Best New Mexico Health Insurance (2024 Plans)


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ByMark Fitzpatrick
Edited byKatherine Kurtz
ByMark Fitzpatrick
Edited byKatherine Kurtz

Updated: May 22, 2024

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MoneyGeek Logo IconBest Health InsuranceNew Mexico
2024

Best Health Insurance in New Mexico

Why Trust MoneyGeek? We downloaded plan data for New Mexico directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.

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Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.

25Plans Analyzed
 
10Providers Compared

Overall Best Health Insurance in New Mexico

Ambetter Plan of WSCC provides the best health insurance in New Mexico, with a MoneyGeek score of 85 out of 100. It has plans with low costs, low out-of-pocket costs and fewer denied claims compared to others.

We looked at 12 Silver HMO plans in New Mexico for this study. Here's more about the best health insurance.

MoneyGeek Pick: Ambetter Plan of WSCC

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Affordable premium rates

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Limited out-of-pocket costs

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Rarely denies claims

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Diverse plan offerings

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Limited plan types available

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in New Mexico is Ambetter Plan of WSCC. The provider offers Silver HMO plans at an average monthly plan rate of $520. The average maximum out-of-pocket cost for these plans is $8,625.

Ambetter's Silver HMO plans provide a network of doctors and facilities that members can use. These HMO plans require members to stay within the network to receive coverage.

It offers an average plan rate of $520, and the average maximum out-of-pocket cost for these plans is $8,625.

Ambetter Plan of WSCC has a denial rate of 14.84%, which is lower than most of the competition.

Plan Recommendations

MoneyGeek recommends the following Silver plans:

  • Focused Silver: $494 per month; MOOP $8,300
  • Clear Cost Silver Plan: $545 per month; MOOP $8,950

Best Health Insurance in New Mexico for Low Out-of-Pocket Costs

Presbyterian Health Plan offers the best health insurance in New Mexico for low out-of-pocket costs, earning a MoneyGeek score of 75 out of 100.

The provider ranks well in terms of plan rates, meaning it offers some of the cheapest plan options. It also ranks well for having lower out-of-pocket costs and for better-than-average performance in not denying claims.

In New Mexico, 13 Gold HMO plans were looked at for this category.

MoneyGeek Pick: Presbyterian Health Plan

Presbyterian Health Plan

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Very affordable premium rates

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Denies very few claims

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Limited plan types available

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in New Mexico for low out-of-pocket costs is Presbyterian Health Plan. It offers three Gold plans, which are known for lower costs when you get medical care.

The Gold plans by Presbyterian Health Plan have a network of doctors that you can visit. If you go to these doctors, the plan takes care of the bills better. They offer an average plan rate of $520, and the average maximum out-of-pocket cost for these plans is $6,222.

Presbyterian Health Plan has a lower denial rate than most of the competition. This means it is more likely to pay for the medical care you get when you need it.

Plan Recommendations

MoneyGeek recommends the following Gold and Platinum plans:

  • Clear Cost Gold Plan: $620 per month; MOOP $5,300
  • Clear Cost Gold Plan - Limited Service Area On: $408 per month; MOOP $5,300
  • Gold Select w/ GYM - Limited Service Area: $382 per month; MOOP $9,450

Best Cheap Health Insurance in New Mexico

Presbyterian Health Plan is the best cheap provider for cheap health insurance in New Mexico, with a MoneyGeek score of 86 out of 100. The provider offers plan options that are more affordable, has lower average out-of-pocket expenses and denies fewer claims than most other providers.

For this analysis, MoneyGeek evaluated 12 Silver HMO plans in New Mexico. To determine the best provider for this category, the analysis placed a heavier weight on plans with lower monthly premiums. Plans with lower premiums typically have higher out-of-pocket costs.

MoneyGeek Pick: Presbyterian Health Plan

Presbyterian Health Plan

pros

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Affordable premium rates

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Very few claims denied

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Low out-of-pocket costs

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Limited plan options with lower average provider type score

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best cheap health insurance in New Mexico is Presbyterian Health Plan. It offers three Silver plans to help you take care of your health without spending too much.

These Silver plans are HMO types, which means you have to stay within its network of doctors and hospitals for your care.

The insurer offers an average plan rate of $623, and the average maximum out-of-pocket cost for these plans is $9,061.

The denial rate information for Presbyterian Health Plan is not available. Without this data, we cannot compare its denial rates to other companies.

Plan Recommendations

MoneyGeek recommends the following cheap Silver plans:

  • Clear Cost Silver Plan: $750 per month; MOOP $8,950
  • Clear Cost Silver Plan - Limited Service Area On: $491 per month; MOOP $8,950
  • Silver Select 7000 w/ GYM - Limited Service Area: $437 per month; MOOP $9,450

Best Health Insurance for Young Adults in New Mexico

In New Mexico, Presbyterian Health Plan offers the best health insurance for young adults, with a MoneyGeek score of 84 out of 100.

