More. In New Mexico, state officials manage the program, including reviewing applications and providing information to residents and applicants. endstream endobj 398 0 obj <>/Metadata 18 0 R/Pages 395 0 R/StructTreeRoot 30 0 R/Type/Catalog/ViewerPreferences 415 0 R>> endobj 399 0 obj <>/MediaBox[0 0 792 612]/Parent 395 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 400 0 obj <>stream Giving gifts under this rule is a violation of Medicaids Look-Back Period. To enroll, you must first apply for Medicaid in New Mexico and must enroll in Medicare parts A and B. %PDF-1.7 Individuals become eligible for Centennial Care, New Mexico's Medicaid Program, when they meet the specific criteria for one of the Medicaid eligibility categories. 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. has expanded 211 0 obj <> endobj A .gov website belongs to an official government organization in the United States. PDF Information Sheet for Application for Medical Assistance - Conduent Heres how you know. Irreversible means that the terms of the trust cannot be changed or canceled. However, in cases where copayments are due, Medicaid coverage caps the amount that a provider may charge for services. 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. 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. If any information is not current, please use your local phone directory to locate the dental providers. Please note that this list is provided only as a resource and the providers may not be members of the NMDA. The term 1937 Medicaid Benchmark or Benchmark Equivalent Plan has been retitled to Alternative Benefit Plans. Medicaids Look-Back Rule There are limitations to some of these services. Nearly 300,000 people . If you qualify for MAGI Medicaid, you may be required to enroll into a managed care plan to receive your medical services. In New Mexico, there are approximately 40 categories of eligibility. Applying for Centennial Care can be a complicated, confusing, and lengthy process. 2) Asset Spend Down Persons with assets over Medicaids limit can spend down extra assets to become asset-eligible. MAGI-based eligibility levels, expressed as a percentage of the FPL, for several key New Mexicos Human Services Department (HSD) is the administering agency. For purpose of comparison, the table also presents (a)the While officials attempt to keep Medicaid cost estimates low, in some cases there are costs to the recipient. % Learn About Medicaid Coverage in New Mexico | medicaid-help.org Individuals become eligible for Centennial Care, New Mexicos Medicaid Program,when they meet the specific criteria for one of the Medicaid eligibility categories. . Information about how determines whether a person Section 8.200.400.10 - BASIS FOR DEFINING GROUP - MEDICAID CATEGORIES 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. It depends. Send hsd100 via email, link, or fax. Presbyterian Healthcare Services has served New Mexicans for more than 110 years. Expansion Adults (all adults, including Parents and . 2. As of December 2019, has enrolled 985,201 individuals in Medicaid and CHIP a net increase of 57.29% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. Before applying for NM Medicaid coverage, petitioners benefit from knowing what expenses may be associated with Medicaid. If you are married and do not have kids, your eligibility will be based on income before taxes and deductions. In New Mexico, Medicaid is called Centennial Care. MAGI Conversion Plans and Results | Medicaid An exception exists for Holocaust restitution payments; they do not count as income. ): up to 90% of the federal poverty level for their household size. I also agree that by submitting this Contact Request form, I am bound by Medicare Health Benefits, LLC Privacy Policy and Terms of Use. The links below give basic information about these eligibility categories. After completing the three-week Step-Up challenge, youll receive your $25 reward value and will be invited to the 9-week challenge. 639 0 obj <>stream To apply online, visit Yes New Mexico.. New Mexico Medicaid categories may differ in the income that is counted and not counted when determining . Just call us at Familiarizing oneself with general information about the application process for long-term care Medicaid can be helpful. reporting period. 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. the indicated month, and is not solely a count of those newly enrolled during the Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Both families and individuals benefit from the assistance. RIL !kr'bA*2La(Q#B7;Sjv}.QAQyWFq,D K.h{wC])Pb>p:.D_h*No` Beneficiaries who are minors, living in nursing homes or pregnant will typically not have to pay any out-of-pocket costs. New Mexico Medicaid covers medical services, prescription drugs, dental, vision, mental health, long-term care, some home health benefits, and transportation services. Read our accessibility statement or click here to enable. The various types of Medicaid insurance and coverage available to petitioners extends across a range of services, but also excludes coverage for other types of services. Medicaid Quality of Care Performance Measurement, state's Some providers may not be able to take new Medicaid patients. %%EOF PDF Dually Eligible Individuals - Categories - Centers for Medicare %PDF-1.5 % Countable vs. Non-Countable Assets $25 value for attending a prenatal visit in your first trimester or first 42 days of enrollment. For instance, those requesting preventative services may face some out-of-pocket expenses. A lock ( New Mexico Medicaid Long-Term Care Definition. This site is for information purposes; it is not a substitute for professional legal advice. Qualified Medicare Beneficiary (QMB) Program | CMS We have cared for New Mexico's Medicaid members since 1997. Health insurance for people 65 and older Under 65 with certain disabilities . The plan includes physical health, behavioral health, and long-term care services. New Mexico Medicaid coverage provides eligible individuals or families with health care at a low or no cost. PDF Women, Children, & Family Medicaid Categories Federal - Conduent -u!EDR'XW{{ik} uUR4avmF:5Si%2P=9^eK\T-U{PIKXh~$n;# *MP([](qy[u3 2*Km@HQ@J0RWn*Q<0%8wo#WK%&9%oPc sj9 .WiNXQuuH Want to learn about who we are? Parents, pregnant women, kids, women with breast or cervical cancer, and adults under the age of 64 can qualify for New Mexico Medicaid based on income. (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: Knowing what Medicaid covers and potential costs are vital for applicants seeking assistance. Reproduction or republication strictly prohibited without prior written permission. Personalized Support Through our Community Health Services Department (CHS), we can help you get the support you need. The CB Program is for New Mexico residents who are elderly (aged 65+) or disabled and between the ages of 0 and 64. Following a long-term care Medicaid beneficiarys death, New Mexicos Medicaid agency attempts reimbursement of care costs through whatever estate of the deceased still remains. Your may may permit or deny cookies on our Cookie Policy page. Furthermore, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse to prevent spousal impoverishment. Home Exemption Rules Version Including Medicaid and Children with Chronic Conditions Supplemental Items (CPC-CH) or the Central Line-associated Bloodstream Infection (CLABSI-CH) measures. Copyright 2023 New Mexico Dental Association. 