New Mexico provides Medicaid coverage through a program called Centennial Care, which serves roughly 687,000 residents as of late 2025. Because New Mexico expanded Medicaid under the Affordable Care Act back in January 2014, adults with low incomes can qualify for coverage even if they do not have children. The program also covers children at higher income levels, pregnant women, seniors, and people with disabilities.
This guide covers everything you need to know about qualifying for Medicaid in New Mexico in 2026, including updated income limits based on the 2026 Federal Poverty Level, step-by-step application instructions, important changes coming later this year and into 2027, and frequently asked questions.
If you want a quick check of your eligibility for Medicaid and other programs, try our free benefits screener. You can also visit our New Mexico Benefits Overview for a full list of assistance programs available in the state.
Who Qualifies for Medicaid in New Mexico?
New Mexico Medicaid eligibility is based on your income, household size, and category (adult, child, pregnant). Because the state expanded Medicaid, most low-income residents under 65 can qualify. Here are the main groups covered:
- Adults ages 19 to 64 with household income at or below 138% of the Federal Poverty Level (FPL)
- Children ages 0 to 5 with household income up to 305% FPL
- Children ages 6 to 18 with household income up to 245% FPL
- Pregnant women with household income up to 255% FPL (with 12 months of postpartum coverage)
- Seniors 65 and older and people with disabilities (subject to both income and asset limits under different rules)
Income eligibility is determined using Modified Adjusted Gross Income (MAGI), which includes a built-in 5% income disregard. This means the effective income limit for adults is 138% FPL (133% plus the 5% disregard).
2026 Income Limits for New Mexico Medicaid
The Federal Poverty Level for 2026 is $15,960 per year for an individual and $33,000 for a family of four. Below are the monthly income limits for the most common Medicaid categories in New Mexico based on the 2026 FPL.
Adults Ages 19 to 64 (138% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 | $1,835 | $22,025 |
| 2 | $2,489 | $29,863 |
| 3 | $3,142 | $37,702 |
| 4 | $3,795 | $45,540 |
| 5 | $4,448 | $53,378 |
| 6 | $5,101 | $61,217 |
Children Ages 0 to 5 (305% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 2 | $5,500 | $66,002 |
| 3 | $6,944 | $83,326 |
| 4 | $8,388 | $100,650 |
| 5 | $9,831 | $117,974 |
Children Ages 6 to 18 (245% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 2 | $4,418 | $53,018 |
| 3 | $5,578 | $66,934 |
| 4 | $6,738 | $80,850 |
| 5 | $7,897 | $94,766 |
Pregnant Women (255% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 | $3,392 | $40,698 |
| 2 | $4,599 | $55,182 |
| 3 | $5,806 | $69,666 |
| 4 | $7,013 | $84,150 |
Note: These figures are calculated from the 2026 HHS Poverty Guidelines. Actual dollar thresholds used by the state may vary slightly due to rounding. Always confirm current limits with the New Mexico Health Care Authority or through the YES NM portal.
Important Medicaid Changes Coming in 2026 and 2027
Federal legislation passed in July 2025 is bringing several significant changes to Medicaid in New Mexico. The New Mexico Health Care Authority has published a timeline of upcoming changes. Here is what to expect:
October 1, 2026: Non-Citizen Eligibility Restrictions
Starting October 1, 2026, some non-citizens may face new eligibility limits for Medicaid. If you or a family member is a lawfully present non-citizen currently receiving Medicaid, watch for updates from the Health Care Authority about how this may affect your coverage.
December 31, 2026: More Frequent Eligibility Reviews
Beginning December 31, 2026, many adult Medicaid enrollees will have their eligibility reviewed every six months instead of annually. This means you will need to respond to renewal paperwork more often to keep your coverage active.
January 1, 2027: Work and Activity Requirements
Starting January 1, 2027, many adult Medicaid enrollees will need to complete 80 hours per month of qualifying activities. These include:
- Working (including self-employment)
- Attending school or job training
- Volunteering or community service
Exemptions are expected for certain groups, though the state has not finalized all exemption categories. Start keeping records of your work hours, school schedules, and any volunteer activities now so you are prepared.
January 1, 2027: New Identity and Residency Verification
Also starting January 1, 2027, the state will begin new checks to verify addresses and Social Security numbers for Medicaid enrollees.
What You Should Do Now
The Health Care Authority recommends these steps to prepare:
- Update your contact information at YES.NM.gov or call 1-800-283-4465
- Open and respond to all mail from the Health Care Authority right away
- Keep records of pay stubs, school enrollment forms, and volunteer logs
- Report any changes to your income, address, or household immediately
- Do not wait for these changes to take effect before getting organized
How to Apply for New Mexico Medicaid
You can apply for Medicaid in New Mexico at any time during the year. There is no open enrollment period for Medicaid. Here are five ways to submit your application:
Step 1: Gather Your Documents
Before applying, have the following ready:
- Social Security numbers for everyone in your household
- Proof of income (pay stubs, tax returns, or a letter from your employer)
- Proof of identity (driver's license, state ID, or passport)
- Proof of New Mexico residency (utility bill, lease agreement, or mail with your address)
- Immigration documents (if applicable)
Step 2: Choose How to Apply
Online (recommended): Visit YES.NM.gov to create an account and submit your application. This is the fastest method.
