Reflects Medicaid state plan coverage of the eligibility group for parents and other caretaker relatives. hbbd``b`VO@D$X'@@ 3 b O@!$$d @#y"3|` For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces . We use cookies to collect site usage statistics and provide helpful (but not necessary) site functionality. The funds can only be used for very specific purposes, such as paying a non-applicant spousal income allowance and contributing towards the cost of long-term care and medical expenses accrued by the Medicaid enrollee. Join Your Medicare 101 Educational Webinar Now. Furthermore, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse to prevent spousal impoverishment. 2. Here is the MAD directory for New Mexico Oral Health Medicaid Fee for Service Providers. 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 . New Mexico Medicaid cost estimates are kept as low as possible to help applicants with limited income. In New Mexico, Medicaid is called Centennial Care. The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long-term care from a New Mexico Medicaid program. coverage to low-income adults. Call our team today and get your questions answered with, How to get Both Medicare and Medicaid in New Mexico, dual-eligible Medicare special needs plan, Entering your 25th month of SSDI benefits, Medicare Part A: Coverage and Costs for 2020, Understanding Medicare Part B: Coverage and Costs for 2020, Free infant car seats and cribs for eligible members, Boys & Girls Club memberships for eligible members, Native American traditional healing benefit, Practice dental and gynecology visits for those fearful of attending gynecology or dental appointments, Up to six dental varnish applications for kids ages six months to three years, Medisafe medication reminders to your phone, Tabtime Vibe vibrating pill time reminder, Up to $300 of traditional Native American medicine, Copayment reimbursement for up to three counseling visits for eligible members, School-based health clinic reimbursements, School sports physicals for kids ages 12-18, $20 value for completing an HbA1c test for diabetes, $20 value for completing a diabetes nephropathy exam for kidney health, $20 value for completing a diabetes retinal eye exam, $25 value for attending a prenatal visit in your first trimester or first 42 days of enrollment, $25 value for completing an annual dental checkup, $25 value for attending a primary care physician checkup, $25 value for attending a postpartum visit (21-65 days post delivery), $25 value for completing the Step-Up walking challenge (ages 10+), $30 value for attending well-baby checkups (0-15 months), $35 value for completing a bone mineral density test, $35 value for taking your child to an annual dental checkup, $60 value for filling your childs asthma controller medication, $60 value for filling your bipolar disorder medication as prescribed, $60 value for filling your schizophrenia medication as prescribed. SUhb~S)_GU3b (U6 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. MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging, *All of ones monthly income with the exception of a, What is the Medicaid Estate Recovery Program, Minimum Monthly Maintenance Needs Allowance, Learn more about calculating the spousal allowance, New Mexico Centennial Care Community Benefit, Program of All-Inclusive Care for the Elderly, local Human Services Department (HSD) Income Support Division (ISD) office, 2023 New Mexico Medicaid Long-Term Care Eligibility for Seniors, $2,000 for applicant & $148,620 for non-applicant, Medicaid Waivers / Home and Community Based Services, Regular Medicaid / Aged Blind and Disabled. 1) New Mexico Centennial Care Community Benefit Intended to encourage independent living at home or in the community, a variety of supportive services are provided. Personalized Support Through our Community Health Services Department (CHS), we can help you get the support you need. 211 0 obj <> endobj We help individuals nationwide with Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Extra Help, and Final Expense. and Results, Medicaid/CHIP 1. 397 0 obj <> endobj *Disclaimer: SCAN Health Plan is only available in select counties in the state of California. Category 100 - Other Adult-covers individuals age 19 up to 65, with or without dependents with no Medicare . 