BestHealth InsuranceNew MexicoBest New Mexico Health Insurance (2023 Plans)
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BestHealth InsuranceNew MexicoBest Health Insurance in New Mexico
Best Overall - Presbyterian Health Plan
Best for Low MOOP - Blue Cross Blue Shield
Best Cheap - Ambetter
Best for Young Adults - Presbyterian Health Plan
Best for HMO - Presbyterian Health Plan
Best Overall for Health Insurance in New Mexico
Presbyterian is the best health insurance provider in New Mexico, earning a MoneyGeek score of 68 out of 100. Of the insurers in our study, it offers plans with the lowest maximum out-of-pocket (MOOP) costs and has the most efficient claims management.
For this category, we analyzed Silver plans in New Mexico, including 160 HMO plans.
pros
Rarely denies claims
Has the lowest average MOOP among four insurers
cons
Has the highest average monthly premium
Only offers HMO plans
COMPANY HIGHLIGHTS
Our choice for the best health insurance in New Mexico is Presbyterian. Although an average Silver HMO plan from this company costs an average of $656 per month — the most expensive in the state — it has the lowest average out-of-pocket maximums at $7,636. This can help reduce your total costs for covered services, depending on how much medical care you need in a given year.
Presbyterian also has a 0% claims denial rate, meaning it almost always accepts valid insurance claims and coverage requests. This company offers 35 HMO Silver plans, which may mean that it's not the best fit for buyers who want more plan type options while shopping around for health insurance.
Plan Recommendations
We recommended the following plans from Presbyterian:
- Ind HDHP/HSA Silver 2 with GYM On: $718 per month, MOOP of $7,050
- Ind HMO Silver 3 with GYM On: $499 per month, MOOP of $9,100
Best Health Insurance in New Mexico for Low Out-of-Pocket Costs
If you're looking for plans with low MOOP costs, Blue Cross Blue Shield is the best health insurance company in New Mexico, receiving a MoneyGeek score of 60 out of 100. The company also offers relatively affordable premiums and rarely denies policyholder claims.
For this category, we rated companies that offer Gold plans in New Mexico for this category, covering 177 HMO plans.
pros
Has the second-lowest average MOOP among four insurers
Offers affordable premiums
cons
Available plan types limited to HMOs
More likely than competitors to deny claims
COMPANY HIGHLIGHTS
Based on our analysis, Blue Cross Blue Shield is the best health insurance provider in New Mexico for those who want low MOOP costs. With this company, you can expect to spend less money on your medical expenses overall if you require frequent or ongoing medical care. Blue Cross Blue Shield offers 75 Gold HMO plans in New Mexico.
This provider also offers affordable average monthly premiums of $408 and has low MOOP costs of $7,283. It has a slightly worse-than-average claims denial rate of 18%, meaning it is more likely than some competitors to deny claims.
Plan Recommendations
MoneyGeek recommends the following Blue Cross Blue Shield health plan with low MOOP costs:
- Blue Community Gold HMO℠ 601 HDHP: $418 per month, MOOP of $4,500
Best Cheap Health Insurance in New Mexico
New Mexico’s best cheap health insurance is offered by Ambetter, which earned a MoneyGeek score of 69 out of 100.
To determine our winner in this category, we placed a heavier emphasis on affordability when evaluating plans. Keep in mind that low-cost plans tend to have higher out-of-pocket expenses. Our analysis for this category included 160 Silver HMO plans.
If you're focused soley on cost, MoneyGeek also determined the cheapest health insurance in New Mexico.
pros
Offers the cheapest average premium in New Mexico
Has the second-lowest MOOP costs in our comparison group
cons
Denies the highest percentage of claims
Limited variety of plan types
COMPANY HIGHLIGHTS
Ambetter provides the best affordable health insurance in New Mexico. On average, its Silver plans cost $471 per month with an average MOOP of $8,000. The company only offers 50 Silver plans, both of which are HMO plans.
In addition, Ambetter has a high claims denial rate of 38.09% — the highest out of the insurers in our comparison group. This means it denies over a third of claims, so it’s likely that you may encounter some issues with your coverage requests. Consider this provider if you value affordable premiums above everything else.
