Applying for Medicaid in New Mexico is straightforward, and hundreds of thousands of residents already benefit from the program. Known locally as Centennial Care, New Mexico's Medicaid program provides health coverage to low-income adults, children, pregnant women, seniors, and people with disabilities. As of mid-2025, over 710,000 New Mexicans were enrolled in Medicaid or CHIP. If you think you or your family might qualify, this guide walks you through every step of the process, from checking your eligibility to submitting your application.
New Mexico expanded Medicaid under the Affordable Care Act in January 2014, which means adults without children can qualify for coverage if their income falls below 138% of the Federal Poverty Level (FPL). The state also offers generous income limits for children and pregnant women, making it one of the more accessible Medicaid programs in the country.
For a broader look at all the assistance programs available in the state, visit our New Mexico Benefits Overview.
Who Is Eligible for Medicaid in New Mexico?
Eligibility for Centennial Care depends on your age, income, household size, and immigration status. New Mexico uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most groups. Here is a summary of the main eligibility categories:
Adults ages 19 to 64: You may qualify if your household income is at or below 138% of the FPL. You do not need to have children or a disability to be eligible, thanks to Medicaid expansion.
Children ages 0 to 5: Children in this age group are covered with household incomes up to 305% FPL, one of the highest thresholds in the nation.
Children ages 6 to 18: Coverage is available for families with incomes up to 245% FPL.
Pregnant women: Pregnant women qualify with incomes up to 255% FPL. New Mexico also provides 12 months of postpartum coverage, ensuring new mothers maintain access to care well after delivery.
Seniors and people with disabilities: Individuals aged 65 and older or those with qualifying disabilities may be eligible through the Aged, Blind, and Disabled category, which has different income and asset rules.
Not sure if you qualify? Use our free benefits screener to check your eligibility for Medicaid and other programs in just a few minutes.
New Mexico Medicaid Income Limits (2026)
The table below shows approximate monthly income limits for the most common Medicaid eligibility categories based on the 2025 Federal Poverty Level guidelines. These figures include the standard 5% income disregard built into the 138% FPL threshold for adults.
| Eligibility Group | % of FPL | Individual | Family of 2 | Family of 3 | Family of 4 |
|---|---|---|---|---|---|
| Adults (19 to 64) | 138% | $1,802/mo | $2,449/mo | $3,095/mo | $3,667/mo |
| Children (0 to 5) | 305% | -- | -- | -- | -- |
| Children (6 to 18) | 245% | -- | -- | -- | -- |
| Pregnant Women | 255% | -- | -- | -- | -- |
| Aged, Blind, Disabled | Varies | $994/mo | $1,491/mo | -- | -- |
Note: Children's eligibility is based on the household's total income relative to the FPL for the given household size. The percentages shown (305% and 245%) are applied to the full FPL for your household. Income limits update each year, typically in January. Always verify current numbers through the official application process or by calling 1-800-283-4465.
How to Apply for Medicaid in New Mexico: Step by Step
New Mexico offers several ways to apply for Medicaid. The most common and fastest method is through the state's online portal, but you can also apply by phone, by mail, or in person.
Step 1: Gather Your Documents
Before you start your application, collect the following information for each household member applying:
- Social Security numbers
- Proof of identity (driver's license, state ID, passport, or birth certificate)
- Proof of income (pay stubs, tax returns, W-2 forms, or self-employment records)
- Proof of New Mexico residency (utility bill, lease agreement, or bank statement with your address)
- Immigration documents (if applicable)
- Information about any current health insurance coverage
- Proof of pregnancy (if applying under pregnancy coverage)
Step 2: Choose Your Application Method
Online (Recommended): Visit the YES New Mexico portal at yes.state.nm.us. Create an account, then complete the application. The online system is available 24/7 and typically provides the fastest processing.
By Phone: Call the New Mexico Health Care Authority customer service line at 1-800-283-4465 during business hours. A representative can help you complete an application over the phone. You can also call the 24/7 information line at 1-855-309-3766 for general questions.
In Person: Visit your local New Mexico Health Care Authority (formerly Human Services Department) field office. Staff can help you fill out an application and answer questions. Find your nearest office by calling 1-800-283-4465.
By Mail: Download a paper application from the Health Care Authority website, fill it out, and mail it to:
Central ASPEN Scanning Area PO Box 830 Bernalillo, NM 87004
Step 3: Complete the Application
Whether you apply online or on paper, the application will ask about:
- Your household members and their relationships
- Your household income from all sources
- Your current employment status
- Whether anyone in the household is pregnant, has a disability, or is a veteran
- Your current living situation and expenses
- Any existing health insurance coverage
Answer all questions as accurately as possible. Incomplete applications can delay processing.
Step 4: Submit and Wait for a Decision
After you submit your application, the Health Care Authority will review it and may request additional documentation. The standard processing time is up to 45 days. For pregnant women, applications are typically processed more quickly, often within a few weeks.
You will receive a notice by mail (or electronically if you opted in) with the decision. If approved, your notice will include information about your managed care plan options.
