En español | Most New Mexico residents can buy health insurance through the New Mexico Health Insurance Exchange (or beWellnm), the state’s Affordable Care Act (ACA) marketplace, now that open enrollment has begun. And you might be able to save money on premiums, thanks to expanded federal tax credits in March 2021’s coronavirus relief bill.
New Mexico will shift from a Healthcare.gov marketplace plan to a state-specific marketplace in 2022, with coverage effective Jan. 1. Current Healthcare.gov customers should be able to access the same or similar coverage on the new state exchange, but you’ll need to set up new billing information through beWellnm.
Most people already enrolled in ACA marketplace plans likely saw their premiums go down this year because the March 2021 American Rescue Plan increased tax credits for insurance premiums and expanded the number of households who qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help them afford health insurance. Prior to the new law, such tax credits were only available to people making up to 400 percent of the federal poverty level (around $51,000 for one person).
The average American with a marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will be available only through the end of 2022.
Who is eligible?
- Most New Mexico residents can buy health insurance through beWellnm, regardless of whether they are currently insured. Some non-U.S. citizens may also be eligible for coverage, and the state offers specific resources for Native American individuals and families seeking coverage.
- Low-income individuals and families may also qualify for free or low-cost health insurance through Medicaid. To enroll or to see if you’re eligible, create an account with YesNM, which also handles assistance programs like SNAP and TANF.
- The Children’s Health Insurance Program offers health insurance for children and teens in families with incomes too high to qualify for Medicaid but who still may struggle to find affordable coverage. To enroll or to see if you’re eligible, create an account with YesNM.
When can I enroll?
- BeWellnm’s open enrollment began on Nov. 1 and runs through Jan. 15. If you enroll by Dec. 23, your coverage will begin Jan. 1, 2022.
- You can enroll outside of open enrollment if you experience a qualifying life event but you have only 60 days from that event to enroll. Qualifying events include births and adoptions, loss of employer-provided coverage, marriage, divorce, moving and other special circumstances.
- You can also enroll anytime if you qualify for Medicaid or if your children qualify for CHIP.
How do I sign up?
First, use beWellnm’s plan comparison tool to estimate costs and see what sorts of plans you may qualify for — or enter personal information like your name, phone number and zip code and set up a time to speak with a certified enrollment assister or insurance broker. Or call beWellnm’s customer engagement center at 833-862-3935 toll-free.
Once you’re approved for a plan, you’ll need to pay your first monthly premium for your coverage to begin. Your first payment is due by the 23rd of the month before your coverage kicks in, so by Dec. 23 for coverage that begins Jan. 1.
To apply and enroll:
- Online: Go to beWellnm’s website and click Sign Up Now!
- If you’re a new customer, you’ll need to create an account and provide personal information like your name, date of birth and email address.
- If you already have coverage through Healthcare.gov and are enrolling for coverage in 2022, you should have received a letter or email from beWellnm with a link to set up a beWellnm account. If you haven’t received a letter or email, call the customer engagement center at 833-862-3935 toll-free for assistance.
- By phone: Call the customer engagement center at 833-862-3935.
- Through an assister or broker: Both offer free help with creating an account and selecting a plan, but only brokers can recommend specific plans and help you apply for other types of coverage and insurance. BeWellnm’s website lets you search for assisters and brokers by zip code. You may be able to meet with an expert in person or virtually.
If you currently get insurance through Healthcare.gov, you’ll be able to enroll in the same plan or a similar plan on New Mexico’s new exchange, beWellnm. But you’ll need to set up a new billing account through beWellnm. Notices have already been sent to existing customers, so contact the marketplace’s customer support team if you weren’t notified or if you have questions.
What is covered, and how much will it cost?
Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family.
If you qualify for Medicaid, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All beWellnm plans cover 10 “essential” benefits, including:
- Emergency services and hospitalization
- Maternity and newborn care
- Mental health services (including counseling)
- Chronic disease management and preventative care
- Prescription drugs
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
Most beWellnm plans cover basic dental services for children, including cleanings and exams. But adults who want dental coverage, or parents who want more substantial coverage for their kids, must add it to their policy.
Deductibles and out-of-pocket costs vary between plans.
What about new federal assistance for premiums?
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income now qualifies for federal tax credits for insurance premiums.
For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.
Is there any other financial assistance available?
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.
What plans are available?
BeWellnm plans are organized into four categories:
- Bronze plans have the lowest monthly premiums and the highest deductibles and copays, and cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury.
- Silver plans have moderate monthly premiums, deductibles and copays. They cover roughly 70 percent of costs. They’re the only plans eligible for cost-sharing subsidies.
- Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays, and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.
The beWellnm plan comparison tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance. New Mexico residents younger than 30 can also apply for a catastrophic plan offering low premiums but with high deductibles.
What if I already have health insurance?
If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to beWellnm. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.83 percent of your household income for individual coverage to qualify for the tax credits.
If you already have coverage through Healthcare.gov, you’ll be able to get the same or a similar plan through the new state-specific marketplace. But you’ll need to set up new billing information with beWellnm. Call the customer engagement center at 833-862-3935 toll free if you need help or have questions.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) because you were terminated from a job or were put on reduced hours, you'll be able to switch to a beWellnm plan during open enrollment.
If you’re on COBRA, you may want to sign up for a marketplace plan during open enrollment or as soon as your COBRA coverage ends. If you’re not sure about whether making this switch makes sense for you, you can ask for free advice from a certified insurance broker or assister.
Will I need to get a new doctor?
That depends. Major insurance providers, including Blue Cross Blue Shield of New Mexico, True Health and Molina, offer beWellnm plans, but not all doctors accept them. You can talk to your primary care physician to see whether he or she accepts a particular marketplace plan.
Will my family members qualify for the same health plan that I do?
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs such as Medicare, Medicaid or CHIP, depending on age, income and disability or caregiver status. Such families may choose to enroll separately. They may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.