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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

New Mexico High Risk Pool Eligibility PDF Print E-mail
Written by nmmip   
Friday, 11 June 2010 03:09

You can qualify for the Pool if:

  • You are a resident of New Mexico with a permanent street address; and

  • Have a qualifying medical condition; or

  • Have a rejection notice for comprehensive healthcare coverage; or

  • Have a quote for, or in-force, premium rate that is higher than the Pool’s qualifying rate; or

  • Have a rider, waiver or limitation on current or offered coverage that reduces or limits your coverage due to a health condition; or

  • You are/will be involuntarily terminated from an individual plan because the carrier stopped selling such coverage in New Mexico; or

  • You are moving to New Mexico and were covered by a High Risk Pool in another state; or

  • You are currently covered by a plan under the New Mexico Health Insurance Alliance and wish to transfer to the Pool; or

  • You have reached the maximum allowable coverage limit of your current health insurance plan; or

  • You meet HIPAA eligibility criteria.

[Click Here] to access information pertaining to HIPAA Eligibility.



You can qualify for the Pool's Medicare Carve-Out Plan if:

  • You are under age 65 and have Medicare due to a disability; and

  • You have both Part A and Part B of Medicare.

[Click Here] to access the Medicare Carve-Out Plan information.

 

You are NOT eligible for the Pool if:

  • You have other comprehensive coverage;

  • You are, or become, eligible for other comprehensive coverage, including insurance from an employer either as yourself or as a family member;

  • You are eligible for Medicaid;

  • You are 65 or older and have, or are eligible for, Medicare;

  • You voluntarily dropped your most recent coverage and it was within the last 12 months;

  • You were terminated from coverage for fraud or nonpayment of premiums;

  • You are in prison;

  • You have military health coverage under Tricare.

 

[Click Here] for a rate quote for the New Mexico Medical Insurance Pool.

Last Updated on Wednesday, 20 July 2011 21:50
 

Board Meeting

Special Board Meeting

Date: May 21, 2013
Time: 8:00 AM - 9:00AM

Location:
Telephone Conference

Special Meeting Agenda
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