As a Medicare beneficiary in New Mexico, you might want to learn about Medicare Supplement (Medigap) plans, which may help pay for Original Medicare’s out-of-pocket costs. Original Medicare includes Medicare Part A and Medicare Part B. Medicare Supplement plan availability may vary depending on where in the state you live.
How Medicare Supplement (Medigap) plans work in New Mexico
Medicare Supplement in New Mexico (as in other states) may help Medicare beneficiaries pay for out-of-pocket expenses associated with Original Medicare, Part A and Part B, such as copayments, coinsurance, and deductibles. In New Mexico and 46 other U.S. states, there are up to 10 standardized Medicare Supplement plans available, with each Medigap plan identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N). Plans of the same letter name offer the same benefits, although some companies may offer additional innovative benefits. Massachusetts, Minnesota, and Wisconsin have different types of standardized Medicare Supplement plans. Note that you must already be enrolled in Original Medicare, Part A and Part B, to sign up for a Medicare Supplement plan in New Mexico (as in other states).
You can sign up for a Medicare Supplement plan in New Mexico during the six-month Medigap Open Enrollment Period, which begins the first day you are both age 65 or older and enrolled in Medicare Part B. During that six-month span, you can join any Medigap plan available in your area, with any insurance company you choose, and you cannot be denied coverage for pre-existing conditions or be required to undergo medical underwriting (although a waiting period may apply). If you decide to enroll in a Medicare Supplement plan in New Mexico after your Medigap Open Enrollment Period has ended, you may be charged more for your insurance plan or even be denied coverage.
Medicare Supplement in New Mexico is designed to supplement rather than replace Original Medicare, so you must remain enrolled in Original Medicare, and continue paying your Medicare Part B premium, to keep your health insurance coverage. It works this way in every state. And since Medigap does not offer prescription drug coverage in plans sold currently, you may need to enroll in a stand-alone Medicare Part D Prescription Drug Plan to get help paying for your prescription drugs costs.
Types of Medicare Supplement plans in New Mexico
Here’s a quick look at the 10 types of standardized Medicare Supplement plans available in New Mexico. Please note that an “X” in the table below indicates the service is covered, while a percentage indicates what portion of the service is covered. A blank cell means the service is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
Also note the following about Medigap plans in New Mexico:
- Medicare Supplement Plan F is the most comprehensive plan, covering almost 100% of Medicare-associated costs, excluding the Medicare Part B premium.
- Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year.
- Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, but it does not cover up to a $20 copayment on some office visits and up to a $50 copayment on emergency room visits.
Choosing a suitable Medicare Supplement plan in New Mexico
As stated above, Medicare Supplement plans with the same letter designation don’t vary in coverage or benefits (except possible extra benefits an insurance company may include). However, each independent insurance company offering Medicare Supplement plans can determine its own monthly premium structure. This means that a resident of Albuquerque in Bernalillo County may pay more or less than a resident of Santa Fe in Santa Fe County for an identical Medicare Supplement plan. Considering the possible differences in costs, it may be a good idea to compare all Medicare Supplement plans available in your area in order to choose the Medigap plan in New Mexico best suited to your personal requirements. Just enter your zip code in the form on this page to start comparing plans.
View the following articles for additional information about Medicare in New Mexico:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.