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
NEW OPTION: As I mentioned in my Federal market update, I have recently come across a set of health plans that will work well for certain people in New Mexico. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They also utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans All plans have a maximum out of pocket limit that will be $1,850 per year LESS than the maximum out of pocket for 2025 non-HSA qualified ACA/Obamacare plans. For HSA qualified plans the maximum out of pocket limit will be $1,500 per year LESS than the maximum out of pocket for 2025 HSA qualified ACA/Obamacare plans. 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.
The plans in this program are health underwritten. They have a simple set of 11 questions. If you can answer “No” to all of them, you are approved at the current rates. If not, you are 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
Given the new rule on Short Term Medical plans, I will remove the Short Term Medical plans from my Health Insurance Buffet program in the states where they are currently a good long-term option.
Primary (Main Course) plans – The new options mentioned above are now included as primary options. In addition, we continue to offer our two main Fixed Benefit plan companies as follows:
Offers several different options. Including their best overall coverage fixed benefit plan – Health Saver Plus Gold.
Manhattan Life – Manhattan Life Affordable Choice 18 fixed benefit plan. NOTE: The Affordable Choice 18 plan has the BEST inpatient hospital coverage of any fixed benefit plan available today.
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.
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 2025 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.
In 2024 the New Mexico exchange had 5 insurers offering plans statewide. Ambetter is leaving the state in 2025. That will make 4 companies in 2025.
The participating insurance companies are proposing average rate increases of 7.43% to 14% for plans in 2025.
In New Mexico, the 2025 Open enrollment begins on November 1, 2024 and ends on January 15, 2025. A health plan must be purchased by December 15, 2024 to have coverage effective January 1, 2025. Plan purchases from December 16, 2024 to January 15, 2025 will start on February 1, 2025.
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 2025 ACA/Obamacare Rate review:
New Mexico 2025 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 2025 individual plan rate filing requests are as follows:
Blue Cross Blue Shield of NM – requested an average increase of 9.01% varying by plan and network (not finalized yet)
Molina Healthcare – requested an average increase of 9.82% varying by plan (not finalized yet)
Presbyterian Health Plan – requested an average increase of 14.07% varying by plan (not finalized yet)
United Healthcare – requested an average increase of 7.43% 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 4.97% varying by plan and network (not finalized yet)
Presbyterian Health Plan – requested an average increase range of 2.49% to 4.96% varying by plan (not finalized yet)
United Healthcare – requested an average increase range of 12.7% to 13.44% varying by plan and network (not finalized yet)
New Mexico 2025 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
Friday Health Plans – Received an average increase of % varying by plan
True Health New Mexico – Received an average increase of % varying by plan
Western Sky Community Care (Ambetter) – 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
Friday Health Plans – Received an average increase of % varying by plan
Presbyterian Health Plan – Received an average increase range of % to % varying by plan
True Health New Mexico – Received an average increase of % 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 the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.