and outpatient hospitalization, pharmacy, lab, x-ray and physical, occupational and speech therapy.