New Mexico Administrative Code

An individual or couple who is determined eligible for the low income subsidy (LIS) under part D of medicare, is eligible for financial assistance with the monthly premium, the yearly deductible, the per-prescription co-payment, and continuous coverage with no gap prior to reachi…

New Mexico Health Care Authority (HCA).

At the time of application, an applicant or an eligible recipient and HCA shall identify everyone who is to be considered for inclusion in the assistance unit and budget group. Each member of the assistance unit and budget group, including each unborn child, is counted as one in …

Refer to 8.200.410.10 NMAC.

Refer to 8.200.410.11 NMAC.

Refer to 8.200.410.12 NMAC.

Age is not an eligibility requirement.

The income support division (ISD) caseworker must notify the refugee's sponsor or local affiliate which provided for the resettlement of the refugee, when a refugee applies for refugee medical assistance.

Refer to 8.200.430 NMAC.

The rule applies to the general public.

A. Assignment of medical support: Refer to 8.200.420.12 NMAC. B. Assignments of child support: Assignment of child support is not required for refugee medical assistance.

Refer to 8.200.430.19 NMAC.

The assistance unit includes individuals who apply for RMA and who are determined eligible. Individuals may be ineligible for refugee cash assistance and eligible for RMA. An eligible recipient of refugee cash assistance who is not eligible for full medicaid services is eligible …

The budget group includes all members of the assistance unit. Additional budget group members include individuals who live in the household with the assistance unit and have a financial obligation of support. A. Except for an supplemental security income (SSI) recipient, the foll…

A. To be included in the assistance unit and budget group, an individual must be living, or considered to be living, in the budget group's home. B. A child considered to be living in the home: A child is considered to be part of the budget group as evidenced by the child's custom…

The New Mexico medicaid program and other health care programs are administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See Section 27-1-12 et seq. NMSA 1…

Permanent.

January 1, 2014, unless a later date is cited at the end of a section.

The objective of this rule is to provide specific instructions when determining eligibility for the medicaid program and other health care programs. Generally, applicable eligibility rules are detailed in the medical assistance division (MAD) eligibility policy manual 8.200 NMAC,…

"Refugee" is an immigrant, who because of persecution or fear of persecution on account of race, religion or political opinion, fled from their home country and cannot return because of fear of persecution because of race, religion or political opinion.

We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

A. A medicaid eligible refugee recipient must meet the following non-financial eligibility requirements: (1) is ineligible for full medicaid coverage; (2) is not a full-time student in an institution of higher education, except where enrollment is part of an individual employabil…

New Mexico Health Care Authority (HCA).

Resources are not an eligibility factor.

Refer to 8.249.500.9 NMAC.

Income consists of money received by a person whose income is considered available to the budget group as described in this chapter. A. Income from a 30 day-period is used to determine eligibility. The 30-day period may be any consecutive 30-day period that is prior to the date o…

A. Determination of eligibility for the assistance unit is made by considering income that is available to the assistance unit and budget group. The amount of countable income is determined using allowable income exemptions, deductions and disregards. The income of a budget group…

A. Individuals included in the budget group may have a legal right to income but not access to it; such income is not counted as available income: (1) old age, survivors, and disability insurance (OASDI); (2) railroad retirement benefits (RRB); (3) veterans administration (VA) be…

Includes all wages, salaries, tips, and other employee pay from employment and net earnings from self-employment.

A. Self employment: Certain self-employment deductions allowed by the federal internal revenue service (IRS) are allowed in the net and gross income test. (1) Self-employment income will be annualized for income projection purposes. If the IRS Form 1040 has been filed, the previo…

Unearned income includes benefits, pensions, etc. A. The following types of unearned income are counted:(1) old age, survivors, and disability insurance (OASDI); (2) railroad retirement benefits (RRB); (3) veterans administration (VA) benefits: (a) income available to veterans an…

The rule applies to the general public.

The New Mexico medicaid program and other health care programs are administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See Section 27-1-12 et seq. NMSA 1…

Permanent.

January 1, 2014, unless a later date is cited at the end of a section.

The objective of this rule is to provide specific instructions when determining eligibility for the medicaid program and other health care programs. Generally, applicable eligibility rules are detailed in the medical assistance division (MAD) eligibility policy manual, specifical…

[RESERVED]

To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.

A. Financial need: The budget group's eligibility is based on financial need. See Section 1931 of the Social Security Act, the rules in this chapter and in 8.200.520 NMAC. B. Financial eligibility: Pursuant to Section 1931 of the Social Security Act, enacted by Personal Responsib…

New Mexico Health Care Authority (HCA).

Application for refugee medical assistance is made on the assistance application form. The application is acted on and notice of the action sent to the applicant within 45 days of the date of application.

A. Approval or denial of application: After the eligibility determination is made, the income support division caseworker sends notice to the applicant or applicant group. The denial notice contains information on the reason for the denial and explanation of appeal rights to the …

No periodic review is required, since coverage is limited to an eligibility period from the date of entry into the United States.

Retroactive medicaid coverage is provided in accordance with 8.200.400.14 NMAC.

Cases are closed when refugee medical assistance recipients no longer meet eligibility standards or after the eligibility period expires, whichever comes first.