The provider has plans that are among the cheapest options available. It has lower out-of-pocket costs and better-than-average record of not denying claims. Only people under 30 years old can buy its Catastrophic coverage.

For this category, we looked at one Bronze HMO plan and one Expanded Bronze HMO plan in New Mexico.

MoneyGeek Pick: Presbyterian Health Plan

Presbyterian Health Plan
COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in New Mexico for young adults is Presbyterian Health Plan. Young adults usually look for less expensive plans since they typically use fewer medical services. The company offers one Catastrophic plan, one Bronze plan and one Expanded Bronze plan.

Presbyterian Health Plan does not offer any PPO or POS plans, but an EPO plan allows you access to a wide network of doctors and hospitals.

It offers an average plan rate of $299, and the average maximum out-of-pocket cost for these plans is $9,450.

Presbyterian Health Plan has a lower denial rate than most of the competition.

Best Health Insurance by Plan Type in New Mexico

Health insurance companies have different kinds of plans. The best providers for all plan categories in New Mexico are:

  • HMO: Ambetter Plan of WSCC (MoneyGeek score: 97 out of 100)
  • HMO: Molina Healthcare of New Mexico (MoneyGeek score: 71 out of 100)

MoneyGeek's recommendations for health insurance are focused on Silver plans. Silver plans work well for balancing cost and coverage. They help people who go to the doctor often without paying too much.

In New Mexico, there are 12 Silver HMO plans available.

MoneyGeek Pick for HMO: Ambetter Plan of WSCC

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in New Mexico for Silver HMO plans is Ambetter Plan of WSCC. It offers an average plan rate of $520, and the average maximum out-of-pocket cost for these plans is $8,625. This provider denies fewer claims than average.

Silver HMO plans tend to cost less each month and are very common. You must go to doctors in the plan's network unless it's an emergency. You also need to get a referral to see a specialist, which can be good if you want lower payments and have network doctors nearby.

Plan Recommendations

We suggest the following Silver HMO plans from Ambetter Plan of WSCC:

  • Focused Silver: $494 per month; MOOP $8,300
  • Clear Cost Silver Plan: $545 per month; MOOP $8,950

How to Find the Best Health Insurance for You in New Mexico

Your best option for health insurance in New Mexico depends on your particular health care needs and budget. You'll need to consider if you would rather pay more in monthly premiums and less in out-of-pocket expenses if you need medical care or vice versa. When buying health insurance, it's important to look for a plan that meets both your coverage needs and budget.

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    Understand when a health insurance plan will cover you

    With in-network health insurance, you see doctors that agree to lower rates with your insurance. You pay less money. Out-of-network coverage means seeing doctors not in the network, which usually costs more. In New Mexico, some plans give you more choice but might cost more.

    Other plans in New Mexico might save you money, but you can't choose as many doctors. They tell you which doctors to see. This makes things simpler but gives you less choice.

    New Mexico has 12 HMO plans.

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    Weigh the cost of premiums vs. the cost of care

    When you look for health insurance, you need to think about how much you pay every month and how much the most you might have to pay in a year is. What is best for you depends on what you need.

    Some plans with low monthly costs might have high limits on what you pay out of your own pocket. If you pay more every month, you could have a lower limit. This could save you money if you go to the doctor a lot.

    Let's talk about a Silver plan with low costs that you pay yourself. The Focused Silver plan has a limit of $8,300. This plan's monthly cost is $494. This cost is less than the average for Silver plans from the same company.

    Plans that have a small monthly cost and a small limit on what you pay yourself are really good. These are even better if the services they offer are also good.

Consider New Mexico Medicare or Medicaid if You’re Eligible

New Mexico residents who are at least 65 years old or have a qualifying illness or disability may qualify for Medicare. This government program subsidizes health care services for eligible individuals.

Medicare comprises the following parts that cover different services:

  • Part A: Also known as Hospital Insurance, this covers medical expenses incurred from hospital stays, skilled nursing facility care, hospice care and some home health care.
  • Part B: Also known as Medical Insurance, it pays for certain doctors' services, outpatient care, medical supplies and preventive care.
  • Part D: Helps cover the cost of prescription drugs and any recommended shots or vaccines.

We rounded up the best Medicare Advantage plans and best Medicare Supplement plans in New Mexico to help you weigh your options.

On the other hand, low-income individuals in New Mexico may qualify for Medicaid if their income is below 138% of the Federal Poverty Level. Unlike Medicare, this program is free, making it an ideal option for those with limited income or resources.

FAQ About Health Insurance in New Mexico

It’s common to have concerns about cost and availability while shopping around for the best health insurance in New Mexico. We've answered some of the most commonly asked questions.

What is the best health insurance provider in New Mexico for 2024?
What should you look for when shopping for the best health insurance plan in New Mexico?

About Mark Fitzpatrick


Mark Fitzpatrick headshot

Mark Fitzpatrick has analyzed the property and casualty insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. Currently, he leads P&C insurance content production at MoneyGeek. Fitzpatrick has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.

Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.