New Mexico Health Insurance Plan Policies

Health insurance is something that you must have simply because giving your family a healthy life is priceless. When something bad occurs, such as an accident or falls ill and needs hospitlization, it will make you financially prepared for the hospital bill. When choosing a health insurance plan in New Mexico, it is essential to conduct a thorough search in order to match your family's medical needs and to recognize what you can and cannot afford. Residents may choose from an array of New Mexico health insurance plans. The Insurance Division of New Mexico Public Regulation Commission holds the regulations by where the New Mexico medical insurers can sell private medical insurance to individuals and families.

Unfortunately in New Mexico, individual medical insurance plans are not guarantee issued. Each health insurance plan in New Mexico is medically underwritten in New Mexico law which means that the health insurance carrier is permitted to review your past and present health history condition. The insurance company denies or approves coverage or may provide a customized coverage with detailed boundaries or exclusions. Each health insurance carrier can require a 6 month exclusionary period limit on pre-existing medical conditions after going through your 6 month old health condition history. New Mexico law also allows elimination riders which temporarily or permanently remove coverage of some health conditions. In New Mexico, insurance premiums are not regulated.

Coverage of small group health insurance which is composed of 2-50 employees in New Mexico is guaranteed issue. This means that the group is assured that they will be given coverage no matter what their past or current health history of the group or its individual members have. Health insurance carriers may entail a maximum of 6 month exclusionary period on pre-existing medical conditions on every applicant who lacks prior creditable coverage. Six months is the look back period. Every eligible individual may need to satisfy an employer imposed waiting period before being a member of the group health plan. The medical underwriting of group rates is given by New Mexico. When with a poor health history, a small group may be charged a maximum fee of no more than 20% of the insurance company's index rate.

COBRA can be extended to groups with more than 19 workers in order to have coverage for 18 months under federal law. Under exceptional conditions, dependents and permanently disabled individuals will still receive coverage for up to 36 months. Within 63 days of the termination date of your group health plan, your COBRA selection must be established.

The mini-cobra law of New Mexico title 13, Chapter 10, Part 11.31, is the same as the federal COBRA law. The regulated COBRA program extends continuation of group health benefits to employees for six months. An employee must have had coverage under the New Mexico group health insurance plan for at least 6 months and must be eligible through a qualifying event for mini-COBRA approval. A qualified person for COBRA must choose their COBRA coverage within 30 days after losing coverage eligibility of the group plan. The employee is responsible for the monthly premiums under the mini-COBRA program. Fortunately for persons who decide to change COBRA coverage into an individual health plan, conversion plans are obtainable. For those who are maxing out their coverage on COBRA, the state high-risk pool put forward guaranteed individual health insurance if established within 63 days of the COBRA termination.

Summary: New Mexico offers guarantee issue on health plans to small groups. Enter your zip code above to receive a free health insurance quote in New Mexico.

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