This article is part of a project of the local Community Health Improvement Council (CHIC). CHICs were created statewide in conjunction with the New Mexico Department of Health (NMDOH) with the goal of getting local citizens and county governments more involved in the manner in which health might be improved in each of their communities. The local CHIC is conducting an on-going awareness campaign addressing all the areas that can potentially affect a person’s health. January has been designated by the CHIC as the month to bring awareness on Health Care in New Mexico.
January 1, 2014 brings big changes to Health Care across the United States. In New Mexico we say goodbye to the Medicaid Salud program and we welcome Centennial Care. Centennial Care is the new Medicaid program for New Mexicans. This program was created from the Affordable Care Act. This will allow New Mexico to get the Federal match for Medicaid. More individuals will be eligible for Medicaid under this new program. This program will include individuals who meet the income guidelines and do not have a disability or dependent children.
What is different? Under saluad we had 4 insurance companies to cover families and children, 2 MCO’s (Managed Care Organization) and 4 waiver programs to cover elderly and disabled and Optum Health Care for Behavioral Health needs. Under Centennial we only have 4 MCO’s: Blue Cross and Blue Shield, Presbyterian, Molina and United Health Care that will cover children, families, pregnant women, elderly and disabled. Each MCO will be responsible to cover all necessary services for those on Medicaid including long term care services that was originally covered by the waiver programs. We will no longer have a separate insurance company for Behavioral Health the MCO’s will be responsible for this piece of care as well.
How will this impact residents in San Juan County? San Juan County has been unique in many ways when it comes to health care. What works in larger cities in New Mexico usually does not work in San Juan County. We are considered a Rural Community. Doctors in our area are hesitant about taking Medicaid let alone signing on with all four MCO’s.
What you should know before selecting your MCO if eligible for Medicaid. Call your doctor or doctors to see who they are taking. They do not have to sign on with all four MCO’s. If you see a specialist make sure they are accepting the MCO you sign up for.
How do you apply for Medicaid? You can apply on line at www.yes.state.nm.us/selfservice, by phone at 1-855-637-6547, at your local Income Support Division office or by mailing an application to: Central ASPEN Scanning Area at P.O. Box 830 Bernalillo, NM 87004. If you apply online you will need to have a scanner to submit your documents and proof of residency and income with your application.
What if I don’t qualify for Medicaid? You may qualify for NM Health Insurance Exchange program where eligibility for other health insurance affordability programs will be determined. You can apply for this program online by going to www.bewellnm.com or by calling 1-855-996-6449.
How do I know which program to apply for? The box below is an income guideline that HSD uses to determine eligibility for Medicaid.
You can find more information on Health Care Reform by visiting the New Mexico Human Services Department website at www.hsd.state.nm.us.
Health Care in New Mexico
Written by Branda Parker, BSW
San Juan Center for Independence
2014 January 07
KSJE 90.9 FM
The Scott Michlin Morning Program
Link to San Juan Center for Independence