New Mexico Health Insurance Market Annual Update
Annual New Mexico Health Insurance Market Update
The following contains information for our NAHP Alternative Health Plan Solutions and ACA/Obamacare plans for individuals and small businesses in the state of New Mexico.
New Mexico Alternative Health Plan Solutions Updates
ACA Compliant Off Exchange Options: As I mentioned in my Federal market update, I now have two programs that offer multiple health plans that will work well for certain people in Arkansas. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They each utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans.
One of the programs is available to self-employed people, independent contractors and small business owners. That program also offers plans with much lower maximum out of pocket limits than ACA/Obamacare plans. The other program is available to anyone with a unique approach of offering research projects for compensation to people that apply, which makes them contract employees eligible for the insurance.
The standard rates for these plans are competitive with the full price without a subsidy on current, similar ACA/Obamacare plans for people in the 45-64 age range who do not qualify for a tax credit subsidy to purchase ACA/Obamacare plans.
Both programs are health underwritten and applicants can be approved or declined.
If you fit this criterion, please reach out to me to see if one of these plans might be a better option for you.
IMPORTANT NOTE: All non-ACA/Obamacare alternative plans are available year-round. For both individuals and small groups. There is NO limited (open enrollment) period for these options.
Individual Alternative Plans
For those who don’t qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan, we have a strong “health insurance buffet” of alternative plans in New Mexico.
On our Primary Fixed Benefit plans we now offer the following:
Philadelphia American – Their newest and best fixed benefit plan – Optimum Health Saver offers the BEST overall coverage for the money of any fixed benefit plan in the market.
Manhattan Life – Manhattan Life Affordable Choice 18 fixed benefit plan.
As noted on our New Mexico state page, we don’t currently have any companies that offer STM plans in the state.
Our Supplemental Plan lineup has also expanded and improved:
REMINDER NOTE: All these supplemental plans pay in addition to ANY other coverage you have. So, they are NOT just for our alternative “buffet” plans. They can reduce/eliminate out of pocket costs (plus provide additional cash for bills and other costs) of ANY primary health plan (group, individual, Medicare, etc.)
Accident Plans – In addition to accident supplemental plans from all our Primary plan companies (above), we offer separate LifeSecure Accident plans.
Critical Illness Plans – Again, along with plans from all our Primary plan companies, we offer separate LifeSecure Critical Illness plans.
Cancer and Dread Disease Treatment – This is my favorite addition to our supplemental plans. Manhattan Life Cancer Care Plus Cancer and Dread Disease treatment plans. For those who choose one of Philadelphia American’s Fixed Benefit plans, their new Specified Disease plan is the preferred option for getting maximum coverage for Cancer and other Dread Diseases.
First Day Hospital Stay Protection – Along with plans from most of our Primary plan companies, Manhattan Life Out of Pocket Protection Plan is my favorite to include with whatever primary health plan YOU have. That includes employer group plans, Medicare, etc.
Preventive Care Plus Plans – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we offer the Enrollment First SelectMed plans. There are 2 options Pro and Max.
More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.
NOTE: You can also combine one of the above Fixed Benefit plans together with Accident, Critical Illness, Cancer Treatment, Hospital Indemnity and Preventive Care (Plus) plans and create a comprehensive plan that will still be at least 15-20% LESS than a high deductible ACA/Obamacare plan!
Small Group Alternative Plans
In addition to the companies we already have (Allstate Benefits, Allied National, and Trustmark), we have added several new companies. Plus two other companies that has previously provided only fully insured plans to small businesses…United Healthcare .and Aetna.
All the above options provide cost-saving, level funded alternative group health plans. Level funded plans can be a BETTER option for many businesses than the “one size fits all” ACA/Obamacare small group health insurance plans. Level Funded plans can provide upfront savings of 10-20%, the same fixed monthly premium as fully insured and the potential for a refund at the end of the plan year. All while providing the same or better coverage as you are used to with a fully insured plan.
If you own, or work for a business with 5 to 50 employees covered on a “traditional,” fully insured group health plan, and believe the covered group members to be reasonably healthy overall, then it might be time for your company to explore a level funded plan.
To get quotes on a level funded group health plan, please schedule a call with us to review your situation. We will also need you to fill out our US Insurance Solutions Group Census form non-WA spreadsheet and email it to: [email protected].
New Mexico 2026 ACA/Obamacare Health Insurance Market Updates
Individual Plans
The following are some of the biggest updates/changes in the ACA/Obamacare individual market in New Mexico.
For 2026, four insurers will offer exchange plans in New Mexico, The same four insurers offered coverage for 2025.
The participating insurance companies are proposing average rate increases of 15% to 53% for plans in 2026.
In New Mexico, the 2026 Open enrollment begins on November 1, 2025 and ends on January 15, 2026. A health plan must be purchased by December 15, 2025 to have coverage effective January 1, 2026. Plan purchases from December 16, 2025 to January 15, 2026 will start on February 1, 2026.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in New Mexico.
New Mexico 2026 ACA/Obamacare Rate review:
New Mexico 2026 Preliminary Rate review:
NOTE: Final approved rates are not readily available at the time of this writing. We will do our best to update this page with the approved rates as soon as we can.
New Mexico preliminary 2026 individual plan rate filing requests are as follows:
Blue Cross Blue Shield of NM – requested an average increase of 38.67% varying by plan and network (not finalized yet)
Molina Healthcare – requested an average increase of 15.31% varying by plan (not finalized yet)
Presbyterian Health Plan – requested an average increase of 29.26% varying by plan (not finalized yet)
United Healthcare – requested an average increase of 52.97% varying by plan (not finalized yet)
New Mexico small group market rate filing requests look like this
Blue Cross Blue Shield of NM – requested an average increase of 21.16% varying by plan and network (not finalized yet)
Presbyterian Health Plan – requested an average increase range of 1.85% to 11.17% varying by plan (not finalized yet)
United Healthcare – requested an average increase range of 13.31% to 13.87% varying by plan and network (not finalized yet)
New Mexico 2026 ACA/Obamacare Approved Rates:
New Mexico individual plan approved rate filings are as follows:
Blue Cross Blue Shield of NM – Received an average increase of % varying by plan and network
Molina Healthcare – Received an average increase of % varying by plan
Presbyterian Health Plan – Received an average increase of % varying by plan
United Healthcare – Received an average decrease of % varying by plan
New Mexico small group market approved rate filings look like this:
Blue Cross Blue Shield of NM – Received an average increase of % varying by plan and network
Presbyterian Health Plan – Received an average increase range of % to % varying by plan
United Healthcare – Received an average increase of 13.2% varying by plan and network
US Healthcare Resources and Shopping Services
I invite you to go to my US Healthcare Resources page and spend some time going through all of the different tools, services and providers that are available to help you become a better health care consumer. I believe these resources can help you lower your overall health care costs no matter what primary health insurance you have.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to my online calendar and schedule a call with me on a day and time that works for you, and I will call you to review your options.