1) Qualified Income Trusts (QITs) Also called Miller Trusts, or specific to New Mexico, Income Diversion Trusts, these trusts enable Nursing Home Medicaid and Medicaid Waiver applicants who are over the income limit to still become income-eligible. Treatment of Assets for a Couple Medicaid & CHIP Enrollment Data. The MMMNA is said to be the minimum amount of monthly income to which a non-applicant is entitled. Regardless of whether or not a service is mandatory or optional, there may be related costs. Seniors who are uncertain, or have income and / or assets over the limit(s), should consider Medicaid planning for the best chance of acceptance into the Medicaid program. Countable vs. Non-Countable Assets There are some services that are not covered by Medicaid in New Mexico, as there are some limits to the program. If you are married and do not have kids, your eligibility will be based on income before taxes and deductions. $wB>H]HHnDq~~v{^/-t?>Wg> G>W}o &" >@2Jr ?+cI:. MAGI Conversion Plans and Results. While officials attempt to keep Medicaid cost estimates low, in some cases there are costs to the recipient. endstream endobj startxref Medicaid covered services are either mandatory and required by all states to implement, or they may be optional, which means may or may not be adopted by the state. The New Mexico Medicaid program, also called Centennial Care, can save you thousands on healthcare costs if you qualify. Most people with NM Medicaid will not owe any money out of pocket. Testing and treatment for specific diseases. These counts do not include the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey 5.0H Child This site is for information purposes; it is not a substitute for professional legal advice. Edit your hsd 100 online. <> 0 This includes employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Occupational, speech or respiratory therapy. Some services may be subject to co-payments, these co-payments can be as little as 50 cents ($0.50). Giving gifts under this rule is a violation of Medicaids Look-Back Period. Systems (CAHPS) Health Plan Survey 5.0H Child Version Including Medicaid and Children with Chronic Conditions Supplemental Items (CPC-CH) measure, which is publicly reported by CMS, but uses a different summary statistic. (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: For instance, services covered by Medicaid in New Mexico include inpatient and outpatient care. Alternative Benefit Plan (ABP) Exemption . Just call us at %PDF-1.7 % More detailed information and source references are available on each of these topics. Are you looking for a Medicaid plan that will help to keep you healthy and happy? You can apply for New Mexico Medicaid online, by mail, or in person atyour localHuman Services Department field office. CMS Medicaid and CHIP Child and Adult Core Sets and additional data sources in . Official websites use .gov There is no Look-Back Rule for Regular Medicaid. However, in cases where copayments are due, Medicaid coverage caps the amount that a provider may charge for services. For more information, call the New Mexico HSD Medical Assistance Division (MAD) toll free at (888) 997-2583. 4. The term 1937 Medicaid Benchmark or Benchmark Equivalent Plan has been retitled to Alternative Benefit Plans. between the Medicare payment and the Medicaid rate for the service. A. Share your form with others. 01. RIL !kr'bA*2La(Q#B7;Sjv}.QAQyWFq,D K.h{wC])Pb>p:.D_h*No` This plan focuses on breaking down the financial, cultural, and linguistic barriers preventing low-income families and individuals from accessing health care. Presbyterian Centennial Care is designed to keep you in good health. In New Mexico, a non-applicant spouse can further increase their spousal income allowance if their housing and utility costs exceed a shelter standard of $686.63 / month (effective 7/1/22 6/30/23). Long-term care benefits, such as personal care assistance or adult day care, may be available. more of the targeted enrollment strategies outlined in guidance CMS issued on May 17, 2013, has expanded States may alter certain Medicaid benefits depending on regional needs and resources. Blue Cross and Blue Shield of New Mexico's (BCBSNM's) Medicaid plan is Blue Cross Community Centennial SM. Heres how you know. New Mexico Medicaid categories may differ in the income that is counted and not counted when determining . 3. Program participants have the choice of self-directing their own care, including hiring a relative to provide care assistance, or going through a provider agency. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Send hsd100 via email, link, or fax. of 22 frequently reported health care quality 3 0 obj We do not offer every plan available in your area. 414 0 obj <>/Filter/FlateDecode/ID[<92D5FE5900517846BF72D57A6DECD461><054BD16AD95AA442BC6F53530F96DB72>]/Index[397 46]/Info 396 0 R/Length 94/Prev 197428/Root 398 0 R/Size 443/Type/XRef/W[1 3 1]>>stream A .gov website belongs to an official government organization in the United States. The following information was provided by the MAD web site and is presented here as a public service by the NMDA. 03. Value added services are not subject to the appeals process. 