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What is the New Mexico Medical Insurance Pool (the Pool)?

The pool was created to provide access to health insurance coverage to all residents of New Mexicans who are denied adequate health insurance and are considered uninsurable.

When was the Pool started?

The New Mexico Medical Insurance Pool (NMMIP) was established by the 1987 New Mexico State Legislature.

Who is the Pool administrator?

The Pool is administered by BlueCross BlueShield of New Mexico who handles eligibility, enrollment, member services, and claims processing.

Who has the Executive Services contract for the Pool?

The Delta Consulting Group has the Executive Services contract to run the day-to-day operations of the Pool.

How does one apply for coverage?

Complete an application and submit it along with requested documentation and a check for the first month’s premium. Instructions for submission, as well as contact information for questions, are on the application form

News and Updates PDF Print E-mail

NMFHRP Program Ending March 31, 2014
[Click Here]

PROPOSED PREMIUM RATE INCREASE LETTER  
"Pool rates to increase 23.8% on July 1, 2014."

[Click Here] to learn more about your policy's proposed premium rate increase on
July 1, 2014.


UPDATED INFORMATION

The following changes were made by the Board of Directors at the January 24, 2014 meeting:

 

  • If a notice of rejection, rider/waiver/restrictive provision, or rate exceeds Pool's "qualifying rate"  are used as the eligibility qualifier, the notice may not be more than 30 days old (previously was 1 year).

  • The Medical Conditions listed on page two of the application have been suspended and are no longer a criteria for eligibility

 

The Pool will still be accepting applications for:

 

  • Newborns, as long as one of the parents is a policyholder
  • HIPAA/COBRA eligible
  • Medicare Carve-out (under age 65 and on Medicare Parts A&B due to disability)
  • Switching enrollment from the New Mexico Health Insurance Alliance,  and
  • Moved from another state's High Risk Pool and coverage will terminate due to non-residency

 

Notice(s) and a check for first month's premium are required with the application.  The Pool does not accept copies for faxes of the application.

No changes to the 6 month pre-existing waiting period have been made.

REMINDER: As of 01/01/14 the $7,500 and $10,000 deductible plans are no longer offered.

 


 

SPECIAL NOTICE:
FEDERAL POOL COVERAGE EXTENDED THROUGH MARCH 31, 2014

The Pre-Existing Condition Insurance Plan (PCIP), also known as the New Mexico Federal High Risk Pool (NMFHRP), will offer the option of two additional months of coverage. This extension will allow you more time to review your health insurance options and enroll in the coverage that best meets your needs [Click Here] to read the entire special notice.

PCIP Coverage for March 2014

The federally-run Pre-Existing Condition Insurance Plan (PCIP) will offer the option of two additional months of PCIP coverage to people currently enrolled in PCIP who have not yet found new health insurance coverage. This transitional coverage through March 31, 2014, will allow PCIP enrollees more time to review Marketplace plan options and enroll in the coverage that best meets their needs before open enrollment closes in March. They will be notified on www.pciplan.com and by mail of this option to extend their PCIP plan through March, along with details about cost-sharing. Eligible enrollees can purchase PCIP transitional coverage by sending in February and March premium payments; which will be the same monthly rate that they paid for January 2014.

 
Medicaid Flyer PDF Print E-mail

Information Regarding Medicaid:

Do you have questions about Medicaid?

[Click Here] to view information from New Mexico's Human Services Department regarding Medicaid.

 
2014 State Pool Renewal Letter PDF Print E-mail

State Pool Policyholders:

Please click on the following link [Click Here] to learn more about the following items pertaining to the 2014 Renewal Letter for Pool members issue by the Executive Office:

This is an important announcement that concerns:

  • Pool Policyholder Losses
  • Your rates January 1, 2014 – June 30, 2014
  • Semi-Annual Rate Review
  • Elimination of $7,500 and $10,000 Deductible Plans
  • Deductible Changes for January 1, 2014
  • Low Income Premium Program
  • Medicare Carve-Out Plan
  • Changes to NMMIP Claims Submission Period
  • Address Changes
  • Pool Addresses
 
PCIP News Release PDF Print E-mail

For Immediate Release
May 24, 2013 
[Click Here] for Press Release


New Mexico's Federal High Risk Pool to Continue Undisrupted NMMIP
Board Vote Avoids Catastrophic Disruption in Coverage for New Mexicans

ALBUQUERQUE, NM – Today the Board of the New Mexico Medical Insurance Pool voted to continue to provide a federal health insurance program that provides health insurance for over 1,500 critically ill New Mexicans. Recently the U.S. Department of Health and Human Services (HHS) gave states the option of running their own Pre-Existing Condition Insurance Program (PCIP) with a cap in total funding for the program or letting the federal government provide the coverage with unknown risks to the enrollees.