By phone: Call 1-800-283-4465 during business hours or 1-855-309-3766 for the 24/7 information line.
Through HealthCare.gov: You can start an application at HealthCare.gov or call 1-800-318-2596. Your application will be reviewed and transferred to the state Centennial Care program. Use this option only if you are under 65 and do not have Medicare.
By mail: Download a paper application, complete it, and mail it to: Central ASPEN Scanning Area, PO Box 830, Bernalillo, NM 87004.
In person: Visit a New Mexico Human Services Department field office for help with your application.
Step 3: Wait for a Decision
Processing takes up to 45 days for most applications. You will receive a notice by mail with the decision. If approved, your coverage can start as early as the date you applied, and in some cases may be retroactive up to three months.
Step 4: Choose a Managed Care Organization
Once approved, you will select one of three managed care organizations (MCOs) that deliver Centennial Care services:
- Blue Cross Blue Shield of New Mexico
- Presbyterian
- Western Sky Community Care
If you do not choose one within a specified timeframe, one will be assigned to you.
What Does New Mexico Medicaid Cover?
Centennial Care Medicaid provides comprehensive health coverage including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance use treatment
- Preventive care and screenings
- Lab work and diagnostic imaging
- Dental care (limited for adults, more comprehensive for children)
- Vision care
- Maternity and newborn care
- Emergency services
- Home and community-based services for eligible individuals
There is little to no cost sharing for most Medicaid enrollees in New Mexico. Most services have no copay.
What If You Do Not Qualify for Medicaid?
If your income is too high for Medicaid, you may still be eligible for affordable health coverage. New Mexico operates its own state-based ACA marketplace called beWellnm.
- Marketplace plans: If your income is between 138% and 400% FPL (or higher with enhanced subsidies), you may qualify for premium tax credits that significantly reduce your monthly premium. Visit beWellnm.com to explore plans.
- Transition assistance: If you lose Medicaid coverage, New Mexico will pay your first month's net premium for a marketplace plan, helping bridge the gap.
- Open enrollment for marketplace plans typically runs from November 1 through January 15. Special enrollment periods are available year-round after qualifying life events like job loss, marriage, or having a baby.
You can also use our free benefits screener to check if you qualify for other assistance programs like SNAP, LIHEAP, WIC, or childcare assistance. New Mexico recently became the first state in the nation to offer universal, no-cost childcare with no income limits.
Frequently Asked Questions
Can I apply for Medicaid at any time?
Yes. Unlike marketplace health insurance, Medicaid does not have an open enrollment period. You can apply any day of the year. If you qualify, your coverage can start right away.
How long does it take to get approved?
Most applications are processed within 45 days. If you are pregnant or applying for a disability-related category, processing times may vary. You can check your application status at YES.NM.gov.
What counts as income for Medicaid?
New Mexico uses Modified Adjusted Gross Income (MAGI) to determine eligibility. This includes wages, salary, self-employment income, Social Security benefits, unemployment compensation, and certain other income. It does not count Supplemental Security Income (SSI), child support received, or veterans' benefits.
Will the new work requirements affect me?
Work requirements take effect January 1, 2027 (not 2026). They will require 80 hours per month of work, school, training, or community service for many adult enrollees. Exemptions are expected for certain groups. The state will provide more details as the date approaches. Start keeping records of your activities now.
What happens if I miss my eligibility review?
If you do not respond to a renewal notice, you risk losing your Medicaid coverage. Starting December 31, 2026, reviews will happen every six months for many adults. Make sure your mailing address is current and respond to all notices promptly.
Does New Mexico Medicaid cover dental and vision?
Yes, though coverage varies. Children receive comprehensive dental and vision benefits. Adults have access to limited dental services and basic vision care through their managed care organization.
Can I have both Medicaid and Medicare?
Yes. People who qualify for both programs are called "dual eligibles." Medicaid can help pay your Medicare premiums, deductibles, and copays through Medicare Savings Programs. Contact the New Mexico SHIP program at 1-800-432-2080 for help understanding your options.
I lost my job. Can I get Medicaid?
Job loss is one of the most common reasons people qualify for Medicaid. If your income drops below the limits shown above, you can apply at any time. You may also qualify for a Special Enrollment Period on the marketplace. Use our benefits screener to check all programs you might be eligible for.
Key Contacts and Resources
- Apply online: YES.NM.gov
- Customer service: 1-800-283-4465
- 24/7 information line: 1-855-309-3766
- Medicaid changes info: hca.nm.gov/medicaidchanges
- beWellnm marketplace: bewellnm.com
- Field offices: Find your local office
- Benefits screener: Check your eligibility now
- New Mexico Benefits Overview: View all NM programs
Medicaid eligibility rules in New Mexico are changing. Stay informed, keep your information current, and do not hesitate to reach out to the Health Care Authority if you have questions. The sooner you apply or update your records, the better positioned you will be to keep your coverage through the transitions ahead.
