New Mexico Medigap Plans (Medicare Supplement Insurance) are additional coverage you can purchase from a private health insurance company to help cover your out-of-pocket expenses in Original Medicare. NM Medigap works pretty much the same way as in most other states. Stick with us and we’ll show you the ropes.

New Mexico Medigap Plans are additional coverage for Original Medicare.

New Mexico Medigap Basics

You can only purchase Medigap if you have Original Medicare. This means you must enroll in both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) before being eligible to buy a Medigap policy.

All MedSup policies are standardized. There are 10 different types of Medigap plans offered in most states, identified by letters: A-D,G, F and K-N. The cost is the only difference between plans with the same letter sold by different insurance companies. (Source)

Why does this matter? Standardized plans ensure that the core coverage and doctor network of the plan remain identical, regardless of the insurance provider. This makes comparing Medigap companies effortless as they offer the exact same benefits (even if their monthly premiums differ). Below we will review all the available plans but the overwhelming majority of those new to Medicare select plan G.

NM Available Plans

Plans available for those Medicare-eligible after January 1, 2020:

Benefits A B D G* K L M N
Medicare Part A Deductible ($1,632) 100% 100% 100% 50% 75% 50% 100%
Part B Deductible ($240)
Medicare Part A Hospital Coinsurance and 365 additional hospital days 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B Coinsurance 100% 100% 100% 100% 50% 75% 100% 100%
First 3 Pints of Blood for a Transfusion 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A Hospice Coinsurance or Copay 100% 100% 100% 100% 50% 75% 100% 100%
Skilled Nursing Facility Coinsurance 100% 100% 50% 75% 100% 100%
Medicare Part B Excess Charges 100%
Foreign Emergency Healthcare 80% 80% 80% 80%
Max Out-of-Pocket $7,060 $3,530

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*Medigap Plan G High deductible ($2,800) is also available. Note: Plan F and Plan C are not featured on this chart as they are no longer available to those new to Medicare.

When to enroll in a New Mexico Medigap Plan

In NM, like many states, when you enroll in Medicare Part B, either due to age or disability, a 6-month open enrollment window for a Med Supp policy is activated. This Open Enrollment Period guarantees your coverage with a plan and a company of your preference.

If you fail to secure a plan during your 6-month open enrollment, any insurance company you approach can reject coverage based on your health status. There are some limited additional open enrollment periods available if you’re disenrolling from credible coverage from work.

It’s important to understand that the term “Open Enrollment” does not refer to an annual occurrence. Instead, it happens only when you become eligible for Medicare for the first time in New Mexico. That is why we like to refer to it as your Initial Enrollment. If for some reason you couldn’t enlist in time, you can read our article Help! I’ve Missed My Medigap Initial Enrollment Period. What Should I Do?

Most Popular Plan in New Mexico

Based on the most recent data published by America’s Health Insurance Plans (AHIP), more than 70,000 individuals in New Mexico have acquired a Medigap policy.

As you might know, there have been alterations in Medigap plans starting from 2020. Previously, Plan F held the top spot in popularity within NM. Although it continues to maintain a substantial clientele, it is not enrolling new policyholders. Consequently, the preferred choice for newly insured individuals is Plan G, with approximately 24,500 beneficiaries opting for it.

New Mexico Switching Medigap Plans

Choosing the wrong Medicare plan can be a headache. With so many options out there, it’s easy to feel overwhelmed. And what worked for you last year might not be the best fit now. In New Mexico, AEP Open Enrollment (Oct 15 – Dec 7) doesn’t apply to Medigap. The good news is, you can switch Medicare plans anytime you want. But, there’s a little twist: you’ll need to answer some health questions before switching to a new Medigap plan. Answer around 20 health questions on the Med Supp application, and your approval and rate will vary based on your responses. Some pre-existing conditions may result in denial.

So, what should you do? If you’re thinking about making a change, give us a call at 800-930-7956. Our team is here to help you find the perfect plan for your needs—for free. Remember: Don’t cancel your old plan until you’re sure your new one is in effect. That way, you’ll never be without coverage.

Want to learn more? Check out our in-depth guide: “Medicare Insurance Switching: Ultimate Guide.”

New Mexico Medigap Discounts

While all Medigap plans follow standardization, some insurers provide “Medigap Household Discounts” or “HH Discounts.” These typically offer a percentage reduction in your monthly Medicare Supplement premium when two individuals from the same address are both enrolled with the same Medigap insurance provider. However, certain insurers do not mandate both household residents to be on the plan for the HH discount. Feel free to contact us for more details.

This discount is available for various types of residences, be it a house, apartment, yurt, trailer, or any other dwelling. It’s applicable even if your spouse is already enrolled, and you are applying as a new enrollee.

Please note that household discounts may not be automatically displayed in our Medigap quoting system. To view them, ensure you click the “show household discount” button on the results page. Alternatively, you can call Senior65.com 800-930-7956 to learn about how HH discounts function in your area.

The Medigap Roommate Discount is another great choice with simple requirements. Find out more in our article, “What is the Medigap Roommate Discount and How Can You Get It?

Medicare Excess Charges in New Mexico

Did you know your doctor can charge you up to 15% more than what Medicare says? It’s called a Part B excess charge. The good news? Medigap plans, like Plan G, cover this extra cost. Want to know more? Check out our article on avoiding Medicare excess charges.

Next Step

Now that you have knowledge about the available plans and accessible discounts, it’s time to make a move. We are here to help you identify the Medigap plan that best fits your unique requirements.

Don’t hesitate to leave a comment or question in the section below, or reach out directly to us at 800-930-7956. Keep in mind, Senior65.com does NOT charge any fees for its services!