Step 5: Choose a Managed Care Organization (MCO)
Once approved, you will need to choose one of three managed care organizations that deliver Centennial Care services:
- Blue Cross Blue Shield of New Mexico
- Presbyterian
- Western Sky Community Care
Each MCO has its own network of doctors, hospitals, and specialists. Compare provider networks to make sure your preferred doctors are included. If you do not choose an MCO, one will be assigned to you.
What Medicaid Covers in New Mexico
Centennial Care provides comprehensive health coverage, including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance abuse treatment
- Preventive care and screenings
- Lab tests and X-rays
- Maternity and newborn care
- Dental services (limited for adults, more comprehensive for children)
- Vision care
- Home and community-based services for qualifying individuals
- Transportation to medical appointments
Important 2026 and 2027 Medicaid Changes in New Mexico
New Mexico Medicaid is undergoing significant changes that current and prospective enrollees should know about:
Starting October 1, 2026: Some non-citizens may face new eligibility limits. If you are a lawfully present non-citizen currently enrolled in Medicaid, stay informed about how these changes might affect you.
Starting December 31, 2026: Many adults will have their eligibility reviewed every 6 months instead of annually. Make sure your contact information is up to date so you receive renewal notices.
Starting January 1, 2027: New work requirements will take effect. Adults will need to complete 80 hours per month of qualifying activities, which include employment, school, job training, or community service. Exemptions may be available for certain groups.
Starting January 1, 2027: New identity and residency verification requirements begin, including address and Social Security number checks.
How to Prepare for These Changes
- Update your contact information at yes.state.nm.us or by calling 1-800-283-4465
- Respond quickly to any renewal letters you receive
- Keep records of work hours, school attendance, or volunteer activities
- Report changes to your income, address, or household composition immediately
- Watch for notices from the Health Care Authority about how changes apply to you
Transitioning from Medicaid to Marketplace Coverage
If your income increases and you no longer qualify for Medicaid, New Mexico offers transition assistance. The state will pay your first month's net premium for a health plan through beWellnm, the state's ACA marketplace exchange. You may also be able to choose a retroactive effective date to avoid any gap in coverage.
Open enrollment for beWellnm typically runs from November 1 through January 15, but losing Medicaid coverage qualifies you for a Special Enrollment Period, so you can sign up for a marketplace plan at any time.
Other Benefits You May Qualify For
Many people who qualify for Medicaid are also eligible for other assistance programs. New Mexico offers several programs through the same YES NM application portal:
- SNAP (food assistance): Helps pay for groceries. Income limit is 200% FPL in New Mexico.
- NMWorks (TANF): Cash assistance for families with children. Income limit is 85% FPL.
- LIHEAP: Helps pay heating and cooling bills. Income limit is 150% FPL.
- Universal Child Care: New Mexico became the first state in the nation to offer no-cost universal child care in November 2025, with no income limits.
- WIC: Nutrition assistance for pregnant women and children under 5. Income limit is 185% FPL.
Use our free benefits screener to check your eligibility for all of these programs at once.
Frequently Asked Questions
How long does it take to get approved for Medicaid in New Mexico?
The standard processing time is up to 45 days from the date your complete application is received. Pregnant women and newborns may be approved more quickly. You can check your application status online through the YES NM portal or by calling 1-800-283-4465.
Can I apply for Medicaid at any time?
Yes. Unlike marketplace health insurance, Medicaid has no open enrollment period. You can apply any time of year and coverage can begin as soon as you are approved.
What if I am denied Medicaid?
If your application is denied, you will receive a notice explaining the reason. You have the right to appeal the decision. The notice will include instructions on how to request a fair hearing. You may also want to check whether you qualify for subsidized coverage through beWellnm.
Does New Mexico Medicaid cover dental care?
Yes, but adult dental benefits are limited compared to children's coverage. Children enrolled in Centennial Care receive comprehensive dental services. Adults receive basic preventive and emergency dental care. Check with your MCO for specific covered services.
Can non-citizens apply for Medicaid in New Mexico?
Some lawfully present immigrants may qualify for Medicaid in New Mexico, depending on their immigration status and how long they have been in the country. Emergency Medicaid is available regardless of immigration status for qualifying emergency medical conditions. Be aware that eligibility rules for non-citizens are changing starting October 2026.
What is the difference between Medicaid and Centennial Care?
Centennial Care is simply the name New Mexico uses for its Medicaid managed care program. When you are approved for Medicaid in New Mexico, you receive your benefits through the Centennial Care system and choose from one of three managed care organizations.
I already have Medicare. Can I also get Medicaid?
Yes. People who qualify for both Medicare and Medicaid are called "dual eligible." Medicaid can help pay for Medicare premiums, deductibles, and copayments, and may also cover services that Medicare does not, such as long-term care and dental. Contact the New Mexico SHIP program at 1-800-432-2080 for help understanding your dual-eligible benefits.
Get Started Today
Applying for Medicaid in New Mexico does not have to be complicated. The fastest way to get started is to visit yes.state.nm.us and complete your application online. If you need help, call 1-800-283-4465 to speak with a representative.
Want to see all the benefits you might qualify for? Try our free benefits screener to check your eligibility for Medicaid and over 10 other assistance programs in just a few minutes.