Plan Recommendations
We recommend the following affordable plans from Ambetter:
- Focused Silver: $461 per month, MOOP of $7,800
Best Health Insurance for Young Adults in New Mexico
With a MoneyGeek score of 88 out of 100, Presbyterian offers the best health insurance for young adults in New Mexico.
We analyzed insurers that offer Bronze, Expanded Bronze or Catastrophic plans, which generally have affordable premiums but high out-of-pocket costs. Catastrophic plans are only available to those under 30. For this category, we evaluated 25 Bronze HMO plans and 10 Expanded Bronze HMO plans in New Mexico.
pros
Has affordable average rate for young adults and low MOOP costs
Rarely denies claims
cons
Only offers HMO plans
COMPANY HIGHLIGHTS
Young adults in New Mexico looking for health insurance may find Presbyterian to be the best option. This company offers plans at an average cost of $291 per month, with an average MOOP of $9,100.
Presbyterian has 25 Bronze plans and 10 Expanded Bronze plans available in New Mexico — both are HMOs. These metal tiers are ideal for young adults who want affordable premiums and don’t anticipate needing much medical attention.
In terms of claims management, Presbyterian has a 0% claims denial rate, so any claims filed by policyholders are very likely to be accepted and processed efficiently.
Plan Recommendations
For young adults in New Mexico, we recommend the following plan from Presbyterian:
- Ind HMO Expanded Bronze 1 with GYM On: $198 per month for 18-year-olds and $214 per month for 26-year-olds, MOOP of $9,100
Best Health Insurance by Plan Type in New Mexico
Health insurance companies typically offer different plan types with varying coverages, benefits, network providers and cost-sharing options. According to our analysis of New Mexico providers, Presbyterian offers the best HMO plans, which are the only plans available from the providers we evaluated.
We limited our recommendations to Silver plans, which are a middle-of-the-road option that provides a balance of affordable premiums and coverage. Our study comprised 160 Silver HMO plans in New Mexico.
Best for HMO: Presbyterian
COMPANY HIGHLIGHTS
In New Mexico, Presbyterian is the best health insurance company for HMO plans. The company offers 35 Silver HMO plans in the state, costing an average of $656 per month and with an average MOOP of $7,636.
HMO plans are generally among the most affordable plan types and are ideal for those who want low monthly payments and have easy access to the plan's in-network providers. However, HMO plans do not cover out-of-network care, except for emergencies, and they require policyholders to get a referral for specialist visits.
In addition to affordable rates, Presbyterian also has a very low claims denial rate, meaning it approves almost all claims. Policyholders can get peace of mind knowing that valid claims are likely to be covered by the insurer.
Plan Recommendations
Consider these plans offered by Presbyterian:
- Ind HDHP/HSA Silver 2 with GYM On: $718 per month, MOOP of $7,050
- Ind HMO Silver 3 with GYM On: $499 per month, MOOP of $9,100
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.
Understand when a health insurance plan will cover you
In New Mexico, the only type of health insurance plans available on the marketplace are HMOs. Although this plan type is usually the cheapest, it’s also the least flexible. An HMO plan usually requires you to stay within a specified network of health care providers to receive care, unless it’s an emergency. You'll also need a referral from your primary care provider (PCP) if you want to see a specialist. Based on our analysis, New Mexico has 372 HMO plans available in various metal tiers.
Weigh the cost of premiums vs. the cost of care
Low-cost health plans may be ideal if you want to save on premiums each month, but they often come with higher out-of-pocket costs that add to your overall medical expenses. In New Mexico, for instance, Presbyterian’s Ind HDHP/HSA Silver 2 with GYM On plan costs an average of $718 per month and has a MOOP of $7,050. Meanwhile, Blue Cross Blue Shield’s Blue Community Gold HMO℠ 705 plan costs an average of $397 per month and has a MOOP of $8,250.
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.
Frequently Asked Questions 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.
About Mark Fitzpatrick