“We were troubled by the anticipated catastrophic disruption in our enrollees' continuity of care in this proposed transition. Our enrollees were at risk of increases in both premiums and out-­of-­pocket costs that would have made their continued enrollment in the PCIP cost-­prohibitive,” said New Mexico’s Superintendent of Insurance John Franchini. We were blindsided and very disappointed by the federal proposal that shifted the risk for cost overruns to the states in the waning days of our state-­run PCIP program.”

“Thanks to the State, the NMMIP Board and our insurance carriers within the State New Mexico, the over 1,500 critically ill individuals from across our state will continue to have access to this decent and affordable health coverage. New Mexico’s insurers have stepped up in light of the federal government’s abandonment of this program,” said Jason Sandel, a Farmington City Councilor and Vice Chairman of the New Mexico Medical Insurance Pool.

The federally funded PCIP was created to serve as a transition program for people with serious medical conditions who could not get insurance coverage elsewhere and to bridge the gap from when the Affordable Care Act (ACA) was signed into law in March 2010 until Jan. 1, 2014, and when the ACA will prohibit health insurers from taking health problems into account in deciding whether to accept applicants. The U.S. House of Representatives recently put off acting on a bill that could have required HHS officials to use some of its ACA funding to shore up the PCIP.

“On behalf of the health insurance community in New Mexico, we continue to help seriously ill New Mexicans obtain the health care coverage they need. We urge our federal decision-­makers to find a way to meet commitments that were made at the inception of the Pre-­Existing Condition Insurance Program,” said Gabriel Parra, NMMIP Board Member and Presbyterian Health Plan's General Counsel.

We appreciate the work of the New Mexico Congressional Delegation helping NMMIP communicate on behalf of our PCIP enrollees during this negotiation with the federal government. They helped make a difference in the outcome for our state,” added Reena Szczepanski, Executive Director of NMMIP.



 
The New Mexico Medical Insurance Pool (NMMIP) PDF Print E-mail

The New Mexico Medical Insurance Pool (NMMIP) was established by the 1987 New Mexico State Legislature.  The Pool was created to provide access to health insurance coverage to residents of New Mexico who are denied health insurance and considered uninsurable.

NMMIP also provides health benefit portability coverage to New Mexicans who have exhausted COBRA benefits and have no other portability options available to them.

NMMIP is administered by Blue Cross and Blue Shield of New Mexico who handles eligibility, enrollment, member services and claims processing.

You may reach the Administrator, Blue Cross and Blue Shield of New Mexico at 1.800.432.0750 (Option #4) or the Executive Director at 866.622.4711 for information or applications.

 

NMFHRP: FAQ

[Click Here] to access answers
to Frequently Asked Questions
regarding the status of the
New Mexico Federal High-
Risk Pool (NMFHRP)

Board Meeting

Annual Board Meeting

Date: March 28, 2014
Time: 9:00 AM - 10:00AM

Location:
BCBSNM - Bandelier Room
5701 Balloon Fiesta Pkwy NE
Albuquerque, NM 87113

Meeting Agenda
[Click Here]

Regular Board Meeting

Date: March 28, 2014
Time: 10:00 AM - 2:00PM

Location:
BCBSNM - Bandelier Room
5701 Balloon Fiesta Pkwy NE
Albuquerque, NM 87113

Meeting Agenda
[Click Here]

NMFHRP Updates

[Click Here] to view Update #6
for information regarding the 
closure of the NMFHRP.

[Click Here] to view Update #5
for information regarding the 
closure of the NMFHRP.

[Click Here] to view Update #4
for information regarding the 
closure of the NMFHRP.

[
Click Here] to view Update #3
for information regarding the 
closure of the NMFHRP.

[Click Here] to view Update #2 
for information regarding 
the closure of the NMFHRP.

[Click Here] to view Update #1 
for information regarding 
the closure of the NMFHRP.

Are You Eligible?

[Click Here] to find out if you are eligible for the New Mexico Medical Insurance Pool.

Rate Quote Generator


Email Updates

Attention Current Members:

Please submit your name and email address in the form below to receive updates from NMMIP about your healthcare coverage.

Name:
Email:

Enrollment Update

NOTICE TO ALL APPLICANTS

Only "original" application forms
will be accepted.

Applications that are faxed or
received by Email will no longer
be accepted.

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