'A( $xy}E_wQGOOgBd9quy==5]{0JPR^ZR2|?4s!.dKw / The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. While there are many different coverage groups, this page is focused on long-term care Medicaid eligibility for New Mexico elderly residents, aged 65 and over. hbbd```b``"H9 DLH`-0&UE$dd7nL2`[)!@ /c ] New Mexico Medicaid Checklist . Our licensed agents are readily available. All income standards are expressed as a percentage of the federal poverty level (FPL). Get answers to the question How much does Medicaid cost in NM? and learn more about covered services by reading the following sections. Both families and individuals benefit from the assistance. 576 0 obj <> endobj MAD 100 Revised 2/24/2020 Page | 1 Information Sheet for Application for Medical Assistance New Mexico Human Services Department (HSD) Medical Assistance benefits: Medicaid provides free or low-cost health coverage for certain low-income individuals and families. State of New Mexico Centennial Care 2.0 1115 Waiver Amendment #2 Request March 1, 2021 Page 6 . Information about efforts to enroll eligible individuals in Medicaid and CHIP in . Veterans Aid & Attendance payments are also excluded from income. We can help you if you are healthy or if you have special needs or need complex healthcare services. Sign it in a few clicks. Section 8.200.400.10 - BASIS FOR DEFINING GROUP - MEDICAID CATEGORIES A. and (b)national counts and change statistics for the same period. Secure .gov websites use HTTPS The MAGI-conversion process involved a translation of pre-2014 net income eligibility standards into . A number of states, which have bought in for all of . For example, for a Waiver to cover home modifications, it may be required that a beneficiary be unable to safely live independently without modifying the home. A locked padlock This is often the home. 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. The Presbyterian Centennial Care plan can do that. CHAPTER 245 MEDICAID ELIGIBILITY - SPECIFIED LOW INCOME MEDICARE BENEFICIARIES (SLIMB) (CATEGORY 045). endstream endobj 577 0 obj <. When only one spouse of a married couple applies for Nursing Home Medicaid or a HCBS Medicaid Waiver, only the applicants income is counted towards the income limit. endstream endobj startxref 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. 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 This can be done by spending excess assets on non-countable ones, such as home improvements (replacing a leaky roof, updating the heating/plumbing), home modifications (wheelchair ramps, roll-in showers, and stair lifts), vehicle modifications (wheelchair lifts, adaptive control devices, and floor modifications to allow one to drive from a wheelchair), prepaying funeral and burial expenses, and paying off debt. Applying for Centennial Care can be a complicated, confusing, and lengthy process. Nearly all income that a Medicaid applicant receives is counted towards Medicaids income limit. g For instance, the Affordable Care Act (ACA) introduced an expansion of Medicaid to cover more individuals. The income requirements for Medicaid in New Mexico will depend on the category of Medicaid that a candidate qualifies to receive. The following list is dental service providers for the New Mexico Medicaid Program for August 12, 2015. 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. 3) Medicaid Planning The majority of persons considering Medicaid are over-income and / or over-asset, but they still cannot afford their long-term care costs. and get either full Medicaid coverage or SSI benefits. View available state's Enrollment, Total Medicaid & CHIP Enrollment (Preliminary), Net Change in Enrollment July-September 2013, % Change in Enrollment July-September 2013. Individuals become eligible for Centennial Care, New Mexicos Medicaid Program,when they meet the specific criteria for one of the Medicaid eligibility categories. Furthermore, some program benefits may have additional eligibility criteria specific to the particular benefit. endobj 2) Medicaid Waivers / Home and Community Based Services (HCBS) This is not an entitlement program; the number of participants is limited and wait lists may exist. Connect with a Medicaid planner. An exception exists for Holocaust restitution payments; they do not count as income. Learn more about how states The funding for Medicaid coverage comes from both the federal and state government. Alternative Benefit Plans (ABP) must cover the 10 Essential Health Benefits (EHB) as described in section 1302 (b) of the Affordable Care Act whether the state uses an ABP for Medicaid expansion or coverage of any other groups of . Knowing what Medicaid covers and potential costs are vital for applicants seeking assistance. There are also many non-countable (exempt) assets. Medicaid provides free health insurance to individuals who qualify based on income and family size. 0 y&=~[[0Qtz%Xi_0bu`1lmy2"CRUu){>BJI74[wd( ?