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. <>/Metadata 457 0 R/ViewerPreferences 458 0 R>> Indian Health Service dental providers are restricted to Native American recipients. 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. Medicaid SLMB Program (Specified Low-income Medicare Beneficiary) The MAD website has helpful links,including this information on dental programs. endstream endobj startxref This table reflects the principal but not all MAGI coverage groups. 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. Depending on your household income, some household members 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). 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. Equity interest is the amount of the homes equity that is owned by the applicant. and get either full Medicaid coverage or SSI benefits. %PDF-1.6 % 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. Alternative Benefit Plan vs. State Plan Comparison Chart, New Mexico Independent Consumer Support System (NMICSS), Centennial Care 2.0 Waiver Application (ARCHIVE), (HIPAA) Recipient Privacy and Confidentiality, Glossary of Acronyms, Abbreviations and Terms for Recipients, Additional Programs for Individuals with Brain Injury who are Medicaid Eligible, Brain Injury Education and Training Opportunities, Providers Critical Incident report Form, Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Program of All-Inclusive Care for the Elderly (PACE), Pre-Admission Screening and Resident Review (PASRR), Behavioral Health Policy and Billing Manual, General Information Memoranda (GIs) for ISD, General Information Memoranda (GIs) for MAD, ISD Interim Policies and Procedures (IPPs), MAD Interim Policies and Procedures (IPPs), Child Support Enforcement Division Registers, Centennial Care Evaluation Interim Report, Centennial Care 2.0 Evaluation Interim Report Draft, Centennial Care 2.0 Interim Evaluation Report, Centennial Care 2.0 Interim Evaluation Report, Appendices, Consumer Assessment of Healthcare Providers & Systems (CAHPS) Reports, Center for Medicare and Medicaid Services 416, Centers for Medicare and Medicaid Home and Community Based Services Settings Final Rule, External Quality Review Organization (EQRO) Reports, Healthcare Effectiveness Data and Information Set (HEDIS) Reports, Income Support Division Plans and Reports, Medical Assistance Division Pending and Approved State Plan Amendments, NM Medicaid Access Monitoring Review Plan, Mental Health Parity Report for Medicaid Managed Care in NM, Home and Community Based Services (HCBS) American Rescue Plan Act (ARPA), Renew NM: SNAP, Cash, and LIHEAP Frequently Asked Questions, Renew NM: Medicaid Frequently Asked Questions, Disaster food benefits available for victims of New Mexico Wildfires, Loss of Parent Caretaker due to Spousal Support, Loss of Parent Caretaker due to Earnings from Employment, Medicaid Eligibility General Recipient Policies, Infants of Mothers who are Medicaid Eligible, Pregnancy and /or Family Planning Services, Emergency Medical Services for Non-Citizens. When spending down, it is best to keep documentation of how the assets were spent as evidence Medicaids Look-Back Period was not violated. 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 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. There are different categories of MAGI Medicaid. Transportation services are usually only available to those who do not have their own reliable means of transportation. 1. 8.200.400 NMAC - New Mexico Medicaid is a health care program for low-income individuals of all ages. How Does the Affordable Care Act (ACA) Affect Me? 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. I also agree that the above entities may contact me utilizing automated technology, including an autodialer. pregnant women, elderly and disabled Americans apply for Medicaid health benefits, determine their eligibility for health coverage, and access information on health care benefits. 027 Transitional Medicaid-provides benefits for up to 4 months following loss of . However, people who qualify under the Working and Disabled waiver may owe copayments of up to $7 for some services, $30 for hospital stays, and $3 for prescriptions. State of New Mexico Centennial Care 2.0 1115 Waiver Amendment #2 Request March 1, 2021 Page 6 . 2019 Centennial Care Rewards. eligibility verifications plans, MAGI Conversion Plans Medicare beneficiaries with limited income and resources may be able to enroll in a Medicare Savings Program . Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance. endstream endobj 577 0 obj <. The following information was provided by the MAD web site and is presented here as a public service by the NMDA. You can download our free guide to learn more about services covered by Medicaid. stream y&=~[[0Qtz%Xi_0bu`1lmy2"CRUu){>BJI74[wd( ?||yeBzm ~I.z!60SFaq/o>g#w0K%8D] h/wKC=dlc=hXun=$ If the individual does not have an existing Medicaid category that requires transition of care, then proceed to Step 4. 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 . 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. change in enrollment since the initial open of the Health Insurance Marketplaces, measures in the CMS Medicaid/CHIP Child Core Set. While there are many different coverage groups, this page is focused on long-term care Medicaid eligibility for New Mexico elderly residents, aged 65 and over. 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 Presbyterian Centennial Care gives you the basic benefits you need, plus extra value-added benefits. The NMDA does not oversee or take part in the administration or rules regarding Medicaid. 0 Treatment of Assets for a Couple The coverage benefits of Medicaid include a range of services that are mandatory across the nation and in New Mexico.