In New Mexico, Ambetter offers the cheapest HMO Silver plan, while Presbyterian Health Plan provides the most affordable HMO Bronze, Expanded Bronze and Gold plans. Depending on the metal tier you choose, premiums, deductibles and maximum out-of-pocket costs (MOOPs) can vary. These costs can also change depending on your age, income level and coverage needs.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in New Mexico.
Most Affordable Health Insurance in New Mexico
Cheapest Health Insurance in New Mexico by Metal Tier
The cheapest health insurance Silver plan in New Mexico is the Focused Silver plan from Ambetter at $461 per month. As a general rule, more valuable metal tiers tend to have more expensive plans, but they offer more coverage.
For those looking for the most affordable health insurance plans, the following is a list of the cheapest plans by metal tier available in the state of New Mexico:
- Bronze: Ind HMO Bronze 2 with GYM On from Presbyterian Health Plan ($418 per month)
- Expanded Bronze: Ind HMO Expanded Bronze 1 with GYM On from Presbyterian Health Plan ($276 per month)
- Silver: Focused Silver from Ambetter ($461 per month)
- Gold: Ind HMO Gold 2 with GYM On from Presbyterian Health Plan ($343 per month)
Paying for a higher tier of health insurance can reduce out-of-pocket expenses for medical services. Higher metal tiers, such as Gold, tend to have higher monthly premiums but lower deductibles and maximum out-of-pocket expenses (MOOP).
On the health insurance exchange, plans are grouped into metal tiers. These tiers are named after metals, such as Bronze, Silver, Gold and Platinum. Typically, the more valuable the metal, the higher the plan's premiums but the lower its out-of-pocket costs.
Young and healthy buyers may opt for less valuable metals, while those who expect to require medical services may prefer more valuable metal tiers. Silver plans provide the best balance between premium cost and coverage of any metal tier since they tend to offer more flexibility for choosing health care providers. If you have a lower income, you may be eligible for cost-sharing reductions that could lower your deductibles with a Silver plan.
Cheapest Silver Plans in New Mexico
The cheapest Silver plan in New Mexico is the Focused Silver plan from Ambetter, with a monthly premium of $461. If you’re looking for the most affordable health insurance in New Mexico, these are the cheapest Silver plans:
- Focused Silver from Ambetter: $461 per month
- Elite Silver from Ambetter: $481 per month
- Blue Community Silver HMO 203 from Blue Cross Blue Shield: $484 per month
Silver plans offer a balance between monthly premiums and coverage options, making them a popular choice. Cost-sharing reductions (CSRs) might be available for eligible individuals. These can lower out-of-pocket costs.
We focus our recommendations in this section on the HMO plan type because they are the most accessible in New Mexico.
Cheapest Gold Plans in New Mexico
The Ind HMO Gold 2 with GYM On from Presbyterian Health Plan is the most affordable Gold plan in New Mexico, costing around $343 per month. Other cheap Gold plans include:
- Ind HMO Gold 2 with GYM On from Presbyterian Health Plan: $343 per month
- Ind HMO Gold 4 with GYM On from Presbyterian Health Plan: $354 per month
- Ind HMO Gold 1 with GYM On from Presbyterian Health Plan: $390 per month
While Gold plans come with lower out-of-pocket costs and provide more comprehensive coverage than Silver or Bronze plans, they typically have higher monthly premiums. In New Mexico, however, Gold plans are actually cheaper than Silver plans.
Cheapest Bronze Plans in New Mexico
The cheapest Bronze plan in New Mexico is the Ind HMO Bronze 2 with GYM On from Presbyterian Health Plan at $418 per month.
Bronze plans generally offer the lowest monthly premiums of all metal tiers, but they also come with higher out-of-pocket costs and limited coverage. While Bronze plans can be a good choice for those who are healthy and don't anticipate frequent medical expenses, they may not be the best option for those with chronic health conditions or who require regular medical care.
Cheapest Expanded Bronze Plans in New Mexico
The most affordable health insurance in New Mexico in the Expanded Bronze tier is the Ind HMO Expanded Bronze 1 with GYM On at $276 per month from Presbyterian Health Plan.
While they may still have higher deductibles and copays than other metal tiers, Expanded Bronze plans can be a good choice for those who need more coverage than a traditional Bronze plan but want to keep their monthly premiums as low as possible.
