New Mexico

In New Mexico, various health insurance options are available to help cover the costs of pregnancy and childbirth care. These include private insurance plans, Medicaid, and specialized programs that ensure expectant parents have access to necessary medical services. Here are some key programs and services:

1. State Plans and Programs

a. New Mexico Medicaid
New Mexico’s Medicaid program provides health coverage for low-income pregnant individuals and children. Services covered include:

• Prenatal and postpartum care
• Delivery services
• Hospital stays
• Infant care up to one year after birth

Eligibility is based on income and household size. Learn more and apply at the New Mexico Medicaid Program.

b. New Mexico Children's Health Insurance Program (CHIP) – Centennial Care
A part of Medicaid, Centennial Care offers coverage for pregnant individuals and children up to age 19. It provides comprehensive care, including prenatal visits, ultrasounds, and delivery.
Learn more at Centennial Care CHIP.

1. Employer-Sponsored Plans

Pregnant individuals can enroll in coverage through an employer-sponsored plan (ESC) from their own job or a spouse’s job. Many employers offer health insurance that includes maternity and newborn care. Coverage typically includes prenatal visits, ultrasounds, labor and delivery, and postpartum care.

1. Health Insurance Marketplace

Through the Health Insurance Marketplace, pregnant individuals can explore various health insurance plans that cover pregnancy and childbirth. Under the Affordable Care Act (ACA), all marketplace insurance plans are required to cover maternity and newborn care as essential health benefits. New Mexicans can compare and enroll in plans through the state-based exchange at beWellnm.com.

1. Private/Individual Insurance Plans

Private health insurance purchased outside the marketplace may also provide coverage, though benefits can vary.
A parent’s health insurance plan (if it offers dependent coverage) can also cover pregnant dependents before their 26th birthday. Employer-sponsored coverage for dependents usually ends during the month of the child’s 26th birthday. If the dependent is covered under their parents' Marketplace plan, they can stay on it until December 31 of the year they turn 26.

1. Other Assistance Programs

a. Indian Health Service (IHS)
New Mexico has a significant Native American population eligible for healthcare services through the Indian Health Service (IHS) or tribal health organizations. These services include maternity and childbirth care, typically at low or no cost.

b. New Mexico’s Maternal Health Task Force
While not an insurance program, New Mexico’s Maternal Health Task Force focuses on reducing barriers to prenatal care for underserved populations.

c. Sliding Fee Scale Clinics
Federally Qualified Health Centers (FQHCs) and community health clinics offer maternity care at reduced costs based on income. Examples include:

• First Choice Community Healthcare (multiple locations)
• Presbyterian Medical Services Community Health Centers

For assistance navigating insurance options, New Mexicans can contact health navigators or Certified Application Counselors through beWellnm or local community health centers.