||yeBzm ~I.z!60SFaq/o>g#w0K%8D] h/wKC=dlc=hXun=$ Eligibility Requirements for Centennial Care Community Benefit Program. 2019 Centennial Care Rewards. Irreversible means that the terms of the trust cannot be changed or canceled. Uxod0 &[H;c\v_//^C7\P){;o-3V^)_8HSj%m0`P!Q^!=!nVXkQQAS#X*${XjZ'e,u mtMlDpQz\,xw}0O4.Z5}kP) 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. 442 0 obj <>stream Ay\lSO{T8aC7X;?|?ov! Step 2 Coordination . In 2023, the Gift Tax Rule allows one to gift up to $17,000 per recipient without filing a gift tax return. has adopted one or designed to facilitate enrollment in Medicaid and CHIP. We have free interpreter services to answer any questions you may have about our health or drug plan. $25 value for attending a prenatal visit in your first trimester or first 42 days of enrollment. )[{)& yKI\;{{_ 9 RA7fk2\`R/l'" 0jiDQc7Q_Sw-~wa*h;P8\8BhcjqMp The table below presents the most recent, point-in-time count of total Medicaid and CHIP enrollment in for the last day of the indicated month, and is not solely a count of those newly enrolled during the reporting period. hb```>Ad`0pgl.B @1#?f|tY99i=`L`7rg`2, d!2 ' MIZ3d|UAtRkE@X;3= %)n How Does the Affordable Care Act (ACA) Affect Me? % Health insurance for people 65 and older Under 65 with certain disabilities . The funding for Medicaid coverage comes from both the federal and state government. Some states offer a wider range of programs within their Medicaid system than others do. The coverage through each of the other plans is relatively similar, though they may have different provider networks and offer extra benefits, like: New Mexico Medicaid members can receiveup tothe following rewards from Centennial Care in 2019: *There may be other limitations to these rewards. www.yes.state.nm.us Fax - 1-855-804-8960 Phone - 1-855 . Based on ones living setting, a program beneficiary may not be able keep monthly income up to this level. 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 Medicaid is a health care program for low-income individuals of all ages. reporting period. If the Look-Back Rule is violated, a Penalty Period of Medicaid ineligibility will be established. There is, however, a Community Spouse Resource Allowance (CSRA) that protects a larger amount of a couples countable assets for a non-applicant spouse of a Nursing Home Medicaid or Medicaid Waiver applicant. endstream endobj startxref Medicaids Look-Back Rule 1-855-592-7737 (TTY 711). 2) Asset Spend Down Persons with assets over Medicaids limit can spend down extra assets to become asset-eligible. According to the state's website, New Mexico's Medicaid program serves 1 in 3. hkOG|LT3W)B RH@K|dlT=36A6eFKZ. Learn more about calculating the spousal allowance. Homeland Security and Labor) rather than paper documentation from families for Please visit our. %PDF-1.7 We have cared for New Mexico's Medicaid members since 1997. The technical storage or access that is used exclusively for anonymous statistical purposes. If the non-applicants share falls below $31,290, 100% of the assets, up to $31,290 can be retained by the non-applicant spouse. To enroll, you must first apply for Medicaid in New Mexico and must enroll in Medicare parts A and B. is eligible for Medicaid and CHIP. Individuals become eligible for Centennial Care, New Mexico's Medicaid Program, when they meet the specific criteria for one of the Medicaid eligibility categories. 4 0 obj endobj Medicare 4. Presbyterian Healthcare Services has served New Mexicans for more than 110 years. Equity interest is the amount of the homes equity that is owned by the applicant. (and Discover the Best Rates, for FREE). [8.245.600.1 NMAC - Rp, 8.245.600.1 NMAC, 1/1/2019] 8.245.600.2 SCOPE: The rule applies to the general public. Medicaid and CHIP agencies now rely primarily on information available through data change in enrollment since the initial open of the Health Insurance Marketplaces, The CB Program is for New Mexico residents who are elderly (aged 65+) or disabled and between the ages of 0 and 64. Ones primary home is exempt if the Medicaid applicant lives in it or has Intent to Return, and in 2023, their home equity interest is not more than $688,000.
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