A cost-sharing reduction (CSR) is a type of financial assistance available to eligible individuals who purchase health insurance through the Health Insurance Marketplace. CSRs help reduce the out-of-pocket costs associated with a health insurance plan, including deductibles, copays and co-insurance.
The amount of the reduction depends on the individual's income level and the plan they choose. It is applied automatically to the plan's cost-sharing requirements when they receive covered medical services. Eligibility for CSRs is based on income and can only be applied to Silver plans.
Cheapest Health Insurance in New Mexico by Plan Type
MoneyGeek only analyzed HMO plans in New Mexico. The most affordable Silver HMO plan in New Mexico is the Focused Silver plan from Ambetter at $461 per month.
Choosing an HMO plan typically involves lower out-of-pocket costs and a smaller network of health care providers. However, your health care options are limited with this plan type.
One of the main advantages of choosing an HMO plan is lower out-of-pocket costs, including lower deductibles, copayments and co-insurance. However, HMO plans typically have a smaller network of health care providers to choose from, limiting options for patients who prefer to have greater flexibility.
Additionally, you’ll need a referral to see a specialist. This makes HMO plans more suitable for people who are on a budget and don’t need specialized care because they are generally in good health.
Cheapest Health Insurance in New Mexico by County
In New Mexico, the availability of health insurance plans may differ by location. Insurance rates can also change across counties within the state. You can use the table below to help you compare the cost of Silver plans by county.
Health Insurance Costs in New Mexico by Age and Metal Tier
In New Mexico, the average health insurance cost can vary based on the metal tier you choose. These are the average premium costs for a 40-year-old in the state:
- Bronze: $418 per month
- Expanded Bronze: $276 per month
- Silver: $524 per month
- Gold: $417 per month
Additionally, health insurance costs tend to increase as you age, with seniors facing higher premiums than teens. For example, the average premium for a Silver plan for an 18-year-old is $375 per month, while a 60-year-old will pay around $1,100 per month.
What to Know About New Mexico Health Insurance
MoneyGeek analyzed data from various private health insurance plans to help you find the cheapest options available during the open enrollment period of the New Mexico Marketplace.
Depending on your income and circumstances, you may qualify for Medicaid if you have a low income or Medicare if you are a senior citizen or have a disability. These programs are often more affordable and can provide a better solution for New Mexico residents who meet the eligibility criteria.
Private Health Insurance in the New Mexico Marketplace
Private health insurance plans in New Mexico can be purchased during the open enrollment period, which usually runs from November 1 to January 15. Signing up before December 15 ensures that your coverage starts on January 1 of the following year, allowing you to have uninterrupted health insurance coverage.
If you miss the open enrollment period, you may still be eligible to enroll in a marketplace plan during a special enrollment period. You can qualify for a special enrollment period if you have a qualifying life event, such as losing your job, getting married, having a baby or moving to a new area.
Medicaid in New Mexico
In New Mexico, if you have an income under 138% of the Federal Poverty Level, you are eligible to enroll in Medicaid. Medicaid is a health insurance program that is provided free of charge to qualified individuals, and people who live in states that have expanded Medicaid, such as New Mexico, can be eligible for the program based on their income level. Since Medicaid is free, it is the most affordable option for individuals who qualify.
Medicare in New Mexico
Residents of New Mexico who are 65 years of age or older are eligible for Medicare, which is a federal government program that provides medical coverage for certain expenses. Medicare is divided into three parts: Part A, Part B and Part D.
Part A covers hospital insurance, including medical expenses associated with hospital stays, hospice care and care facilities. Part B covers outpatient expenses, including preventive care, medical supplies and medical devices. Prescription drugs and vaccines recommended by your doctor are usually covered under Part D of Medicare.
Expert Advice: Finding Affordable Health Insurance in New Mexico
- How do I take advantage of cost-sharing reductions and tax credits for health insurance in New Mexico?
- Outside of plans on the health insurance exchange, where else can I get health insurance in New Mexico?
Professor at the New Mexico State University, College of Business
New Mexico Health Insurance Frequently Asked Questions
If you are looking for health insurance, you likely have questions about availability and cost. Here are some common questions from New Mexico residents about coverage in the state.
About Mark Fitzpatrick
- HealthCare.gov. "Special Enrollment Period (SEP)." Accessed May 25, 2023.