New Mexico Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in New Mexico.
7.6 million Medicaid long-term care recipients nationwide
New Mexico Human Services Department (HSD) - Medical Assistance Division
Processing Time
30-45 days for standard Medicaid; CoLTS enrollment typically occurs within 30-45 days of Medicaid approval. New Mexico has relatively streamlined managed care enrollment.
New Mexico Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in New Mexico, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). New Mexico follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
New Mexico Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $7,867/month average (semi-private), $8,629/month (private) (the average monthly nursing home cost in New Mexico).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in New Mexico
Nursing Home Care
Medicaid pays 100% of nursing home costs in New Mexico once eligibility is established. The average monthly cost is $7,867/month average (semi-private), $8,629/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
CoLTS - Assisted Living Services: New Mexico's CoLTS program includes coverage for assisted living services. Participants can receive Medicaid-funded personal care, medication management, and care coordination while residing in licensed assisted living facilities. Room and board costs are not covered by Medicaid—residents must pay housing expenses from their income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
New Mexico offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Coordination of Long-Term Services (CoLTS)
New Mexico's managed care program for long-term services and supports serving individuals age 21+ who meet nursing facility level of care. Delivered through managed care organizations (MCOs). Covers adult day health, case management, customized in-home supports, emergency response services, employment supports, environmental modifications, home-delivered meals, respite, and specialized therapies. Over 18,000 participants.
Program Details →Mi Via Self-Directed Waiver
Self-directed waiver allowing participants to manage their own budgets and hire caregivers. Serves individuals with disabilities (including elderly) who prefer maximum control over their care. Includes consultant services, customized community supports, employment supports, related goods and services.
Program Details →How to Apply for Medicaid in New Mexico
New Mexico Medicaid applications typically take 30-45 days for standard Medicaid; CoLTS enrollment typically occurs within 30-45 days of Medicaid approval. New Mexico has relatively streamlined managed care enrollment.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in New Mexico through:
- Online at YesNewMexico.gov (unified state benefits portal)
- Phone: 1-888-997-2583 (HSD Medicaid hotline) or 1-800-432-2080 (Centennial Care enrollment)
- Download application and mail to: NM Human Services Department, P.O. Box 2348, Santa Fe, NM 87504
- In-person at local HSD Income Support Division office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in New Mexico from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
New Mexico-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Medicare Part B premium. QI pays Part B premium (limited funding).
Learn MoreCentennial Care (Medicaid Managed Care)
New Mexico's integrated managed care program combining physical health, behavioral health, and long-term services. Most Medicaid beneficiaries enrolled in one of three MCOs.
Learn MoreAging and Long-Term Services Department (ALTSD) Programs
State aging agency providing case management, adult protective services, and caregiver support independent of Medicaid waiver programs.
Learn MoreNeed Help with New Mexico Medicaid?
Contact New Mexico Human Services Department (HSD) - Medical Assistance Division for specific questions about eligibility, application status, or covered services.